A TURNING POINT ON DRUGS

President Bush has an opportunity to lead a budding revolution in the
nation's policy on substance abuse. For the first time in the nation's many
wars on drugs, the forces are there to balance and strengthen all four legs
of the effort against abuse and addiction: research, prevention, treatment
and law enforcement.

During his trip to Mexico, Bush showed he recognized that drugs come to
America by invitation, not by invasion. The problem we've neglected, he
stressed, is reducing demand. That same week, a surprising bipartisan group
of senators -- Republican conservatives Orrin Hatch, Strom Thurmond and
Mike DeWine; Democratic liberals Joe Biden, Patrick Leahy and Edward
Kennedy -- introduced legislation to provide an additional $900 million for
research, prevention and treatment and to toughen criminal laws to protect
kids.

The scientific stars are also aligned for revolution. Several years ago,
the National Center on Addiction and Substance Abuse at Columbia University
(CASA) identified the statistical relationship, especially among young
teens, between smoking, drinking and using marijuana and the move to harder
drugs. Recently scientists have found that all substances -- nicotine,
alcohol, cocaine, heroin, marijuana -- similarly affect brain levels of
dopamine (the substance that gives pleasure). Coupled with CASA's finding
that an individual who gets through age 21 without smoking, abusing alcohol
or using illegal drugs is virtually certain never to do so, these
scientific discoveries point to more effective ways to battle substance
abuse and addiction.

First, we must stop ricocheting from nicotine to alcohol to marijuana to
LSD to heroin to cocaine to crack to amphetamines to ecstasy. The problem
is addiction. Finding a teen on marijuana or harder drugs who didn't start
with cigarettes and beer is like searching for a grain of sand at the
beach. The sharp 48 percent decline in teen nicotine smoking in Florida has
been accompanied by a 38 percent drop in teen marijuana smoking. Most
individuals in treatment are hooked on more than one substance.

In research, we need a National Institute on Addiction that combines the
current fragmented institutes on drug abuse (illegal drugs and nicotine)
and alcohol abuse and alcoholism. Such a combination would strengthen our
research efforts and provide a better return for our tax dollars.

In prevention, the prime targets are children and all substances.
Prevention, education and media campaigns should target alcohol and tobacco
as aggressively as illegal drugs. Congressional restrictions that confine
the White House drug policy director to illegal drugs should be lifted.
That means taking on the tobacco and alcohol lobbies on Capitol Hill and in
state legislatures.

The movie "Traffic" vividly captures the crude corruption that undermines
law enforcement attempts to curb illegal drug distribution and sales. But
our campaign finance laws provide cover for polished tassel-loafer
corruption by the beer, liquor and tobacco industries. Their campaign
contributions and high-priced Washington lobbyists have killed Sen. John
McCain's tobacco legislation, proposals to label the dangers of alcohol on
bottles of beer, wine and liquor, and cigarette and alcohol tax hikes to
increase the price of these drugs and thus reduce initiation of teen
smoking and drinking.

As for treatment: It's time to take advantage of captive audiences where so
much drug and alcohol addiction is concentrated: prison inmates and
individuals receiving benefits from Medicaid, welfare, child welfare and
other public assistance programs. Of the 2 million Americans in prison for
felonies, more than a million have drug and alcohol abuse and addiction
problems. Hundreds of thousands can benefit from treatment, but precious
little is available. Since on average an addict commits at least 100 crimes
a year, for each 10,000 successfully treated, 1 million crimes will be
eliminated.

Motivation is the key here. Drug courts help. Mandatory sentences hurt.
Where the entire sentence must be served, the carrot of early release is
not available to encourage a prisoner to seek treatment; where there is no
parole, the stick of immediate return to prison is lost as an incentive to
continue treatment and aftercare upon release. Beneficiaries of public
assistance programs who have drug and alcohol problems should be required
to enter treatment as a condition of receiving benefits.

In law enforcement, it's time to concentrate on making illegal drugs less
available to kids and to expand the policing horizon. For teens, illegal
drugs are the tip of the iceberg and at the end of the substance abuse
journey. Alcohol is implicated in far more teen violence, suicide and
deadly accidents than all illegal drugs. Teens learn how to inhale on
nicotine cigarettes before smoking pot. Laws prohibiting sale of alcohol
and cigarettes to minors should be toughened. Their reach should be
extended to cover adults who purchase beer and cigarettes for minors and
tobacco and beer companies that distribute their products to outlets that
sell to minors.

Much more energetic efforts should be devoted to enforcing those laws and
punishing those who violate them. President Bush's statements on demand
reduction, treatment and protecting our children are as refreshing as
Lyndon Johnson's words on alcohol in his 1967 Message on Crime in America.
There LBJ urged that "drunkenness [then America's number one crime] should
be regarded as a criminal offense only when it is accompanied by disorderly
conduct." That signal kicked off a revolution in how our nation viewed and
confronted drunkenness.

The Texan in the White House today has the opportunity to spark the same
kind of revolution in how the nation views and confronts all substance
abuse and addiction.

The writer, president of the National Center on Addiction and Substance
Abuse at Columbia University, was President Lyndon B. Johnson's special
assistant for domestic affairs from 1965 to 1969.