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The Center on Addiction and Substance Abuse at Columbia is 

 the only national organization to bring under one roof all profes- 

 sional disciplines needed to study and combat all types of sub- 

 stance abuse — illegal drugs, alcohol, pills, and tobacco — in all sec- 

 tors of society. Our mission is to inform the American people of the 

 costs of substance abuse throughout society and the impact on their 

 lives, to find out what works in prevention and treatment, and to 

 encourage all individuals and institutions to take more responsibil- 

 ity to combat substance abuse. 



You have asked me to testify, Mr. Chairman, about how the con- 

 duct of tobacco companies which has been disclosed in recent news 

 reports and in the New York Times — news reports in the New York 

 Times and the Washington Post has affected Government policy 

 over the past 30 years. 



Mr, Chairman, I have been in public life for most of the past 35 

 years. I have been picketed, I have been attacked for one position 

 on one issue or another, but I have never been subjected to such 

 a crude attempt at intimidation as I was last night. At about 5 

 p.m. last evening there was delivered to my office at CASA the fol- 

 lowing faxed letter: "To the Honorable Joseph Califano, Center on 

 Addiction and Substance Abuse, re: May 17 hearing of the House 

 Subcommittee on Health and the Environment. 



"Dear Mr. Secretary, King & Spalding represents Brown and 

 Williamson Tobacco Corporation. We understand that you will par- 

 ticipate tomorrow in a hearing of the House Subcommittee on 

 Health and the Environment that may include a discussion of one 

 or more articles appearing recently in the New York Times. Those 

 articles included references to documents believed to have been sto- 

 len and which are subject to a State court injunction. A copy of that 

 injunction is being provided with this letter." And it enclosed a 

 copy of an injunction which purports to block anybody from talking 

 about these documents. 



Mr. Chairman, this is a blatant attempt to intimidate me, to ob- 

 struct the work of this committee, and to scare me off of testifying. 

 I will not be intimidated, and I will lay out the facts based on those 

 news reports, which is the only knowledge I have of their activities. 



I would like to submit this for the record, Mr. Chairman. 



Mr. Waxman. Without objection, we will receive that document 

 for the record. 



Mr. Califano. For 2 years the Center on Addiction and Sub- 

 stance Abuse has been conducting an analysis of the cost of sub- 

 stance abuse to the health care system, the entire health care sys- 

 tem. This is the first undertaking of its kind. 



As the initial phase of this analysis, last year we completed and 

 published a study of the costs of substance abuse to the Medicaid 

 program. I have provided copies of the study to the committee and 

 ask that the Medicaid study be entered into the record. 



Mr. Waxman. Without objection, that will be the order. 



Mr. Califano. The Center's study found that at least $1 in every 

 $5 that Medicaid spends on inpatient hospital care can be traced 

 to substance abuse. That is at least $7.4 billion in 1994, and 40 

 percent of that amount, about $3 billion, is attributable to tobacco 

 use. On average, Medicaid patients with a substance abuse as a 

 secondary diagnosis are hospitalized twice as long as those patients 



