Alcoholism and Drug Abuse

W

hen I was a senior medical student at Emory University the chairman of the Psychiatry Department, Dr Bernard Holland, a mentor and advisor, who had taken a special interest in me, asked if I would like to do a one year fellowship in his department right after graduation instead of leaving for my internship. He had received a grant from the city of Atlanta to study the roughly 50,000 arrests a year for public drunkenness and to make recommendations as to how they could be better handled.. I, along with two psychiatric residents, was to conduct the study.

It turned out that the bulk of the 50,000 arrests could be attributed to around 6,000 individuals, roughly half white and half African-American and almost entirely men. I spent countless hours in the court room and the Atlanta city jail interviewing arrestees almost all of whom were chronic alcoholics. The bulk of them, if not first offenders, were sentenced to 30 days at the city’s prison farm where they were deprived of alcohol and fed a wholesome diet of the produce they themselves helped to grow. However, at the end of their sentence many had nowhere to go, no home, no job, and usually no family that wanted anything to do with them. They invariably went to the nearest bar got thoroughly drunk and where back in jail that night. I realized that most of these men were drinking only between prison sentences which might be as little as twelve times a year. Their problem had become less alcohol than the inability to break the revolving-door cycle they were in.

I identified a handful of men with whom I had built a relationship and who seemed sincerely interested in turning their lives around. I convinced them to take the drug Antabuse which if combined with alcohol caused violent vomiting thereby deterring any drinking. The pill had to be taken every day and, to be sure they were consumed, they had to be swallowed in front of me. This kept them sober. I then rented a building near the city jail which we did up as a hostel. Several of the alcoholics had been in the building trades and gave their labor to make it an attractive residence. I arranged to have a job counselor from the Georgia Department of Labor assigned to the project and hired a social worker. Within weeks I had a group of men who were sober, holding down a job, and living in relatively comfortable surroundings. Of course a few disappeared, stopped taking the Antabuse, and went back to drinking. But there were many stunning successes. One man considered to be among the most hopeless and recidivist cases proved the most responsive. He had been a successful meat cutter and had been widely respected in his trade. Within six months he went from being a hopeless drunken bum on the streets to a successful employee with a good steady income, a new car, and reunited with his wife and children, a nice home to live in.


News of the success with this initial group spread through the community of habitual drunks in the city. Soon we were inundated by requests to be on the program. Working with the judges in the municipal court, arrested drunks were screened and offered either a sentence of 30 days at the city prison farm or 30 days staying in the community provided they came in every morning and took an Antabuse pill. During that month we worked with them to get employment and accommodation. Perhaps 20 to 30 per cent of the white arrestees were able to turn their lives around. With African-Americans, most of whom suffered lives of quiet desperation, even when they were not drinking, the success rate was lower. It was a time when Atlanta remained segregated. African-Americans were treated contemptuously in the court system and given few if any breaks to overcome their problems. There was not a single practicing African-American psychiatrist in the state of Georgia and no out-patient psychiatric facility for African-Americans.

The year after the study the number of arrests dropped by 50 per cent saving the city hundreds of thousands of dollars. But after I left, the program began to slowly erode. It required intensive, energetic, dedicated commitment which I had at that stage in my career. In the absence of someone in that role the forces of moral judgment, vengeance, and punitive retribution towards these sick people returned. I published an article on the program in the scientific literature that spurred some other cities to try the same kind of approach. But few wanted to spend the money and had trouble finding physicians who saw working in such an environment as any benefit to their careers.

In July 1963 I moved on to begin my internship at King County Hospital in Seattle (now Harborview Hospital). As the charity hospital for the city a high percentage of the patients who ended up there had a drinking problem. My year on the streets and in the city jail in Atlanta gave me a leg up over my fellow interns, largely from Harvard, Yale or Columbia, in treating these people.
 

