MISINFORMATION DOGS DEBATE OVER DRUGS

WASHINGTON - For the moment, Barry McCaffrey, who heads the Office of
National Drug Control Policy, doesn't want to argue drug policy. He wants to
use this modest lunch in his office (turkey on white toast, tea and water)
to get some facts out so that when people do argue drug policy, they can
argue from agreed-upon facts.

He's talking about me, I suspect, but he's talking about lots of people,
"including the president of the United States who said at least twice that
the United States, with 5 percent of the world's population, uses half the
world's supply of illegal drugs."

Wrong, says McCaffrey. The real figure? Nobody knows for sure, but the
retired general and present drug "czar" thinks the presumed half may be
closer to 11 percent.

Does it matter? Of course it matters, he says. You can't make rational
policy until you have some fairly clear idea of the problem the policy is to
address. Painting pictures of America as a drug-ridden society leads to bad
policy - as does the tendency in some quarters to conflate the various drug
abuses into a single dreadful statistic.

Quite apart from the different - and differentially addictive - drugs of
choice, McCaffrey is saying, it is important to distinguish between two
broad types of drug users.

"One group of people take drugs to feel better. The second group of people
are using drugs to feel good."

What is he talking about? "I've got underlying mental health problems,
psychiatric problems," he says, lapsing into his habit of describing other
people in first-person terms. "I'm a 14-year-old girl and I'm sitting there
in this Rhode Island treatment center with 16 other girls telling this drug
policy guy I wouldn't be alive today were it not for drugs. I was using
drugs to self-medicate. I've got a severe mental health problem, and, by the
way, if you diagnose me with that mental problem at an earlier age, and
start treating that, I won't turn into a chronic addict at 25."

That's the first group of abusers. The second: "You go down to the Johns
Hopkins Research Center where they have laboratory rats and rhesus monkeys.
If you take a male rhesus monkey and give him an option of pushing a lever
to open a trap door to get at water, food, a lady rhesus monkey or cocaine,
for sure he'll go for the cocaine. He'll wind up chronically addicted to
cocaine. He'll malnourish himself. He'll go into neurotoxic shock and die.
He will choose cocaine over any other reward - and it won't have anything to
do with mental health problems or growing up with a bad rhesus monkey
mother. It's the drugs."

The point? Some drug abusers can stop on their own; some can't. It's what
our young people know, and what too many of their well-meaning advisers
can't bring themselves to acknowledge. Not everyone is equally susceptible
to addiction. Or to put it another way, our children have contemporaries who
use drugs recreationally, often for years, without getting hooked. Drawing a
link between casual use and hard-core addiction makes as much sense to them
as drawing a link between the glass of cabernet you have at dinner and the
stupefied wino devoting his life to collecting "spare change" for the next
bottle of cheap wine.

But then there are the others. "I'm not undisciplined or immoral or weak,"
McCaffrey describes them. "My brain is telling me I must continue this
behavior or I'm going to feel intensely bad. At this point, I'm exhibiting
severe problems and mental health challenges. I'm malnourished, HIV positive
and I've got a whole host of medical, social and legal problems. You can't,
at this point, disentangle them, but for sure what the numbers tell me is if
you get me off drugs, in mandatory treatment and testing, even for say 30
days, I've got the flush back in my cheeks, and a lot of my problems start
disappearing. Keep me in treatment for a year, and the likelihood of my
going back to work and remaking family connections skyrockets."

But if McCaffrey is right - not just about our haphazard use of statistics
but also about drug abuse typology - why isn't he screaming from the
rooftops that throwing people in prison for abusing drugs (or, more
accurately, for selling drugs to support their addictions) makes no sense at
all? Why isn't he saying, as former Baltimore Mayor Kurt Schmoke was saying
years ago, that the drug problem ought to be treated more like a medical
problem than a criminal justice problem?

And how do the facts he lays out support the administration's proposal to
stick a $1.6 billion military, criminal-justice and drug-interdiction nose
into Colombia?

Maybe next lunch.