THE HELL OF ADDICTION

An American Epiphany: Perhaps The Only Way To Win The Drug War Is To Do
More To Treat Its Victims

Feb. 12 issue - In the new U.S. thriller "Traffic," just opening on
international screens, Michael Douglas plays Ohio judge Robert Wakefield, a
Scotch-drinking conservative who is named the new U.S. drug czar. During an
information-gathering trip to the Mexican border, he begins to see how
complex and intractable the illegal-drug trade really is.

LOCAL HONEST COPS like Javier Rodriguez Rodriguez (Benicio Del Toro) might
be able to withstand the temptation of taking bribes, but they are
powerless to stop corruption among those around-and above-them. Wakefield's
misgivings about his appointment parallel the growing realization that his
own teenage daughter is addicted to crack.

Near the end of the movie, during his first official press conference, the
drug czar deviates from his prepared text and launches into an impromptu
speech about the futility of the fight against drugs. "I don't see how you
wage war on your own family," he says, effectively resigning his post. A
few scenes later, he and his wife are shown beside their daughter at a
meeting for substance abusers. "We're here to listen," he says.

That's hardly the attitude the world has come to expect from the American
drug czar. After all, U.S. prisons are filled with drug offenders; the
number of inmates tripled over the past 20 years to nearly 2 million, with
60 to 70 percent testing positive for substance abuse on arrest.

The country has spent billions of dollars attacking the problem at its
roots: coca growers in Latin America, poppy cultivators in Asia, even
domestic marijuana farmers.

But there is a growing consensus that the "war on drugs" has been lost; the
United States is still the world's largest consumer of illegal substances;
cocaine continues to pour over the border from Mexico. "Traffic" taps into
the national frustration, depicting the horrors of both drugs and the drug
war. Without taking sides, the film illuminates the national debate and
poses an alternative that Americans seem increasingly willing to consider:
finding new ways to treat, rather than merely punish, drug abuse.

WASTED MONEY?

Policy revolutions-like legalizing narcotics-remain a distant dream.

But there is growing public awareness that the money and energy wasted on
trying to stanch the flow of drugs into the United States might be better
spent on trying to curb demand instead.

Voters in several states are far ahead of the politicians, approving ballot
initiatives that offer more treatment options. "Drug courts" that allow
judges to use carrots and sticks to compel substance-abuse treatment have
grown fiftyfold since the mid-1990s, part of a new understanding that, even
with frequent relapses, treatment is much less expensive for society than
jail and interdiction. Each of the former drug czars as well as the man
rumored to be President Bush's choice for the job, retired Col. James
McDonough, stress treatment and demand-side reduction as their first priority.

Drug addiction is increasingly being viewed more as a disease than a crime.
Science is yielding clues about the "hedonic region" of the brain, while
breakthrough medications and greater understanding of the mental-health
problems that underlie many addictions are giving therapists new tools
(following stories). California approved Proposition 36 last fall, a
landmark referendum that offers treatment options in place of jail. New
York is rewriting its draconian Rockefeller-era drug laws. The outgoing
drug czar, Gen. Barry McCaffrey, says the phrase "drug war" should be
retired in favor of "drug cancer." His No. 1 recommendation on leaving
office last month was that insurance companies offer "parity" coverage for
mental-health and drug disorders.

Even hard-liners like to say that Americans can no longer incarcerate their
way out of the problem.

All this is a way of saying that American views are coming into line with
Europe's. The allies' drug-use patterns are similar: marijuana is the most
widely used illegal substance, and while cocaine is more prevalent in the
United States, its use is rising across Europe. Amphetamines and ecstasy
are the second and third most commonly consumed drugs in Europe, and their
use-especially of ecstasy-is growing rapidly in America as well. In both
places, heroin addiction remains the most deeply entrenched-and
costly-public-health crisis.

In a dozen major American cities, men ages 20 to 54 are more likely to die
of a heroin overdose than in a car accident. And according to the
Lisbon-based European Monitoring Centre for Drugs and Drug Addiction, of
the EU's 1.5 million estimated "problem" drug users, most are heroin addicts.

SHIFTING FOCUS

Officials across the continent have already begun shifting their focus from
repressing drug flow to rehabilitating drug users.

The new European Union Drugs Strategy for 2000-2004 makes a commitment to
increasing the number of successfully treated addicts.

Germany, Italy and Luxembourg have transferred responsibility for drug
policy from their Ministries of the Interior to the Ministries of Health or
Social Affairs. In Britain, Tony Blair's government has set up a National
Treatment Agency to coordinate the efforts of social-service agencies and
the Department of Health. And drug-prevention and support agencies there
are getting about 30 percent more funding this year.

The first step in confronting addiction is understanding the addicted
population. And often that means facing up to some uncomfortable facts.