I was then out of the substance abuse business for three years while I served my time in the US Army. In July 1967 I went to Stanford University Medical Center to finish my residency in psychiatry and to do a masters degree in anthropology. Early in the summer of 1968 one of the faculty members opened a seminar by announcing to our small group of residents, that a doctor at the University of California San Francisco, David Smith, had opened a free medical clinic in the Haight-Ashbury district of the city and was seeking volunteer physicians to help staff it. It was the so-called “Summer of Love” and thousands of young people were pouring into the city. Anti-war, quietly rebellious through their life style, and heavily into drugs the hippie army included a wide range from the most ardent idealists to the psychologically alienated and mentally disturbed. I signed up to work at the clinic one night and one weekend day a week. Apart from the usual minor health problems ranging from cut feet to the complications of pregnancy the bulk of the complaints were drug related. Sometimes it was bronchitis from chronic marijuana use, or the adverse effects of a bad trip on LSD or occasionally a heroin overdose. Over the months I became expert in treating these conditions.


At the end of my residency in July 1969 I returned to Atlanta on the faculty of the psychiatry department at Emory Medical School. Part of my job involved running a federally funded mental health center on the south side of the city. It served a population of 45,000 universally poor and majority African-American residents. Among these people was a small hardcore population of heroin addicts that was rapidly expanding. I decided to set up a treatment program for them, but in order to use the heroin substitute, methadone, I needed to apply for a special license from the Food and Drug Administration (FDA). With the license in hand I began treating a group of around 30 addicts on methadone maintenance. At the same time Atlanta was developing its own exclusively white hippy community with the same patterns of drug use I had seen in San Francisco. I donated my time to provide free care for those who got into difficulty and also began writing an anonymous column, under the pen-name “Dr Aquarius” for the alternative newspaper The Great Speckled Bird. By word of mouth and several newspapers articles I became publicly recognized as the “drug expert” in the city and for that matter in the state. In my own mind I was more “the one eyed man in the land of the blind” because while my experience at the Haight-Ashbury Free Medical Clinic made me more qualified than my fellow physicians in Georgia I did not really consider myself a true expert in addiction medicine.

Over the July 4th weekend 1970 a gigantic “rock festival” was held in the little town of Byron, Georgia. Modeled on the Woodstock Festival and with the support of Capricorn Records in nearby Macon it attracted more than 300,000 people and many of the top performers of the day. For four days this gathering of humanity constituted the fifth largest city in the state. In preparation for the event I and some other like-minded progressive physicians planned a program to provide medical care for the festival-goers. With a series of small tented first aid centers we operated around the clock from Friday morning to Monday morning. We saw and treated more than 7,000 people, delivering three babies, setting broken bones, and taking care of routine medical problems. The temperature was in the high nineties all three days creating special problems. The taking of drugs was ubiquitous. It involved the experienced counter-culture hippy community, but also a large number of young rural Georgians with little or no drug taking experience. Because of the heat, in addition to drug consumption, beer was consumed in prodigious quantities. People who normally knew better lay in an oblivious, stuporous state in the searing heat of the sun becoming seriously dehydrated. At times we had several dozen people on IV drips to overcome their heat prostration. The largest problem was the adverse reactions to drug taking by na´ve, first time users, many of them red-neck farm boys. Happily no one died. With almost no sleep for three days I returned to Atlanta as tired as I had ever been in my life.


By 1970, drug abuse hysteria was sweeping the country. GIs in Viet Nam were getting addicted to heroin and studies of inner city crime showed the perpetrators were overwhelmingly heroin addicts. Richard Nixon against his natural inclinations and that of many of his fellow Republicans decided to opt for an intensive focus on treatment along with the traditional hard line law enforcement efforts. Much of the credit goes to ‘Bud’ Egil Krogh a member of his domestic policy staff dealing with law enforcement who convinced him that treating addicts could result in a dramatic drop in crime rates for which he could claim credit. (Krogh would later achieve notoriety as one of the “White House Plumbers.”) Nixon created the Special Action Office for Drug Abuse Prevention (SAODAP) directed by Dr Jerome Jaffe. Federal money was made available to the states to set up drug treatment programs and governors began giving the problem a high priority. Governor Jimmy Carter was one of them. He needed to appoint someone to be the head of a statewide treatment program. As it was to focus primarily on heroin addicts that person would need to have the FDA license to use methadone. Carter asked me if I would take the job, initially to be on a one year leave of absence from the Emory faculty. My transition from medical school academic to gubernatorial staff member is described elsewhere (click on Jimmy Carter.)

