NEW REPORT HAS FEW SURPRISES

It will not come as a huge surprise that states spend billions of dollars
cleaning up the aftermath of substance abuse -- about the same amount they
pay for higher education, in fact -- but very little on attacking the root
of the problem. A just-released study analyzing spending from state to
state showed that some $81 billion was spent on substance-abuse problems in
1998. The report, which took three years to compile, found that more than
$7 billion was spent on tobacco-related illnesses. But get this -- and
again, it probably won't surprise many: Only about $3 billion was spent on
prevention and treatment. The vast bulk of the spending went toward law
enforcement, welfare and social services and health care. Does anyone see a
problem with this picture?

Even casual observers of public policy now realize that spending huge sums
of money after drugs, alcohol and cigarettes have taken their toll is not
the wisest approach to such a social issue. If people could be persuaded
through convincing education programs to stay away from these products,
wouldn't we likely end up with the proverbial (and desirable) win-win
situation?

But there is this little matter of political will: If the people and their
elected representatives aren't all that keen to invest significant dollars
in prevention, then it won't happen.

The study, titled "Shoveling Up: The Impact of Substance Abuse on State
Budgets," of course undoubtedly did not take into account all funds spent
on any aspect of substance abuse. The study's principal researcher noted it
does not include federal or local funding and noted that states spend
different proportions of their budgets on social programs. The study found
that states spend at least 6 percent of their budgets and up to as much as
18 percent on the direct and indirect consequences of substance abuse.

Whether it's 6 percent or 18 percent, the sum is significant. And it is
inarguable that throwing these huge sums at a problem after the fact is
doing nothing to deal with the root of the problem.

"This is truly insane public policy," said Joseph A. Califano Jr.,
president of National Center on Addiction and Substance Abuse at Columbia
University, which conducted the study. "States that want to reduce crime,
slow the rise in Medicaid spending, move mothers and children from welfare
to work and responsible and nurturing family life must shift from shoveling
up the wreckage to preventing children and teens from abusing drugs."

Of course that is easier said than done. But there are some actions and
steps that state and local governments have adopted that have proven
worthwhile. What we need to do is concentrate more on proven successes that
prevent substance abuse rather than continue simply trying to pick up the
pieces.

Such a major shift in public policy will require political will and
intestinal fortitude of the sort that we rarely see. But as one observer
noted, it's a matter of pay me now, or pay me later.