Pubdate: Tue, 08 May 2001
Source: Washington Post (DC)
Copyright: 2001 The Washington Post Company
Contact:  http://www.washingtonpost.com/
Details: http://www.mapinc.org/media/491
Author: Joseph A. Califano Jr.
Note: The writer was secretary of health, education and welfare from
1977 to 1979. He is president of the National Center on Addiction and
Substance Abuse at Columbia University. 

LEARNING FROM ROBERT DOWNEY JR.

The relapses of actor Robert Downey Jr. and athlete Darryl Strawberry
are being cited in supporting briefs of extremists at both ends of the
drug policy debate: those arguing for legalization and those pressing to
lock up addicts and throw away the keys until they cure themselves.

These are hard cases, but we should not let them make bad policy. Both
extremes are policies of despair that ignore the success of efforts to
date and misread the lessons these tragic cases offer.

Drug use in the United States peaked in 1979 and 1980. Since then,
despite the 55 million increase in the general population, the number of
drug users has dropped 50 percent. If teen pregnancy, the incidence of
new AIDS cases, domestic violence or breast cancer had plummeted 50
percent, corks would be popping across the nation in celebration.

There are lessons to be derived from the tragic experiences of Downey
and Strawberry. Lesson One is the need for more effective efforts to
prevent experimentation with drugs such as marijuana. Downey was given
his first joint at age 6 by a father who then thought it was "cute."
Downey and Strawberry began their drug experience with marijuana and
alcohol, as do virtually all individuals who get hooked on cocaine and
heroin. The plight of these celebrities should remind us that the only
sure way not to get hooked is not to experiment.

Lesson Two is the need for research to discover how better to motivate
addicts to enter treatment, stay there and continue in aftercare.
President Bush's proposed budget increases of 16 percent for the
National Institute on Drug Abuse and 11 percent for the National
Institute on Alcohol Abuse and Alcoholism are steps in the right
direction. But they fall far short of the kind of commitment this nation
would make if we recognized that we are dealing with the country's
number one disease and stopped stigmatizing addicts as modern-day
lepers.

To appreciate the difficulty of shaking an addiction, just think how
hard it is to lose weight and keep it off for any extended period of
time. Multiply that by a million to get a sense of what it is like to
give up a drug forever after your brain has flipped on the addiction
switch. A few weeks in a treatment program followed by prompt return to
the stress of a weekly TV sitcom or major league pennant contender is an
express ticket to relapse.

Lesson Three is that both these guys are victims of the pressure to get
back on the stage and playing field, expensive lawyers who got them out
of coerced treatment well before they were able to lay a solid
foundation for recovery, and the easy availability of drugs.
Availability is a key factor in drug use. Downey and Strawberry easily
got the stuff for a high once they were released or escaped from
custody.

Law enforcement that curbs availability can play a vital role in demand
reduction. Stephen Gaghan, screenwriter for the film "Traffic" and a
recovering addict, sought treatment out of desperation on the weekend
that his dealer and his two backup dealers were arrested. Neither
legalizing drugs nor locking up addicts without providing treatment
makes any sense.

There are two legal drugs in America -- alcohol and nicotine -- and we
have more than 60 million nicotine addicts and some 15 to 20 million
alcoholics. We have 4 million to 6 million regular illegal drug users, a
number that would soar like Jack's beanstalk if marijuana, cocaine and
heroin were as available as Budweiser, Marlboros and Jack Daniels. Such
a step would be especially destructive to our children, since in our
free society we have shown little ability to keep legal drugs such as
beer and tobacco out of their hands.

Locking up addicts without providing them treatment ensures their return
to crime and incarceration. Alcohol and drug addicts released from
prison without receiving treatment are almost certain to get high on
their first day out and shortly thereafter to slip back into criminal
conduct: robbery, assault, rape, selling drugs.

Evaluations of drug courts by the National Center on Addiction and
Substance Abuse at Columbia University have found that coerced treatment
works. Many prosecutors, such as Brooklyn District Attorney Joe Hynes,
believe treatment entered under fear of going to prison is often more
effective than purely voluntary treatment. In this sense, the tragedy of
Downey and Strawberry is not so much that they have been criminally
charged; it is that their special status and access to high-powered
lawyers denied them the motivation to accept appropriate treatment for a
sufficiently long time (at least a year) to get their act together.
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