I went to work in the governor’s office on June 27th and the deadline for the submission of the grant proposal for federal money was June 30th. In an around-the-clock effort I met the deadline and secured the funds that allowed me to launch a statewide initiative. A college friend from Emory, Dr Robert DuPont, had set up a heroin addiction treatment program for the District of Columbia, the Narcotic Treatment Administration (NTA). It was a large scale methadone operation for heroin addicts that drew heavily on referrals from the District courts but was also available to any addict voluntarily seeking treatment. I accompanied Governor Carter on a trip to Washington DC to meet with Pentagon officials and to testify before a Senate committee about the drug problems in Georgia. I convinced him to spend the afternoon visiting the NTA. On the flight back to Atlanta he asked if I could set up something similar in Georgia.

The next six months were perhaps the most hectic of my life. I set up neighborhood clinics across Atlanta with a large downtown intake center in order to make treatment readily available and to get as many addicts off heroin as quickly as possible. I also opened treatment centers in the other major cities in State. Most were out-patient clinics but I started one residential facility for teenage addicts. Especially outside Atlanta I developed counseling centers that were aimed primarily at drug users who were not heroin addicts. By the end of the year we had more than 7,000 people in treatment. I also had to sell the program to the public and the state legislature. In the first year I gave 186 speeches around the state. The drug issue had high visibility because of what Nixon had done in Washington and in most of the states. We had constant media attention. It was also a high visibility accomplishment that Governor wanted to get maximum credit for. When he hosted the Southern Governors’ Conference he proudly brought a group of them to the intake center for a tour and a briefing from me.

Simultaneous with my efforts in Georgia other large-scale heroin treatment programs were being started in other major cities including, New York, Detroit, Chicago, San Francisco, Boston, and Bob DuPont’s well-established program in DC. Faced with common problems and in a pioneering role in largely uncharted territory a high level of comraderie developed between the directors of these programs. We decided to meet for a weekend every three months in one of our cities so that we could spend several hours sitting together exchanging experiences, sharing new ideas and generally picking each other’s brains. I remember it with great pleasure as an experience in which we were all working very hard in our respective locations, constantly in the public eye, with heavy responsibility on our shoulders, all willing to share and help others and all eager to learn what we could that might make our jobs a little bit easier. I particularly admired Dr Robert Newman director of the New York City program that had more than 20,000 patients. He was an excellent administrator, highly experienced and a constant source of new and original ideas.


During this period of time I was also working with a colleague at the Yerkes Primate Center of Emory University on developing an animal model for alcohol dependency. Delirium tremens, the tremulous and convulsive disorder resulting from the sudden cessation of alcohol use, was a clear clinical entity in humans, but there was some question as to whether it could be duplicated in animals. The purpose for doing so was in order to test various experimental treatments. Working with young chimpanzees over a six month period of time we were able to replicate delirium tremens in them. We published the work in Science generating considerable attention in the addiction field.

One day I received a call to say that Egil “Bud” Krogh from the domestic policy staff of the White House wanted to visit me and to tour my program. He began his day in Atlanta with a private meeting with Governor Carter. Only in the last year did he explain to me that the decision had already been made in Washington to offer me the job as the assistant director of SAODAP and his trip to Atlanta was really just a courtesy on behalf of President Nixon to let Carter know they were trying to hire me away. A week later when the official job offer came it put me in a difficult position. I was already deeply enmeshed in the secret plans for Carter to run for president in 1976 and to go to work for a Republican administration might seem highly disloyal not to mention putting me out of the action with the embryonic campaign. On the other hand Carter was a one term governor and it was unlikely that his successor would keep me on. If the Carter campaign was not successful I would be in trouble. I decided to discuss it with Carter. He encouraged me to take the job with the agreement that I would stay in a central role in the campaign returning regularly to Atlanta for the key strategy meetings. And when he finally announced his candidacy publicly (planned for late in 1974) I would resign from SAODAP and set up the Carter campaign office in Washington.

