Interview With the Drug Czar

The US Drug Czar, Gil Kerlikowske, shapes the nation's drug enforcement policies. In a rare sit-down, the former Seattle Police Chief discusses a new emphasis on recovery, the deadly prescription pill epidemic, and the truth behind Mexico's bloody Drug War.

Kerlikowske briefs his boss.

Officially, Gil Kerlikowske is the Director of the Office of National Drug Control Policy. Unofficially, he's known as America's Drug Czar. Tall, affable and impeccably groomed, with an ONDCP lanyard around his neck, Kerlikowske is the former Chief of the Seattle Police Department, where he oversaw the force's shift to diverting attention away from arresting people for marijuana possession. When he was nominated by President Barack Obama to run the ONDCP and craft the nation's drug policies, he said, "There is much work to be done." Indeed, there still is. His appointment was viewed with guarded optimism by drug law reform advocates—and in fact Kerlikowske has proven, in this shark-tank political climate, to be far and away the most progressive Drug Czar the country has had.

Recently, Kerlikowske gave a speech at the Betty Ford Center in Rancho Mirage, CA, in which he discussed a "paradigm shift" in the way America views addicts. "Drug addiction is not a 'moral failing' on the part of the individual," Kerlikowske told the audience. "It’s a chronic disease of the brain that can be treated." For many, this isn't a new concept. But it's a welcome statement when it comes from a bully pulpit long dominated by remorseless drug warriors like retired General Barry McCaffrey (who recently told The Fix that Portugal's example of drug decriminalization was "bullshit").

Kerlikowske invited The Fix to visit him on a sweltering summer afternoon in Washington, DC for a rare face-to-face interview. He greets us in the doorway of his office, housed in a nondescript office building a block away from the White House, and asks, "Hot enough for you?" In a wide-ranging interview, he sounds off on the Recovery Movement, the government having missed the boat on crystal meth, the toll of the prescription pill epidemic, and even bath salts.

Mike Guy: In your speech at the Betty Ford Center, you signaled that our national drug policy will put more emphasis on recovery. Is this a shift in the Obama Administration’s thinking?

Gil Kerlikowske: Well, it’s more of the continuing shift in my thinking. Coming into the job, I said, “Look, I think I understand the law enforcement part. But frankly, the details of treatment, medicine, addiction, recognition and then recovery—they really were not in my lane. So as we started to look for a more balanced approach, I realized we were lacking the balance, particularly with recovery and addiction as a disease, and that we needed to remove the stigma of addiction. It is almost kind of like we're trying to use a 3-legged stool, with aspects of law enforcement making up those three legs. By adding recovery to our overall drug policy, we want to have a fourth leg in the stool. That is where we are headed.

You were the chief of the Seattle Police Department before your appointment at the ONDCP. As a cop, did you have a notion of what addiction was?

No, no. Not at all.

What were some of the big surprises when you took office?

There were so many! One was that, I recognized that people in law enforcement and criminal justice almost always have the fingers pointed at them. They're told to do something about the drug problem in a neighborhood, do something about the drug dealing downtown, do something about drug-related crime, and on and on. When you are in the business of law enforcement, you’re here because you can do things, take charge, make decisions. And quite often mayors, councilors, elected officials turn to law enforcement as an answer to those problems.

So part of education has been realizing that, look, if we just continue to use this one tool—law enforcement—we are not going to make any real progress. And you know, some of my colleagues in law enforcement are pretty happy to embrace that too, because it'll mean the finger is pointed perhaps less at them.

Adding recovery as a pillar of the national drug policy is a great concept, but when we look at the ONDCP budget for 2013, there's nothing allocated for recovery services. Why is that?

Well, I think the money sometimes lags behind the change in philosophy and the change in discussion.

The problem is, the prescription pill epidemic is killing people, and the age range is incredible: 14 to 65. It knows no demographic, it knows no ethnic, gender, or economic class. It is clearly an equal-opportunity addiction.

