Pubdate: Fri, 21 Apr 2000
Source: Washington Post (DC)
Copyright: 2000 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: William Raspberry

NOT A DRUG-RIDDEN SOCIETY

For the moment, Barry McCaffrey, who heads the Office of National Drug 
Control Policy, doesn't want to argue drug policy. He wants to use this 
modest lunch in his office to get some facts out so that when people do 
argue drug policy, they can argue from agreed-upon facts.

He's talking about me, I suspect, but he's talking about lots of people, 
"including the president of the United States who said at least twice that 
the United States, with 5 percent of the world's population, uses half the 
world's supply of illegal drugs."

Wrong, says McCaffrey. The real figure? Nobody knows for sure, but the 
retired general thinks it may be closer to 11 percent.

Does it matter? Of course it matters, he says. You can't make rational 
policy until you have a clear idea of the problem the policy is to address. 
Painting America as a drug-ridden society leads to bad policy--as does the 
tendency in some quarters to conflate the various drug abuses into a single 
dreadful statistic.

Apart from the different--and differentially addictive--drugs of choice, 
McCaffrey is saying, it is important to distinguish between two broad types 
of drug users.

"One group of people take drugs to feel better. The second group of people 
are using drugs to feel good."

What is he talking about? "I've got underlying mental health problems, 
psychiatric problems," he says, lapsing into his habit of describing other 
people in first-person terms. "I'm a 14-year-old girl and I'm sitting there 
in this Rhode Island treatment center with 16 other girls telling this drug 
policy guy I wouldn't be alive today were it not for drugs. I was using 
drugs to self-medicate. I've got a severe mental health problem and, by the 
way, if you diagnose me with that mental problem at an earlier age, and 
start treating that, I won't turn into a chronic addict at 25."

That's the first group of abusers. The second: "You go down to the Johns 
Hopkins Research Center, where they have laboratory rats and rhesus 
monkeys. If you take a male rhesus monkey and give him an option of pushing 
a lever to open a trap door to get at water, food, a lady rhesus monkey or 
cocaine, for sure he'll go for the cocaine. He'll wind up chronically 
addicted to cocaine. He'll malnourish himself. He'll go into neurotoxic 
shock and die. He will choose cocaine over any other reward--and it won't 
have anything to do with mental health problems or growing up with a bad 
rhesus monkey mother. It's the drugs."

The point? Some drug abusers can stop on their own; some can't. Not 
everyone is equally susceptible to addiction. Or, to put it another way, 
our children have contemporaries who use drugs recreationally, often for 
years, without getting hooked. Drawing a link between casual use and 
hard-core addiction makes as much sense to them as drawing a link between 
the glass of cabernet you have at dinner and the stupefied wino collecting 
"spare change" for the next bottle of cheap wine.

Then there are the others. "I'm not undisciplined or immoral or weak," 
McCaffrey relates. ". . . I'm exhibiting severe problems and mental health 
challenges. I'm malnourished, HIV positive and I've got a whole host of 
medical, social and legal problems. You can't, at this point, disentangle 
them, but for sure what the numbers tell me is if you get me off drugs, in 
mandatory treatment and testing, even for say 30 days, I've got the flush 
back in my cheeks, and a lot of my problems start disappearing. Keep me in 
treatment for a year, and the likelihood of my going back to work and 
remaking family connections skyrockets."

But if McCaffrey is right--not just about our haphazard use of statistics 
but also about drug abuse typology--why isn't he screaming from the 
rooftops that throwing people in prison for abusing drugs (or, more 
accurately, for selling drugs to support their addictions) makes no sense 
at all? Why isn't he saying, as former Baltimore mayor Kurt Schmoke was 
saying years ago, that the drug problem ought to be treated more like a 
medical problem than a criminal justice problem?

And how do the facts he lays out support the administration's proposal to 
stick a $1.6 billion military, criminal justice and drug interdiction nose 
into Colombia?

Maybe next lunch.
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