I moved to Washington in November 1972 shortly after Nixon was re-elected. In my new job as Assistant Director of SAODAP I was primarily responsible for overseeing the treatment programs around the country. Within twenty-four hours of my arrival I was on the road traveling around the US holding hearings on the newly promulgated regulations on the use of methadone for the treatment of heroin addiction. I encountered intense questioning and criticism. I had not been involved in the writing of the regulations, had barely read them before I left on the tour but was suddenly the point person selling these complex stipulations for the administration. It was a real baptism by fire. Over time I became more knowledgeable and confident with a steadily increasing grasp of how the federal government worked and how to get things accomplished. I learned to deal with policy makers at the highest level overcoming a natural timidity and shyness. I also began traveling overseas, mainly to Europe and Asia representing the US government either at conferences or for bilateral discussions with the leaders of other government about their drug control policies.


My main job was to work in collaboration with the National Institute on Alcoholism and Drug Abuse and the state drug abuse authorities to expand the treatment capacity for heroin towards the SAODAP goal of being able to say “there should be no addict in the country who can say I want treatment but there is no place I can get it.” I had at my disposal a budget of several hundred million dollars which enabled me to get people’s attention and to get them to carry out the programs we wanted.. It had become apparent to me that in addition to heroin addicts there was a significant group of young people taking a variety of mostly prescription drugs. Some took just barbiturates others took simultaneous a variety of other substances. There was no specifically targeted treatment model for these people. I put out a request for proposals inviting treatment programs around the country to come up with innovative experimental models to treat these people. We had many submissions and an independent panel of experts to chose the six initiatives we would fund. I was happy when two of the winners turned out to be King County Hospital (now Harbor View) in Seattle where I had interned and David Smith’s Haight-Ashbury Free Medical Clinic in San Francisco where I had worked as a volunteer.

 

 





 

 




In an era very different from today SAODAP had been set up to attract the best and brightest professionals in the addiction field regardless of their political persuasion. The director, Dr Jerry Jaffe, was one of the brightest and most inspiring people with whom I have worked. He never talked much about his political views but I think at heart he was Democrat. Jaffe had a clear vision of the way he felt heroin abuse could effectively be controlled in the country. I learned from him to think strategically and on a very big national or global scale. His deputy, Paul Perito, was a partisan Democrat who had previously been a legislative assistant to a Democratic member of Congress and had been instrumental in drafting the legislation that created SAODAP. Following Nixon inaugural celebrations for his second term Perito resigned to go into private law practise. As the senior Assistant Director I would have been the natural choice to succeed him. However, the bipartisanship of the Nixon administration did not extend that far. The Deputy’s position required Senate confirmation and with the Watergate battle beginning they did not want to nominate again someone as overtly Democratic as I. I was very happy with the decision because although I could tell no one in Washington the last thing I needed with my Carter colleagues was to become a Nixon Presidetial appointee approved by the Senate. For the rest of my time at SAODAP the Deputy position remained unfilled which was ideal for me. I functioned in that role without the burden of the Nixon imprimatur. As the Watergate scandal grew drug abuse shrank to a low level on the White House agenda. Several of SAODAP’s early advocates such as Bud Krogh,
and John Erlichman would be indicted and later go to jail. Jerry Jaffe eventually resigned and his place was taken by my friend Bob DuPont.


