NOT A DRUG-RIDDEN SOCIETY

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 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 thinks it may be closer to 11 percent.

Does it matter? Of course it matters, he says. You can't make rational
policy until you have a clear idea of the problem the policy is to address.
Painting 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.

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. 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 collecting
"spare change" for the next bottle of cheap wine.

Then there are the others. "I'm not undisciplined or immoral or weak,"
McCaffrey relates. ". . . 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.