Pubdate: Sat, 11 Apr 2009
Source: Chicago Tribune (IL)
Copyright: 2009 Chicago Tribune Company


PHILADELPHIA -- In another clear break from past policy, President 
Obama announced Friday that he intended to nominate as the nation's 
No. 2 drug czar a scientist often considered the No. 1 researcher on 
addiction and treatment.

A. Thomas McLellan, a University of Pennsylvania psychologist, will 
be charged with reducing demand for drugs, a part of the 
foreign-supply-and-domestic-demand equation that many policy experts 
say has been underemphasized for years.

"We're blown away. He understands," said Stephen J. Pasierb, 
president and chief executive of the Partnership for a Drug-Free 
America, that addiction "is a parent, a family, a child issue."

If confirmed by the Senate, McLellan will be deputy director of the 
Office of National Drug Control Policy, which advises the president 
and coordinates anti-drug efforts. Obama last month nominated Seattle 
Police Chief Gil Kerlikowske to head the office.

Kerlikowske's reputation for innovative approaches to law enforcement 
and McLellan's stature as a treatment scientist make them "a perfect 
match," Pasierb said.

Although hardly known outside his field, McLellan is regarded as a 
leading researcher on a range of addiction-related issues.

As a scientist at the Veterans Administration Medical Center in 
Philadelphia in the 1980s, he led development of two measures, known 
as the addiction severity index and treatment services review, that 
characterized multiple dimensions of substance abuse. The tools, used 
worldwide, help determine the type and duration of treatment.

In 2000, he was lead author of a groundbreaking paper that compared 
drug addiction with chronic medical conditions.

When diabetes or asthma patients relapsed after treatment ends, he 
argued, doctors concluded that intervention worked and that treatment 
needed to be continual.

"In contrast, relapse to drug or alcohol use following discharge from 
addiction treatment has been considered evidence of treatment 
failure," the authors wrote in the Journal of the American Medical Association.

McLellan, 59, grew up outside Harrisburg, Pa., and did his graduate 
work at Bryn Mawr College, earning a doctorate in 1976. In 1992 he 
cofounded the nonprofit Treatment Research Institute to study and 
adapt promising scientific findings into clinical practice and public policy.

He worked with the State of Delaware, for example, to implement a 
system that tied part of the payments to state-funded treatment 
centers to predetermined measures for success.

"I think his long and rigorous examination of how drug-abuse 
treatment is delivered is pretty unique," said David Friedman, 
director of addiction studies at the Wake Forest University medical school.

People in the field have long been frustrated by drug policies under 
both Democrats and Republicans that they say were driven not by 
science but by ideology -- essentially, arrest the drug suppliers and 
get the users out of sight.

Friedman was buoyed several weeks ago when Secretary of State Hillary 
Rodham Clinton made an unusual acknowledgment of the role played by 
domestic consumers of illicit substances.

"Our insatiable demand for illegal drugs fuels the drug trade," she 
said in Mexico.

Friedman said that "if that's the way the administration feels about 
this, then all of a sudden the deputy for demand reduction" -- 
McLellan's job, in addition to being the second in command -- 
"becomes a very important position." 
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MAP posted-by: Richard Lake