Throughout my time at SAODAP I had flown, more or less secretly, back to Atlanta every other weekend to work with Carter and others on his incipient Presidential campaign. In August of 1974 I resigned from SAODAP to begin publicly organizing the Carter campaign office in Washington in preparation for the formal announcement of his candidacy on December 12th of that year. I also became a fellow at the Drug Abuse Council, a non-profit, foundation supported, think tank focusing on drug abuse issues. Its president was a medical school classmate of mine Dr Tom Bryant who had also acquired a law degree. He had been the director of the Office of Health Affairs in Lyndon Johnson’s Office of Economic Opportunity (“War of Poverty”). I wrote and published several papers on different aspects of the drug problem and simultaneously devoted an increasing amount of my time to the Carter initiative. Because of my international activities while at SAODAP I received several contracts from the State Department and other organizations to attend international meetings on drug abuse and to serve as consultant visiting mainly countries in Asia. It began a long series of visits to Burma and to Iraq where I had meetings with several of the top government officials arranged for me by Sen. William Fullbright. I also had a small grant from the state of Wyoming to assess the extent of addiction there. I used my several trips to the state to recruit a small following for a Carter presidency.

During the Ford administration the legislation creating SAODAP expired. Congress quickly passed a new bill creating the Office of Drug Abuse Policy (ODAP). Members of Congress wanted to maintain some momentum in the drug abuse area, but many also liked the idea of having a significant policy making entity in the Office of the President with a senate confirmed director that they could call to testify before the committees in both houses. Normally anyone working directly for the president could avoid testifying before Congress by claiming executive privilege. In order to get bipartisan support for SAODAP Nixon had made an extraordinary concession in allowing a component of his executive office to be subject to such direct oversight by the Congress. SAODAP, although it had sweeping authority, had exercised it only for the demand (or treatment) side. The new legislation creating ODAP gave it authority over all aspects of the drug abuse problem, law enforcement, foreign policy, the military and treatment. Ford signed the legislation but never implemented it. Why not is uncertain . Whether, as a former congressional leader, he understood the danger of allowing congress to intrude into the executive power of the president, or whether he was just too pre-occupied with other priorities such as the fall-out from the Nixon pardon or his own campaign to run for re-election is unclear.


When Carter was elected I found myself in a difficult quandary. I was appointed as a special assistant to the president and as one of the eight staff people in the White House reporting directly to the President. My first major undertaking was to put together a presidential commission on mental health and mental illness which was going to be Rosalynn Carter’s main initiative. Also, beginning during the transition, I had prepared for the president a 100-page document on SAODAP, ODAP and the question of drug abuse policy in the new administration. I did not particularly want to be the director of ODAP as I wanted a mandate much larger than just the drug issue. On the other hand my role was poorly circumscribed and I knew I would have to scramble all the time to justify my presence in the White House just as a special assistant. As director of ODAP I would have a clear legislated mandate and a position that was Senate-confirmed. The ODAP role, unlike SAODAP, included authority over not just the “demand side” (treatment) but also over law enforcement and foreign policy as well. At SAODAP it had always been frustrating, despite the significant power the office wielded, to have people at the Drug Enforcement Administration or the State Department pursuing their own policies which were often at odds with what I was trying to accomplish. As head of ODAP I would have policy control over the entire drug abuse issue throughout the federal government. In addition I was arrogant enough to believe that there was no one else who was better prepared or could do the job better than I. If I did not take the job I would have to come up with the name of someone else to do it. I knew that whoever that might be I would find it very frustrating not to have control over this area, particularly if I was losing out in the power struggles in the White House.

Carter was happy to nominate me for the job and also agreed to my having a dual role with an additional title as special assistant for health issues. This allowed me to stay in a vital position in the administration’s effort to develop national health insurance. This involved especially working with Sen. Ted Kennedy and other key members of Congress. Also over time I became the point person in the White House dealing with United Nations humanitarian issues such as international health, world hunger, and emergency relief. I put together a presidential commission on Hunger and Malnutrition as well as a Commission on the International Year of the Child. I also directed a study of all international health programs in the US government that resulted in the publication of a definitive report. I was also the point person for the White House Fellows program serving on the commission that picked the fellows each year. The only problem with this dual role was that I was stretched extremely thinly and was always buried in work.

