Tackling America's Drug Addiction

Tackling America's Drug Addiction : NPR.

I heard parts of this when it was initially broadcast, and hunted around for the text version.   It contains some statistics that surprised me.   Here's the first part of the interview:

MICHELE NORRIS, host:  Earlier this week, Mexican President Felipe Calderon defended Mexico's war against the drug cartels, and cast some blame on his neighbor to the north: the U.S. The origin of our violence problem begins with the fact that Mexico is located next to the country that has the highest level of drug consumption in the world, Calderon wrote in a newspaper editorial. It is as if our neighbor were the biggest drug addict in the world.

Harsh words, to be sure. It got us wondering about the appetite for drugs in the U.S., and whats being done to curb it.

For answers, we turn to Joseph Califano, the former secretary of Health, Education and Welfare, and now director of the National Center on Addiction and Substance Abuse at Columbia University.

Mr. Califano, welcome to the program.

Mr. JOSEPH CALIFANO (Director, National Center on Addiction and Substance Abuse, Columbia University): Nice to be here.

NORRIS: Now first, any truth in President Calderon's statement? Is it fair to characterize the U.S. as the biggest drug addict in the world?

Mr. CALIFANO: The U.S. is 5 percent of the world's population. We consume two-thirds of the world's illegal drugs. So there is a lot of truth...

NORRIS: Hmm.

Mr. CALIFANO: ...in what President Calderon said.

NORRIS: Let me ask you about the war on drugs right now. The current administration is trying to focus on a balance between interdiction and treatment: drug courts, for instance, followed by mandatory treatment, things like that.

Will that shrink the domestic market for drugs - since when you're talking about treatment, there are so many issues surrounding access to treatment?

Mr. CALIFANO: You're absolutely right. The rhetoric of the administration is good, but the dollars haven't changed. We're still putting roughly two-thirds into interdiction and enforcement, and one-third into treatment and prevention. Interestingly, when President Nixon started the war on drugs, his first budget was two-thirds for prevention and treatment, and one-third for interdiction.

NORRIS: Oh, so it's flipped.

Mr. CALIFANO: It's flipped totally. Now, we have to look at a lot of systems to really do something about this. The drug courts are great. We've analyzed them at our center. They work. And the prison population is important because 65 percent of the people in prison meet the medical criteria for drug or alcohol abuse and addiction. That's a wonderful - in a sense, captive audience. But we don't provide much treatment for them.

NORRIS: So it's just a wasted opportunity. They're not getting treatment.

Mr. CALIFANO: About one in 10 that need treatment gets some kind of treatment. But most of it is not good.

There's a Medicaid population: 30 percent of the beneficiaries of Medicare have drug and alcohol problems. We have to go after those populations. That's the short-run - in a sense - solution to this problem.

There's a longer-run solution. We know from our research that if you get a child through age 21 without getting into this stuff, that child is virtually certain to be home free for the rest of his or her life. And when you say a drug-free society - and there will always be drugs being used - what you're really talking about is that population of children - and that's parents, that's schools, that's people that are dealing with that. And they've got to get focused on it.

NORRIS: Is the U.S. serious enough about the war on drugs?

Mr. CALIFANO: No, we're not. I'll tell you - and we're not serious. The government is not serious enough. You can barely hear any of the leaders in the government talk about it. The medical profession is not serious enough. The public-health profession is not serious enough.

Think about it.  The richest nation in the world.  And our wealth is quite concentrated in a relatively small portion of our population: 1% of us have over one third of the net worth.  10% of us have over 71% of the net worth.

And 10% of us get nearly half of the pre-tax income, and 20% of us get 61%, and 40% of us get 80%, leaving not much for the rest.

The rest of us keep talking about our nation's ideals, as if we'd already achieved them and we should all be content.  But clearly our concentration of wealth and concentration of income are producing effects which burden a large number of us and then get transmitted to other parts of the world.  (Am I a master of understatement?)

Comments

[Nicholas D. Rosen]

I'd be careful of numbers from CASA and Mr. Califano. They've been caught making statements that were definitely not true (about teenagers drinking some very large percentage of all the liquor consumed in America, for example). There's also room for disagreements about the significance of statistics (e.g., to what extent is correlation causation?) even when the numbers themselves are not bogus. Thirdly, there's room for political disagreement even when the statistics are not in dispute. I'm not eager to let the Drug WArriors impose compulsory testing and then "treatment" on Medicaid recipients, children, and various other segments of the population.

Anyway, what does this have to do with tax reform. If we fixed our economic problems, I fear that human cussedness would remain. Some people would still choose to abuse drugs rather than live productive, sober lives.

[LVTfan]

You make some very wise points, and I don't disagree with any of them.

What interested me about the statistics Califano presented was that in this "best of all possible countries" we have so many people experiencing psychic pain that seems to be calling for these so-called recreational drugs. This creates amazing havoc in the lives of many other people, here and elsewhere. So many people in this rather-well-off-on-average country feel the need to self-medicate.

Obviously "on-average" is one part of the story. Averages which include our top 2%/5% are so high as to be irrelevant to most Americans (not irrelevant but clearly out of range) ... compare averages on any measure of wealth or income to the medians for the same measure and you'll find hat 75% to 80% of us are below average -- and across time, that horizon is increasing. Not good.

Also obviously, we all want to avoid pain, and many people live in fear of physical pain, particularly as we age and face diseases of various kinds, sometimes without medical insurance and the assurance of quality healthcare. To the extent that our system helps produce that fear of physical pain rather than alleviate it, we manufacture a demand for drugs which currently can only be obtained through illegal channels.

We can do better, can't we?