TheDC Interview: Drug Czar Gil Kerlikowske on Mexico, pill mills, and the medical marijuana stalemate

Submitted by Norm Roulet on Sun, 02/13/2011 - 02:50.

All Americans should have a great interest in the actions of our Drug Czar, Gil Kerlikowske, as he impacts all our lives and $ billions of tax dollars. Always AT WAR WITH AMERICANS and in denial of healthcare (and our national debt) - disrespectful of the medical profession - killer of innocent Mexicans - his job has become more complex and urgent, in the last few years, as his failed war on drugs has continued taking turns for the worst... turning Mexican pot fields into killing-fields and suburban America into a pharmaceutically-poisoned waster-land - as his entire credibility in battling God-given marijuana is undermined by effective medical legalization efforts America-wide, and by his own Federal government... as far more significant crises have surfaced with pharmaceutical drugs that fail to provide healthcare, but do kill - which marijuana does not.

As America is bankrupt, and going down the toilet - along with all Gil Kerlikowske's pills and poison piss, poisoning our natural resources, wildlife and all humanity - the following thorough interview by The Daily Caller of our Drug Czar is required reading:

TheDC Interview: Drug Czar Gil Kerlikowske on Mexico, pill mills, and the medical marijuana stalemate

 
Mike Riggs is a staff writer at The Daily Caller. He has written and reported for Reason magazine and reason.com, GQ, the Awl, Decibel, Culture 11, the Philadelphia Bulletin, and the Washington City Paper, where he served as an arts and entertainment editor.
Gil Kerlikowske, Director of National Drug Control Policy, speaks during a press conference in Washington, DC, on May 12, 2010. Kerlikowske spoke on the Obama adminstration's drug control strategy. AFP PHOTO/Jewel Samad

Gil Kerlikowske looks exhausted. The Seattle police chief-turned-drug czar is facing a litany of issues du jour (bath salts, pill mills) as well as more long-term challenges, like Mexico’s cartels and a tenacious and growing alliance of drug-law reformers in the U.S. Before the month is over, Kerlikowske will tour Appalachia to meet with state and city leaders about the prescription pill crisis and make his eighth trip to the Mexico border. The Daily Caller caught up with him this week to discuss drug policy. Our interview follows.

THE DAILY CALLER: I want to start with something you’ve said in past interviews, which is that you don’t like the term “drug war.” You don’t like this term because it’s hard to define who the enemy is, and sometimes the enemy is American citizens.

Do you think that what’s happening on the ground — the use of no-knock raids and SWAT teams, people’s pets being shot, their homes being trashed — do those things complicate your efforts at redefining this as something other than a war?

KERLIKOWSKE: Well, it might, but I guess the difference that I see is the level of violence in the United States and the training that law enforcement goes through. Whether they’re dealing with an armed robbery or taking down a drug house, and given the number of officers who are shot and killed anymore, and the type of weaponry that is out on the streets, I don’t think there’s any way to approach it from a safety standpoint that wouldn’t involve this.

So while it would be wonderful to be like the London Metropolitan Police and walk around unarmed, frankly, the United States was founded in violence, and we’re a pretty violent country. You can’t change that.

I do think we can change the angst that is caused by calling it a war on drugs, especially since to the minority community it feels like a war on them. Community policing and those kinds of things can help change it.

TheDC: You don’t want to take resources away from enforcement, but you do want to see more money going towards rehabilitation. What do you see as some good rehabilitation strategies? Tehran has a clean-needle exchange program, but D.C. doesn’t. So what should we have and where should the money come from?

KERLIKOWSKE: It’s not always about the money. Sometimes you have to look at how do you leverage some of the resources, especially in the prevention programs, which are labor intensive. Look at Drug Free Communities. It’s a small grant; $125,000. But if you look at the amount of work that these 720 or 730 communities do for a very small amount of money — it’s a lot of volunteers and a lot of enlisting other resources.

When it comes to treatment — and you wouldn’t want to call this a peace dividend — but treatment is half the cost of incarceration. When the president asked me not long after I took this job, “Gil do you really think we can make some progress on the drug front?” I naively said, “I think we can.”

And in a way, the wind’s at our backs in this recession. You have places like Texas talking about treatment instead of incarceration for low-level drug offenses. You have John Kasich newly elected governor of Ohio talking about how to keep low level drug offenders out of the prison and the criminal justice system.

There may be some benefit to dealing with the problem that way than with the high cost of incarceration.