My nomination to be director of ODAP was well received in the Senate with the exception of Sen Orin Hatch of Utah. He was a very conservative and xenophobic Mormon. I had the sense that he opposed me more than anything because I had not been born in the US. I was nevertheless confirmed by 98 votes to one.

I came into the job with a pretty clear idea of what I wanted to do. I approached the drug abuse issue as a public health problem in which the primary objective was to reduce the harm that the use of drugs caused people. I made a point whenever I spoke in public about the adverse health effects of drugs of always saying “drugs including alcohol and tobacco...” My goal, as I saw it, was to bring the number of drug related deaths, from both legal and illegal sources, as low as possible and to minimize the overall harm that drug use inflicted on society and the individual. I believed that a long prison term could do far more to destroy the life of a drug user than the drug he or she was convicted of using. I wanted to continue the policy established by Jerry Jaffe that sought to guarantee access to treatment for every addict who wanted it. I was also committed to restricting the availability of drugs at the source through international collaboration. I also believed that law enforcement was critical but primarily when it focused on major traffickers rather than street level dealers. I also thought that pharmaceutical companies had a major responsibility in curtailing the abuse of their products.


Peter Benzinger had been appointed head of the Drug Enforcement Administration by President Ford. He was someone I knew well, respected and liked.. I re-appointed him to the position. Today keeping on someone from the other party would be almost unthinkable. My friend Bob DuPont was by then the director of the National Institute for Drug Abuse. I arranged for my friend Mathea Falco, a lawyer and former congressional staffer with wide experience in drug abuse to become the Assistant Secretary of State for Narcotic Affairs at the State Department. Robert Chasen was the Commissioner of Customs. I appointed as my deputy Lee Dogoloff who had been Bob DuPont’s deputy at the DC Narcotic Treatment Administration. We met, as a team referred to as “the principals group,” very Monday for an hour to compare notes and plan the national strategy. (The Commandant of the Coast Guard would also attend periodically).

I spent a great deal of my time testifying before Congress. Drug abuse was a high profile issue and members saw it as an easy way to grab headlines and raise their profile. Congressman Lester Wolfe was chairman of both the House Select Committee on Narcotics and of the Asia sub-committee of the House Foreign Relations Committee. His Republican counter-part, Cong. Ben Gilman, someone I greatly liked, shared his enthusiasm for travel and interest in the narcotics issue. They made regular trips to South East Asia where on one occasion Cong. Wolfe met with the drug lord Khun Sa. He negotiated a deal whereby, in return for $35 million from the US government Khun Sa would undertake to stop all heroin coming out of Burma. It was an absurd proposition as it was something Khun Sa could not hope to deliver on not to mention that he was leading an insurgent group pitted against the government of Burma with which the US had diplomatic relations and a cordial dialogue at that time. Before the Congress and in the media Cong. Wolfe played the issue for all it was worth dragging before countless hearings and berating me for not accepting this “wonderful offer.” It did, however, establish the basis upon which I was able to go, several years later, to the Shan State and meet with Khun Sa myself. (Report on the visit to Shan State.)

During my time as Director of ODAP I achieved a number of success of which I felt proud.


• Under my tenure we brought the number of people dying in the US from heroin overdoses down to its lowest level in 30 years (around 800 per year).

• Working with the pharmaceutical industry I negotiated a voluntary code to restrict the use of barbiturates to hospital settings. This included a special exception for rare forms of epilepsy that could only be controlled by these drugs. The result was dramatic decline in the availability of barbiturates on the street and a significant drop in overdose deaths attributable to them. Although the industry had no particular problem with the arrangement the Reagan administration cancelled it on the grounds that it was an unwarranted restriction on private industry. The result was more people died.

