Politicking Is the Big Enemy on AntiDrug Battleground

Scientific, coordinated strategy of prevention is seen as key

Drug abuse in America has failed to decline despite an increasingly
expensive war against it. In the last 15 years, federal antidrug
expenditures have skyrocketed from $1 billion to more than $16 billion,
while teenage drug abuse has doubled and annual cocaine consumption has
remained unchanged.

Science magazine's current issue gives the persuasive viewpoint of
scientists on the reasons for these costly failures. In it, six new studies
point out what Alan L. Leshner, director of the National Institute on Drug
Abuse and one of the authors, calls a "dramatic lag" between advances in
the scientific understanding of substance abuse "and their appreciation by
the general public or their application in either practice or public policy
settings."

A conclusion shared by all of the Science authors is that decisions on how
to spend substance abuse prevention dollars are guided by politicking that
wastes taxpayer dollars on failed approaches, not by knowledge of programs
that have proven effective.

For example, officials at the Office of National Drug Control Policy
(including current director Barry McCaffrey) have long called for more
expenditures on prevention and proven treatment programs and fewer for
historically ineffective interdiction and law enforcement programs.

But the funding equation, determined mostly by Congress, has remained
unchanged since the early 1980s: onethird for treatment, twothirds for
enforcement.

Worse, the treatment and prevention dollars are often handed out to
untested, unsupervised regional programs without expertise in the new
science regarding drug treatment strategies.

After the Bush administration committed to cutting teenage drug use 50% by
2000, regional "substance abuse treatment campuses" were hurriedly created.
Despite a cost of nearly $70 million, substance abuse policy experts say
the experiment failed to dent drug abuse.

Earlier this year, McCaffrey took a promising step away from this
helterskelter approach, submitting a mostly scientifically sound, 10year
drug abuse prevention plan and asking for funding in advance to help keep
politics out of the yearly allocation process.

But Congress and the Clinton administration have failed to grant him the
funding and the backing he needs to implement strategies that go beyond
politically safe seizures of truckloads of drugs. These include ensuring
the availability of methadone treatment for heroin addicts and substance
abuse prevention programs for prisoners (which federal studies have shown
could save the nation $67 billion a year in social, health and criminal
costs).

Because of the lack of leadership, the nation's drug policy is administered
by half a dozen competing federal agencies doing redundant work.

For example, four federal agencies currently duplicate drug abuse
monitoring, from telephone surveys of individual households to analysis of
county health records. The redundancy drains federal dollars, and the data
are not coherently combined or analyzed.

To remedy the problem, Health and Human Services Secretary Donna Shalala
should appoint a single agency, along the lines of the Center for Health
Statistics, to coordinate drug abuse studies and findings.

Better approaches are out there; what we lack, the Science studies show, is
not scientific knowledge but political will. As McCaffrey recently
lamented, "getting the U.S. government to do anything is like herding ducks
with a broom."

Congress could at least give him enough nostringsattached money to buy a
bigger broom.