NEXT: A new approach to Mexico's drug problem

TheDC: What obstacles are you running into now that you didn’t anticipate when you agreed to take this job?

KERLIKOWSKE: Mexico has received a huge amount of my time and attention, and I don’t think I quite expected that. I’ve had four trips to Mexico, seven trips to the border, and I’m going to make my eighth trip next week. That consumes a lot of your time and effort.

TheDC: Pres. Obama said in a recent YouTube interview that his administration is focusing more on Mexico. Can you tell me more about what needs to be done in Mexico?

KERLIKOWSKE: In the Bush administration the Mérida Initiative focused — and rightly so — on reducing violence as much as they could and improving law enforcement and the technology and equipment.

This administration is moving beyond that initiative and saying it can’t be just about law enforcement and the quality of intelligence. It also has to be about building civil society, building trust and cooperation of Mexican citizens towards law enforcement and the criminal justice system.

And as Arturo Sarukhan, the ambassador to the U.S. will tell you, “Don’t think of Mexico as just a transit country. We’re also a consumer country.” They’re dealing with their own drug problems, also. And so we helped Mexico open up their first drug court in Monterrey. I think they’re going to open their second drug court in Tijuana. So I think that trying to use the same balanced approach the next couple of years will make sense.

TheDC: American police officers can go into our country’s most dangerous neighborhoods with the expectation that unless something extreme happens, they’ll be safe. That’s not the case in Mexico. How do you introduce the civility that is at the root of civil society?

KERLIKOWSKE: Clearly President Calderon and his administration recognize that. He has been using the military to do essentially policing. Everyone recognizes, particularly the Mexicans, would be to move toward police forces rather than the military to do policing. That’s critical. But right now, the level of violence — Juarez always comes to mind — is one that the military has been taking on.

TheDC: The U.S. has invested a lot of money in training the military and the police to fight the cartels. Looking back, do you think we should’ve invested in civil society reforms sooner? The violence doesn’t seem to be ebbing.

KERLIKOWSKE: I think — and the research bears this out — that when you put a lot of pressure on these gangs, when you interrupt their system, a natural outcome is violence. The shelf life of a cartel leader is a lot shorter. These organized crime gangs are now fighting for turf and for control. But it’s very hard for me to go back and say, “You should’ve been concentrating on this first,” because I think we’re trying to deal with the violence and with getting the SSP and others coordinated and working properly. And they’ve made a lot of progress.

TheDC: How’s that drug court in Monterrey doing?

KERLIKOWSKE: There are about 30 people who have gone through it. And remember, this is in the context of Mexico changing its entire legal system from the oral advocacy system that they’ve had. But the last I’ve heard is that they had a good start.

NEXT: The marijuana issue isn't going away: Will the government change its approach?

TheDC: I want to switch gears. You’ve said before that you don’t see medical benefits to smoked marijuana and also that the jury is still out on medical marijuana. What sort of scientific consensus does the ONDCP require? How many studies have to come out arguing for medical benefits? What do you need to see?

KERLIKOWSKE: One thing that’s helpful to understand is that the Institute of Medicine has said that smoked marijuana — inhaling smoke — is not something that we would use in medicine.

TheDC: Because of carcinogens?

KERLIKOWSKE: Exactly. And you know there are over 100 groups doing marijuana research, and they’re getting their marijuana from the University of Mississippi. There are several things in clinical trials right now. So we’ll just have to wait for those.

But it isn’t like researchers and pharmaceutical companies are beating down the door to say that their profit margins are going to be around marijuana.

TheDC: Would that make more of a difference, if pharma were asking for reform? As opposed to advocacy groups?

KERLIKOWSKE: You know, this started in California in ‘96 and has been off the radar until the last few years. When I became police chief in Seattle in 2000, it had passed in 1999 in an initiative, and until the last year that I was there, medical marijuana wasn’t even a subject of any discussion about anything.

But in the last two or three years, it has just exploded. What has been made extremely clear is that the legalization community has made it patently clear that marijuana drug is a gateway for legalization. I think they’ve made that intention clear.

TheDC: Do you think they are complicating the debate? Do you think that’s hurting them?

KERLIKOWSKE: I think it hides the debate. If you call it medicine, if you call the people using it patients and the people distributing it caregivers, it completely masks the debate. I think that sends a bad message to young people, and I’ve heard that from high-school students we’ve done focus groups with.

I think it came back to hurt them in the legalization push in California, where dispensaries are more ubiquitous than Starbucks. They’re on every corner. They’re outside waving signs. I think people got pretty tired of having it jammed down their throats. And it isn’t a constitutional right, the last time I checked.