• I negotiated effective drug control policies with the governments of the source countries Thailand, Burma, Mexico, and Columbia providing them with financial assistance and aircraft including helicopters to Burma and Mexico. I also devoted considerable time to coordinating US drug policy with my counterparts in European nations.

• Deciding that the best way to track major dealers was through their money rather than chasing the drugs they moved I had the Justice and Treasury Departments institute a process whereby all banks had to file a form with the Federal government whenever they received a cash deposit of $10,000 or more.


• I down played the issue of marijuana from which essentially no one died and which posed, compared to other illicit drugs not to mention alcohol and cigarettes, a very modest public health threat. Because of the wide difference in attitudes around the country (Alaska wanted to legalize, the Southern States to maintain harsh penalties) I established the policy that the individual states should set their own penalty levels for possession and sale.

• I expanded nationwide the availability of treatment programs and increased the funding for prevention programs especially those that were community based.

• I worked with the military leadership to up grade the treatment of those serving in the armed forces.

• Most importantly I maintained the basic policy position of the US government that drug abuse was primarily a public health problem. This policy was overturned by Reagan as soon as he came into office. Drug dependence, he decreed, would no longer be viewed as a health issue but as a moral and criminal problem. Immediately deaths began to climb and the numbers in prison on drug related charges soared.

In July 1978 I became aware that one of my staff members was having personal problems causing emotional distress that was interfering with her work. She had recently had an abortion. Late one evening we had a frank discussion during which I suggested that she seek professional help and offered to refer her to a psychologist friend of mine. She was reluctant to do this, in part, because having previously been a staff member of the House Intelligence Committee she was worried that any record of having seen a psychiatrist or psychologist might put her security clearance in jeopardy. “Besides” she said “My main problem is just having difficulty sleeping.” I offered to write her a prescription for sleeping medication and to further allay her concerns about confidentiality agreed to use a pseudonym in place of her real name (a fairly standard practice with people in prominent positions). My only dilemma at the time was what drug to use. A barbiturate would have been the natural choice, but being in the middle of a campaign to end the prescribing of that category of drug on an out-patient basis I felt I could not be on record as having done so myself. I quickly settled on Methaqualone, a non-narcotic sedative that was widely popular with 25 million prescriptions written for it a year. It had some reputation as drug of abuse, but that was true for virtually every prescribed psychoactive drug.


My assistant took the prescription home that evening and asked her room-mate, a physical therapist, to get it filled for her at a pharmacy near to where she would be working the next morning in Manassas, Virginia. The pharmacist asked the room-mate if the prescription was for her. She said ‘no’ it was for her room-mate. “What is the name of your room-mate?” the pharmacist asked. The name she gave was, of course different from the pseudonym on the prescription, a discrepancy she attempted to explain. By sheer coincidence a state pharmacy inspector happened to be in the drug store at the time and the pharmacist involved him in the discussion. When it emerged that I, the writer of the prescription, worked n the White House it spurred phone calls up the regulatory, political and judicial system of the state of Virginia. system. I suddenly found myself engulfed in a maelstrom of press stories, innuendoes and out-right lies. When you are in a prominent position it is amazing how much jealousy and hostility you engender. It seemed every enemy I had ever made was out to get even with me including sveral of my colleagues in the White House. A new story emerged alleging that several months earlier I had been at a party hosted by the son of the president of CBS television at which cocaine was used and that I probably was a participant. The first part of the story was true but not the second. The media conveniently ignored the fact that my assistant took and passed a lie detector test in which she was asked if she ever had any intention of using the drug I prescribed for anything other than legitimate medical purposes. There was no suggestion that a special prosecutor should be appointed as would occur later in the Carter presidency when questionable conduct by other White House staff was alleged. In the end no charges were filed against me or my assistant. However, the political hysteria had become such a distractio for the White House that I decided out of loyalty to President Carter that I should resign.

I would move on to an appointment at the United Nations which kept me busy with other issues, but over the years I have continued to stay involved with drug abuse and alcoholism.



© Peter G. Bourne - 2009