Do you coordinate with the President’s advisers about his re-election campaign platform on drug policy?

No, not at all. There is a very specific part of the ONDCP’s authorization that precludes us from being involved in any federal election issue. And that’s actually a very good thing, because frankly the nation’s drug policy should not be a partisan issue. And I have not found it the least bit partisan when we have been up on Capitol Hill discussing it. I’ve never personally donated to any state or local election campaigns. The best thing I could do as a police chief was to try and run a good police department. So my involvement in politics—other than voting and some donations, but not the kind that the superPACs would be too aware of—is pretty minimal.

Did I hear you say that you haven't found the drug policy to be a partisan issue on Capitol Hill?

That’s correct. Not at all.

I find that really surprising.

You know, I do not. When you start talking about how to keep a community or a city safe, you don't find a lot of chest-thumping when it gets down to the nitty-gritty. Sure, out on the stump, there is a lot of, “Well, we need more mandatory minimums, etc.” But the changes that are coming in criminal justice are nothing short of significant. There will be changes in sentencing, changes in the way we look at drugs, reductions in prison populations—these changes will impact the country for decades.

At the same time, the nature of the drug problem seems to be changing radically. It's not about street drugs like cocaine and heroin anymore, it's about prescription pills.

Well, cocaine use is down significantly. With heroin, all of the anecdotal information and news clips we get every day the past year or so shows either a treatment or law enforcement professional talking about an increase in heroin use. We see that as a result of us putting the pressure on prescription drugs.

And yet last week Congress shot down efforts to put rational controls on hydrocodone. As the nation’s Drug Czar, is that a disappointment?

When I was getting ready for Congressional confirmation, a staffer who was playing the part of Senator Chuck Grassley, asked me, “Are you aware that more people die from prescription drug overdoses, than any other drug?” And I said, “Well, actually, no, I am not.” Listen, this is a complicated problem. Do we reduce the quota put on pharmaceutical companies? Do we put restrictions on the number of prescriptions that can be written? What you realize once you get into this issue is how incredibly complicated it is. From kids who get pills for free from any medicine cabinet in America, to the phenomenon of doctor-shopping. The problem is, it is killing people, and the age range is incredible: 14 to 65. It knows no demographic, it knows no ethnic, gender, or economic class. It is clearly an equal-opportunity addiction.

One that often leads to a heroin problem.

It can.

So what do you do about it? If you’re not given the tools in Congress to address the problem, what direction do you go in?

Well, we do have a lot of tools. And I think we are really making a lot of progress on prescription drugs. There are a couple of things that are troubling. One is, if you become addicted to opioids and you move to heroin. You have a heroin-naïve population, mostly because heroin has not been a big issue or threat to this country in a good number of years—since French Connection kind of movies. So, we have a relatively stable heroin-injecting population. Lots of people are naïve about it now, many feel that if they snort it and smoke it, they will not become addicted. You talk to a treatment person and they'll say, "Yeah, and about three weeks later those people smoking it are IV drug users."

The other concern is this: as you put the pressure on the pills, then people turn to heroin. So, the harder question that you asked is, "Okay, what do you do about it?" So I'm convening a group of federal counterparts right now to talk about heroin. The data on drugs always lags, as you know, but you cannot really ignore the anecdotal evidence about heroin. We don't want to be a group that says, "Here is the next tidal wave,” and have it not appear. You know how many tidal waves of drug problems have come out, surged across the country, and then turn out to not be quite so bad?

Bath salts, for instance.

Synthetics and bath salts could end up being a huge problem, but you do not want to cry wolf. Also, you don’t want to be too far behind the curve, and say, "Well, if we just wait for two or three years until we get more data from DAWN [the Drug Abuse Warning Network], and more data from treatment..." Then, you end up missing it, like we did with crystal meth. We missed that one on a national level, but if you were in a little town in Iowa, and you're devastated by meth, you don’t really care what the national data tells you.