TheDC: While Prop 19 failed in California, Arizona successfully passed a medical marijuana initiative in November, and more state organizations plan to do so in 2012. Do you think your office — and the entire federal government — is at a stalemate with this issue? And at what point do you have to say, What do we do next?

KERLIKOWSKE: The states that have contemplated it — their mantra is, “We don’t want to be like California.” They don’t want the friction, and they see cities passing moratoria against additional dispensaries, plus those that are operating outside of whatever state law happens to be. There are indictments by the United States government pretty regularly. Arrests are made, cases are made in Nevada.

I think there was a belief that when the attorney general issued those guidelines

TheDC: — deprioritizing raids on medical marijuana

KERLIKOWSKE: Well, essentially saying, We have limited resources, like every police department in the country, and we’re going to use those limited resources in effective ways. So, you’re seeing cases being made against dispensaries that are not operating within state law.

TheDC: How concerned are you by the supposed rise in legal alternatives to illegal drugs? Are Spice, K2, bath salts and the like as big a threat as the media make them out to be?

NEXT: Trends in drug use: What's real? What's a media scare?

KERLIKOWSKE: We’ve heard a lot over the last two months on bath salts. And over the last year, year and a a half, we’ve heard a lot about synthetic marijuanas.

But if you look back through history, these things have bubbled up and down. We still have a significant problem with inhalants. Even keyboard cleaner. Our biggest problem, though, is prescription drugs.

TheDC: I read recently about an increase in pharmacy robberies.

KERLIKOWSKE: Yeah, the New York Times piece.

TheDC: Is that a fake trend or a real trend?

KERLIKOWSKE: When I talk to physicians, when I talk to pharmacists, that quest for those opioid painkillers is significant. Doctor shopping, pharmacy robberies, pill mills, on and on. We’re past the days of the doctor making a house call carrying a bag full of pills, but you can go back to those days, 30 and 40 years ago, and doctors back then were robbed and assaulted for the drugs in their bags.

It became far less of a problem over the last several decades, but now it’s coming back strong because of the prescription drugs. Things like Dilaudid and Percocet have always been subject to abuse, but OxyContin is the one that’s gotten so much attention.

Next week I’m making a swing through Appalachia, where the problem is most significant right now. Then-Gov. Manchin, now Sen. Manchin said he can’t go anywhere without people bringing up prescription drug problems.

TheDC: Why is this happening? What’s causing this? Parents like to complain that kids are all doped up now a-days. Is this an increased cultural reliance on prescription drugs?

KERLIKOWSKE: Well, we’re a country that has direct-to-consumer marketing, but I don’t have any evidence to support that’s the reason this is happening. A couple of reasons, there isn’t a lot of training, and often times there’s no training, about prescription drugs for physicians. There’s no training for recognizing dependence and addiction; it’s very hard to diagnose pain, so pain management is difficult to.

TheDC: There was a case in Florida some years back in which a man named Richard Paey was convicted of several drug-related crimes because he was found in possession of too many prescription painkillers. But as he argued during his trial, he actually needed it. He wasn’t over-medicating, he was in serious pain.

KERLIKOWSKE: You’re right. It’s difficult. If you go in with a broken arm, the doctor can look at an X-Ray and see the problem. But if you go in and say, “I have back pain, and I’m really hurting.” Whew. These can be life-giving drugs for people who are suffering. You don’t want to [over]react and not be able to provide them.

It’s an issue of educating the medical community. The pill mills in Broward County, Fla., is kind of considered the epicenter of abuse. The advertising is unbelievable. People say, “Are we becoming a pill nation?” They turn on the TV, and there’s something out there to fix almost every problem we have. That’s not anything that’s taking my time. I’m thinking more about actual pill mills.

The penny savers are just page after page of advertisements: ”Get your first prescription here.”

TheDC: Is that code?

KERLIKOWSKE: Absolutely. Absolutely.

TheDC: These are pharmacies?

KERLIKOWSKE: No, these are MDs! People who are paid a lot of money to write a lot of prescriptions for pain. And it’s not like buying heroin off the street, where you don’t know the purity. You know what the dosage is, you know it’s been manufactured, the purity levels, the cleanliness. You’re not buying it out of the back of a gas station in a piece of tin foil.

But I think the more recognition the public health system gets, and physicians, the better off we’ll be. So far it’s been pretty much under the radar screen.