FEAR CAN BE A GREAT MOTIVATOR IN TREATING DRUG ADDICTS

The relapses of actor Robert Downey Jr. and athlete Darryl Strawberry are
being cited by 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. 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, new AIDS cases, domestic
violence or breast cancer had plummeted 50 percent, corks would be popping
across the nation.

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. This should remind us that the only sure way not to get
hooked is not to experiment.

Lesson Two is the need for research on motivating 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 fall far
short of the kind of commitment this nation would make if we recognized
that we are dealing with the country's No. 1 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 baseball 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. Stephen
Gaghan, screenwriter for the film "Traffic" and a recovering addict, sought
treatment out of desperation on the weekend 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 15 million 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 Daniel's. 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 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.