The Last Drug Czar?

The mixed record of Obama’s outgoing drug chief.

Gil Kerlikowske heads for a press conference at the Mexican Foreign Ministry building on June 22, 2011 in Mexico City.
National Journal
Lucia Graves
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Lucia Graves
March 13, 2014, 7:06 a.m.

It might as well have been a life­time ago when Gil Ker­likowske began his job as the na­tion’s top drug of­fi­cial back in 2009.

When Pres­id­ent Obama ap­poin­ted him to be dir­ect­or of the Of­fice of Na­tion­al Drug Con­trol Policy — a po­s­i­tion known as the “drug czar” — only a dozen-plus states had leg­al­ized med­ic­al marijuana; a poll show­ing a minor­ity of Amer­ic­ans sup­port leg­al­iz­a­tion could still be con­sidered “re­cord break­ing;” and the dis­par­ity in sen­tences for users of crack and users of co­caine was still 100-1. The idea that two states would soon fully leg­al­ize the re­cre­ation­al use of marijuana seemed ab­surd.

Ker­likowske was fresh off a gig as po­lice chief in Seattle, a city known for ex­per­i­ment­ing with pro­gress­ive drug pro­grams, giv­ing re­formers some hope and drug war­ri­ors some heart­burn. But after a ten­ure that proved to be re­l­at­ively con­ven­tion­al, Ker­likowske has been tapped to head Cus­toms and Bor­der Pro­tec­tion, and is ex­pec­ted to be re­placed by someone who could rep­res­ent a sea change in fed­er­al drug policy.

When Ker­likowske was first ap­poin­ted, re­formers hoped it signaled a shift from the typ­ic­al fed­er­al ap­proach em­phas­iz­ing ar­rest and pro­sec­u­tion to a more mod­ern one, centered around edu­ca­tion and pre­ven­tion. It was a no­tion Ker­likowske had paid con­sid­er­able lip ser­vice to, prom­ising in his first in­ter­view as drug czar to end the “war on drugs” and, later, to pro­mote pub­lic health solu­tions and a “21st cen­tury” ap­proach.

People on the en­force­ment side of things wor­ried that would come at the ex­pense of law en­force­ment. As it turns out, they needn’t have wor­ried.

“He’s been an ex­tremely valu­able part­ner and someone we could re­li­ably ex­pect to work with us, co­oper­ate with us, and ap­prise us of where the ad­min­is­tra­tion was headed,” said Jim Pasko, ex­ec­ut­ive dir­ect­or of the Fraternal Or­der of Po­lice, the na­tion’s largest law-en­force­ment labor or­gan­iz­a­tion. “We were very happy with him.”

The White House budget for 2014 de­votes 57 per­cent of drug-con­trol spend­ing to pun­ish­ment and in­ter­dic­tion while just 43 per­cent went to treat­ment and pre­ven­tion. Ker­likowske has noted such num­bers in­creased treat­ment and pre­ven­tion fund­ing from pre­vi­ous years, and there’s some truth to that. But look a little fur­ther back, and you’ll see OND­CP is just now bring­ing this ra­tio in­to line with about where George W. Bush had it in fisc­al year 2004.

Marijuana Ma­jor­ity spokes­man Tom An­gell was un­der­whelmed by what Ker­likowske billed as pro­gress. “If the ad­min­is­tra­tion really be­lieves drug ab­use is a health is­sue that we can’t ar­rest our way out of, they need to put their money where their mouth is and stop em­phas­iz­ing de­vot­ing so many re­sources to the same old failed ‘lock ‘em up’ policies,” An­gell said. “It’s quite dis­con­cert­ing that spend­ing for the Bur­eau of Pris­ons is go­ing up at a time when the at­tor­ney gen­er­al of the United States says we are in­car­cer­at­ing far too many people for far too long at too great a cost.”

It’s not just Ker­likowske’s re­cord on marijuana that re­formers take is­sue with. The num­ber of over­dose deaths from heroin has in­creased dra­mat­ic­ally in re­cent years, grow­ing 45 per­cent between 2006 and 2010, ac­cord­ing to OND­CP. The up­tick in deaths has been shown to be cor­rel­ated with the the re­cent crack­down on pre­scrip­tion drugs. Ker­likowske has ad­mit­ted that heroin “was not on the radar screen” dur­ing most of Obama’s first term, ac­cord­ing to The Wash­ing­ton Post, and that he “didn’t do everything I should have” to raise aware­ness of the prob­lem.

