DRUG WAR FALLACY

We waste billions of dollars on prosecution and prison; prevention, when
potential addicts are young, is the sensible choice

A parent can immunize a child against many killer diseases for pennies per
shot. If the child still gets sick, treatment costs more than immunization,
but is usually effective. Only if a parent were to be so irresponsible as to
fail to prevent and then to treat the disease is the child likely to die or
be permanently disabled.

Parents and the greater society, working together, could immunize most of
our children against the killer diseases of alcohol, drug and tobacco abuse
and addiction. In cases where that failed, we could treat those who succumb
as teens or young adults. But we don't. Instead, we spend billions on
police, prisons, welfare, foster homes, educational services, child
protective services and health care.

The high cost of this backward approach to substance abuse is made clear in
``Shoveling Up,'' a report from the National Center on Addiction and
Substance Abuse at Columbia University. ``Shoveling up'' is what states have
to do in the wake of the damage caused by rampant substance abuse.

The cost of this salvage operation is shocking: more than $81 billion a
year, nationwide. On average, according to the report, states are spending
as much money on clearing up the devastations caused by addictions as they
spend on higher education, about 13 percent of total spending. In
California, it's even higher: 16 percent of state spending in 1998, or $11
billion. And of this enormous sum, only about 4 percent goes for prevention
and treatment.

As a society, we are like an irresponsible parent. We spend little money on
preventing substance abuse and addiction, and where money is spent it too
often goes for politically popular programs like Project D.A.R.E., whose
effectiveness is questionable.

After prevention fails, we spend a little bit more on treatment. But it's so
little that even people who voluntarily seek treatment for addiction (a
disease marked by denial that a problem even exists) encounter long waiting
lists.

And then, when drugs, alcohol and tobacco take their toll, we finally step
in with massive amounts of money to pursue, prosecute and, all too often,
imprison the victim.

It makes no sense. Especially when there are proven ways to help kids avoid
getting hooked. And it's kids whom we should target first.

Joseph A. Califano Jr., president of the Center and secretary of health and
human services under President Carter, makes that clear enough in his
foreword to the report:

``We know that a child who gets through age 21 without smoking, abusing
alcohol or using illegal drugs is virtually certain never to do so. It is a
slap in the face of this knowledge for states to spend 113 times more to
shovel up the wreckage of children savaged by substance abuse and addiction
in social, criminal justice and education programs than they spend to
encourage children to stay away from these substances and treat those who
ignore that advice.''

Of course, preventing alcoholism isn't nearly as simple as administering a
series of polio shots. And treating methamphetamine addiction is infinitely
more complicated than treating whooping cough. Researchers disagree on
whether genetics or family backgrounds or other elements contribute most to
individual predilection toward addiction. Prevention programs must address
messed-up families and dangerous neighborhoods to make a real difference to
high-risk adolescents. Treatment programs must often tackle more than one
addiction, at significant expense, to have lasting benefit.

There's little consensus on what works best, which may help explain the lack
of public investment in prevention. This study and others, however, provide
evidence that prevention and treatment deserve a far greater share of
resources than they receive now.

The accompanying column takes a look at current research and opinions in
that field.

We do know what doesn't work. We know that repeating ``just say no'' to
youngsters doesn't work. We know that trying to stop the supply doesn't
work. We know that sending alcoholics for brief hospital stays and then
expecting them to reform themselves doesn't work.

Viewed as a public health problem, substance abuse is a terrible example of
ignoring the problem and then blaming the victim. California voters showed
in November that they are beginning to grasp the problem when they approved
Proposition 36, which calls for treatment rather than prison for many drug
offenders. But much more can be done to get kids through their most
vulnerable years so that they won't end up using and abusing in the first
place.

State officials for too long have treated addiction as a law enforcement
problem. Instead, they should pay attention to this report and respond by
putting more money and effort into prevention and treatment than into
``shoveling up.''