Pubdate: Tue, 13 Mar 2001 Source: Washington Post (DC) Copyright: 2001 The Washington Post Company Contact: 1150 15th Street Northwest, Washington, DC 20071 Feedback: http://washingtonpost.com/wp-srv/edit/letters/letterform.htm Website: http://www.washingtonpost.com/ Author: Joseph A. Califano Jr. Note: The writer, president of the National Center on Addiction and Substance Abuse at Columbia University, was President Lyndon B. Johnson's special assistant for domestic affairs from 1965 to 1969. A TURNING POINT ON DRUGS President Bush has an opportunity to lead a budding revolution in the nation's policy on substance abuse. For the first time in the nation's many wars on drugs, the forces are there to balance and strengthen all four legs of the effort against abuse and addiction: research, prevention, treatment and law enforcement. During his trip to Mexico, Bush showed he recognized that drugs come to America by invitation, not by invasion. The problem we've neglected, he stressed, is reducing demand. That same week, a surprising bipartisan group of senators -- Republican conservatives Orrin Hatch, Strom Thurmond and Mike DeWine; Democratic liberals Joe Biden, Patrick Leahy and Edward Kennedy -- introduced legislation to provide an additional $900 million for research, prevention and treatment and to toughen criminal laws to protect kids. The scientific stars are also aligned for revolution. Several years ago, the National Center on Addiction and Substance Abuse at Columbia University (CASA) identified the statistical relationship, especially among young teens, between smoking, drinking and using marijuana and the move to harder drugs. Recently scientists have found that all substances -- nicotine, alcohol, cocaine, heroin, marijuana -- similarly affect brain levels of dopamine (the substance that gives pleasure). Coupled with CASA's finding that an individual who gets through age 21 without smoking, abusing alcohol or using illegal drugs is virtually certain never to do so, these scientific discoveries point to more effective ways to battle substance abuse and addiction. First, we must stop ricocheting from nicotine to alcohol to marijuana to LSD to heroin to cocaine to crack to amphetamines to ecstasy. The problem is addiction. Finding a teen on marijuana or harder drugs who didn't start with cigarettes and beer is like searching for a grain of sand at the beach. The sharp 48 percent decline in teen nicotine smoking in Florida has been accompanied by a 38 percent drop in teen marijuana smoking. Most individuals in treatment are hooked on more than one substance. In research, we need a National Institute on Addiction that combines the current fragmented institutes on drug abuse (illegal drugs and nicotine) and alcohol abuse and alcoholism. Such a combination would strengthen our research efforts and provide a better return for our tax dollars. In prevention, the prime targets are children and all substances. Prevention, education and media campaigns should target alcohol and tobacco as aggressively as illegal drugs. Congressional restrictions that confine the White House drug policy director to illegal drugs should be lifted. That means taking on the tobacco and alcohol lobbies on Capitol Hill and in state legislatures. The movie "Traffic" vividly captures the crude corruption that undermines law enforcement attempts to curb illegal drug distribution and sales. But our campaign finance laws provide cover for polished tassel-loafer corruption by the beer, liquor and tobacco industries. Their campaign contributions and high-priced Washington lobbyists have killed Sen. John McCain's tobacco legislation, proposals to label the dangers of alcohol on bottles of beer, wine and liquor, and cigarette and alcohol tax hikes to increase the price of these drugs and thus reduce initiation of teen smoking and drinking. As for treatment: It's time to take advantage of captive audiences where so much drug and alcohol addiction is concentrated: prison inmates and individuals receiving benefits from Medicaid, welfare, child welfare and other public assistance programs. Of the 2 million Americans in prison for felonies, more than a million have drug and alcohol abuse and addiction problems. Hundreds of thousands can benefit from treatment, but precious little is available. Since on average an addict commits at least 100 crimes a year, for each 10,000 successfully treated, 1 million crimes will be eliminated. Motivation is the key here. Drug courts help. Mandatory sentences hurt. Where the entire sentence must be served, the carrot of early release is not available to encourage a prisoner to seek treatment; where there is no parole, the stick of immediate return to prison is lost as an incentive to continue treatment and aftercare upon release. Beneficiaries of public assistance programs who have drug and alcohol problems should be required to enter treatment as a condition of receiving benefits. In law enforcement, it's time to concentrate on making illegal drugs less available to kids and to expand the policing horizon. For teens, illegal drugs are the tip of the iceberg and at the end of the substance abuse journey. Alcohol is implicated in far more teen violence, suicide and deadly accidents than all illegal drugs. Teens learn how to inhale on nicotine cigarettes before smoking pot. Laws prohibiting sale of alcohol and cigarettes to minors should be toughened. Their reach should be extended to cover adults who purchase beer and cigarettes for minors and tobacco and beer companies that distribute their products to outlets that sell to minors. Much more energetic efforts should be devoted to enforcing those laws and punishing those who violate them. President Bush's statements on demand reduction, treatment and protecting our children are as refreshing as Lyndon Johnson's words on alcohol in his 1967 Message on Crime in America. There LBJ urged that "drunkenness [then America's number one crime] should be regarded as a criminal offense only when it is accompanied by disorderly conduct." That signal kicked off a revolution in how our nation viewed and confronted drunkenness. The Texan in the White House today has the opportunity to spark the same kind of revolution in how the nation views and confronts all substance abuse and addiction. The writer, president of the National Center on Addiction and Substance Abuse at Columbia University, was President Lyndon B. Johnson's special assistant for domestic affairs from 1965 to 1969. - --- MAP posted-by: Jo-D