Kev­in Sa­bet, a former OND­CP of­ficer who now runs the anti-leg­al­iz­a­tion group Smart Ap­proaches to Marijuana, doesn’t hold Ker­likowske re­spons­ible for that. “No one can pos­sibly blame the of­fice for de­vot­ing so many re­sources — so quickly — to re­du­cing the pre­scrip­tion-pill epi­dem­ic,” he said in an email. “Ac­tion was swift and cer­tain, as it had to be. Is the cur­rent surge in heroin ad­dic­tion a res­ult of a crack­down on pills? I don’t know, but no one can blame someone for tak­ing ac­tion on a hor­rible pub­lic-health crisis.”

Bill Piper, dir­ect­or of na­tion­al af­fairs for Drug Policy Al­li­ance, a pro-re­form group in Wash­ing­ton, sees Ker­likowske’s re­cord as mixed. “It’s in­ter­est­ing be­cause tra­di­tion­ally drug czars have been pro­pa­gand­ists for the fed­er­al war on drugs” he said. “Since the cre­ation of OND­CP, they’ve largely been cheer­lead­ers for the drug war; they’ve put polit­ics over sci­ence; they’ve op­posed re­form; and stifled de­bate. Drug czar John Wal­ters, who was Bush’s drug czar, once com­pared drug users to ter­ror­ists.”

By con­trast, Piper called Ker­likowske’s ap­proach “a re­fresh­ing change.” He sup­por­ted the Obama ad­min­is­tra­tion’s re­form agenda around crack sen­ten­cing re­form and over­dose pre­ven­tion, as well as syr­inge-ex­change pro­grams. He also helped to change some of the rhet­or­ic around the is­sues, con­stantly say­ing that drug re­form should be treated as a health is­sue in­stead of a crim­in­al-justice is­sue.

“All of that is good,” Piper said. “But his rhet­or­ic hasn’t al­ways matched up with his ac­tions. This is es­pe­cially the case with marijuana.”

Sa­bet blames en­vir­on­ment­al factors for any short­com­ings. “Gil Ker­likowske was one of the most ef­fect­ive drug czars, work­ing in one of the most dif­fi­cult en­vir­on­ments a drug-con­trol dir­ect­or has ever had to work in,” he said. “He was the head of drug policy in a White House largely ag­nost­ic about today’s great drug-policy de­bates, and that makes it dif­fi­cult.”

Some drug re­formers spec­u­late the White House moved Ker­likowske be­cause he’s out of step with the trend to­ward lib­er­al­iz­a­tion of marijuana, not­ing his out­spoken op­pos­i­tion to a Cali­for­nia ref­er­en­dum that would have leg­al­ized the drug in 2010. “It makes me won­der if that’s why he left,” Piper said.

A back­ground in law en­force­ment, or a hawk­ish polit­ic­al ca­reer, used to be an un­writ­ten re­quire­ment for as­sum­ing the po­s­i­tion of drug czar. Now, for the first time, we’re see­ing something dif­fer­ent.

Ker­likowske’s in­ter­im re­place­ment, act­ing dir­ect­or Mi­chael Bot­ti­celli, hails from a back­ground in pub­lic health and has even re­ceived ser­vice awards for pro­mot­ing re­cov­ery ad­dic­tion. Bot­ti­celli, who served as Ker­likowske’s deputy at OND­CP, is the former dir­ect­or of the Mas­sachu­setts Sub­stance Ab­use Ser­vices Bur­eau, where he ex­pan­ded treat­ment and re­cov­ery ser­vices and helped es­tab­lish early in­ter­ven­tion treat­ment pro­grams for ad­oles­cents. It’s un­clear wheth­er he’ll be form­ally nom­in­ated by the Obama ad­min­is­tra­tion, and even more un­clear that he could clear a Sen­ate vote. But if he is chosen, it would mark the first time in his­tory someone with a back­ground in pro­mot­ing ad­dic­tion re­cov­ery be­came the na­tion’s top drug of­fi­cial — since he’s in charge now, it already does.

“It’s still an open ques­tion on where he’s go­ing to be on marijuana,” said Drug Policy Al­li­ance’s Piper. “We hope that he’s evid­ence-based on that, but it’s nice to see someone at the helm who has a health back­ground in­stead of a law-en­force­ment back­ground. We’re hop­ing to be able to work with him where there’s com­mon ground.”

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