PARENTAL INVOLVEMENT IS CRUCIAL IN TREATING DRUG PROBLEMS

Joseph Califano Jr., founder of the National Center on Addiction and
Substance Abuse at Columbia University, is calling for a cultural
revolution to address the nation's drug problem. He served in the
Johnson and Carter administrations, and started the country's first
anti-smoking campaign in 1978.

Califano is an advocate for more investment in addiction treatment
and prevention.

During a phone interview, Califano talked about many of the issues he
raises in his book "High Society: How Substance Abuse Ravages America
and What to Do About It." Here is a condensed version of his comments.

Q: Why does America have a drug problem?

A: From the earliest times, we're subjected to a lot of advertising,
a lot of sense that there are drugs to change your mood, there are
drugs to change your pain, help you get rid of headaches, help you
ease arthritis,if you're down, if you're tense to help you relax. . .
. There's the constant merchandising, particularly with respect to
alcohol. . . .

I think you can't separate alcohol from drugs. I think most people
who are using drugs are abusing alcohol: it's very much of our young
people. If you get a kid through age 21 without smoking, without
using illegal drugs and without abusing alcohol . . . that child is
virtually certain not to abuse substances in the future. There will
always be exceptions.

Q: What needs to change?

A: We need a revolution. Parents do have to get involved. We have to
recognize this is a major -- if not the major -- public health
problem -- Two, we've got to get the stigma off of this stuff. We
have to recognize it is a disease and start treating it like a disease.

Q: Do you think more money needs to be devoted to treatment?

A: We need to learn a lot more about (treatment). That's particularly
true in respect to adolescents. There's a tremendous absence of good
treatment for adolescents all over the country. We need a major
investment. If this were any other disease, we'd have a major
investment in the National Institute on Health Research. The
availability of treatment is very important. This is a complex
disease. At the moment when somebody says, "I'm going to try to get
this monkey off my back,' not to have someplace to go is devastating
. . . because those moments are rare and far between. If you miss
that opportunity, that person can be condemned to more years of
suffering and addiction.

Q: The reasons that people get into drugs in the first place are
complex and it sounds like the ways to fix it are, too.

A: Parents really (need to be) engaged in their children's lives. If
I could wave a wand and create a new world, that would be a big part
of the new world. Because getting those kids through high school,
through age 21, without getting into this stuff is critical. And that
is mostly the function of parents. That's the biggest prevention
potential we have. Parents don't understand how great their influence
is on their kids. Kids do listen and parents should be talking to
their kids about it. It's not simply a matter of saying to your
child, "Don't use drugs." If you haven't built a relationship, that's
just a hollow statement.

Parent power is the most under-utilized tool we have in the war on
drugs. I hate that term, "war on drugs." I think that we have to get
the message out to parents that they are where the action is. That's
where it's at. They can do more about it than any senator,
congressman, any cop or counselor.

Q: What do you tell a parent whose child is already using drugs? How
can parents help those children?

A: It's awful. If they had the resources, they could put them into
treatment. That's one of the tragedies of insurance. Insurance
doesn't cover most of this treatment, not just the absence of public
programs, but private insurance for the most part doesn't adequately
cover substance abuse treatment. . . .

If somebody has diabetes or hypertension, they can go to the doctor
and they have to have continuing treatment. . . . If an alcoholic or
drug addict needs continuing treatment, we don't give it to them. If
they fall off, we condemn them. The length of time someone needs in
treatment varies enormously, depending on their situation. . . . We
need a revolution in the way people look at this problem. It's doable.