Pubdate: Tue, 29 Jun 1999 Source: San Francisco Chronicle (CA) Copyright: 1999 San Francisco Chronicle Contact: http://www.sfgate.com/chronicle/ Forum: http://www.sfgate.com/conferences/ Author: Stephen Sidney DRUG CONTROL IS A BUST CLINTON ADMINISTRATION'S POLICY CONTINUES COSTLY FAILED STRATEGIES THE CLINTON ADMINISTRATION unveiled earlier this year its 1999 National Drug Control Strategy, a continuation of an ambitious program initiated in 1989 to reduce illegal drug use in the United States. Although most government officials will not admit it, the plan launched in 1989 has not only failed to meet most of its objectives, but it has also failed to stem disturbing trends, especially in the area of adolescent drug use. Despite these discouraging results, the new federal drug policy continues to focus on law enforcement. Nearly two-thirds of the proposed budget for the 1999 program is allocated to this effort, while education, prevention and treatment programs account for only a third of the funds. During the past year, drug czar General Barry McCaffrey announced 97 new goals for the program. The most notable is that of cutting illegal drug use, as well as the drug supply itself, by half within the next 10 years. Seemingly ignored in the announcement of this plan was an important piece of drug policy history. When the national plan to control drugs was announced in 1989, it set just nine goals to be met within 10 years, including reducing by 50 percent the use of illegal drugs, the number of emergency room visits associated with illegal drug use, the amount of illegal drugs coming into the United States, the amount of marijuana grown here, and the number of high school students who report that they do not disapprove of illegal drug use. The results of these goals are available but have not been well publicized. In preparing to unveil these new program goals, President Clinton stated last year that ``Drug use in America has declined by 50 percent over the last decade.'' The facts do not support this statement. According to the National Household Survey on Drug Abuse, the decline in the use of illegal drugs between 1988 and 1997 was only 16 percent, with virtually no decline since 1991. In fact, of those nine original goals, only one, to reduce cocaine use by 50 percent, has been met. Cocaine use has declined in the general adult population by about 50 percent. Meanwhile, use of hallucinogens has risen 20 percent, and heroin use has more than tripled. The most notable failure has been in reducing adolescent drug use. Instead of meeting the goal of a 50 percent decrease, there was a greater than 40 percent increase, including a nearly 75 percent increase in marijuana use. Similarly, the goal to decrease by 50 percent the number of high school students who report that they approve of illegal drug use has met with failure. Indeed, the results show a trend in the opposite direction, with the proportion of high school students approving of illegal drug use significantly higher than it was a decade ago. Efforts by the federally funded Drug Abuse Warning Network to reduce by 50 percent emergency room visits attributable to illegal drugs also failed. Between 1988 and 1996, drug-linked emergency room visits increased by 21 percent. The goals targeting reductions in domestic marijuana production and in the amount of illegal drugs entering the United States cannot be assessed because there are no reliable estimates. These discouraging results come during the same period that federal spending on drug control has more than tripled, from $4.7 billion in 1988 to $16 billion in 1998. The proposed budget for the next four years is $70 billion. The record of failure for goals set 10 years ago, and the lack of fundamental change in the approach to drug control, makes it unreasonable to believe that these 97 new goals will be met. It is time for politicians to drop expensive programs based on strategies that do not work. If we are to be truly effective in decreasing drug use, we must demand thoughtful alternative policies. Stephen Sidney, M.D., is associate director for clinical research for Kaiser Permanente's Division of Research in Oakland. His opinion reflects his personal views and not those of Kaiser Permanente Medical Group. - --- MAP posted-by: Don Beck