In most places, drug users are getting younger and younger.

So some countries all over the world have begun targeting their efforts
directly at young people. In tough areas of Greece and Finland, flashy new
late-night cafes offer alternatives to doing drugs on the streets.

One British rehab project, the Ley Community, joined forces with Earthwatch
to allow recovering addicts to go on scientific field trips, where they
might study dinosaur footprints in north Yorkshire or birds on the Isle of
Mull. Last year Hong Kong, alarmed by the number of teenagers crossing into
southern China for raves in Shenzhen, announced plans for a new counseling
center aimed exclusively at teenage abusers of psychotropic drugs,
including ecstasy.

The government has also allocated $45 million to find new approaches for
treating psychotropic drug abuse.

Addicts are increasingly being given a voice in formulating drug policy.

In Britain, the National Treatment Agency has consulted users' groups, and
drug czars Keith Hellawell and Mike Trace often listen to the tales of
users. "We're very much being brought into the debate in an interesting
way," says Bell Nelles, general secretary of the Methadone Alliance, a
users' lobby group. "We've cracked the credibility thing.

Now [users] are involved as part of the strategy."

THE EUROPEAN APPROACH

Some countries have no doubt gone further than America probably ever will.
Needle exchanges are common all over the EU, as are "substitution
treatment" programs, where users can exchange, say, a bag of heroin for a
dose of methadone.

In France and Spain, pharmacists are allowed to distribute syringes and
methadone.

Belgium recently decriminalized possession of marijuana for personal use,
following similar moves by Spain, Portugal and Italy. Last year Germany
legalized the use of sanitary "injection rooms," arguing that drug-related
deaths have declined in cities like Frankfurt, where they are available.

The Netherlands, Spain and Switzerland also provide injection centers as a
way to get users off the street and to reduce the spread of diseases
through needle-sharing. Peter Cohen, director of the University of
Amsterdam's Centre for Drug Research, maintains that cultural acceptance of
drug use is growing so rapidly that soon it will be considered as
unremarkable as "homosexuality, which [decades ago] was seen as an illness,
but is now totally normal behavior."

That's pretty radical even for many Europeans. In America, old habits die
harder. Washington still directs two thirds of the federal drug budget
(including $1.3 billion in military assistance to Colombia) to law
enforcement, while state legislatures-leery of seeming to coddle
criminals-lag behind public opinion on funding treatment.

So-called "harm reduction" strategies like needle exchanges have a tough
time winning approval, despite many studies proving that they save lives.

The new U.S. attorney general, John Ashcroft, has opposed not just needle
exchanges and increased federal funding for treatment, but a
taxpayer-supported media campaign aimed at teens. Courts-including many
drug courts-won't often authorize methadone treatment, and junkies
routinely fail to report overdoses to the authorities for fear of being
arrested.

In "Traffic," the kids leave their overdosed friend at the hospital and run
away-a common response.

But there are small signs of change all over the country.

In New Mexico, where GOP Gov. Gary Johnson is an outspoken drug reformer,
the authorities are trying a new harm-reduction strategy to fight overdoses.

Last month New Mexico doctors were authorized to give addicts syringes full
of Naloxone, commonly known as Narcan, an easy-to-inject medication that
immediately counteracts the heroin and saves the life of the overdosing addict.

One test of the new public mood on drug enforcement will be if other states
follow suit. New York is beginning to reassess it's tough drug laws, which
date from the 1970s and the governorship of Nelson Rockefeller. Last month
Gov. George Pataki, once a major hard-liner, proposed cutting the minimum
sentences for serious drug felons from 15 years to eight and giving judges
more discretion. "It was clear when we went through the clemency process
that there were people who were caught up in the drug laws in ways that
resulted in dramatically unfair sentences-people sentenced to 15 years when
their involvement was minimal," Pataki says.

How does the rest of the world view America's new tack? Most Europeans
think it's about time that their puritanical cousins got with the program.
Indeed, a few critics in London have faulted "Traffic," which opened there
to generally positive buzz on Jan. 26, for not going far enough in support
of legalization. Hong Kong police fear that an increase in funding for
treatment will mean a decrease in U.S. drug-enforcement help; in November,
the then President Clinton asked Congress to remove Hong Kong from the list
of major drug-transit territories. And while Mexican analysts are
encouraged by America's new attention to demand reduction, they remain
skeptical about Washington's true intentions. "The Americans have to fill
all of those jails with [people] caught smoking a joint," says Haydee
Rosovsky, who until recently headed Mexico's national anti-addiction program.

Changing the main national strategy from attacking drug pushers to
rehabilitating addicts won't come easy. But slowly, steadily, Americans
seem determined to try.

With Jonathan Alter in New York and Carla Power in London, Alan Zarembo in
Mexico City and Mahlon Meyer in Hong Kong