DRUG CONTROL IS A BUST

CLINTON ADMINISTRATION'S POLICY CONTINUES COSTLY FAILED STRATEGIES

THE CLINTON ADMINISTRATION unveiled earlier this year its 1999 National Drug
Control Strategy, a continuation of an ambitious program initiated in 1989
to reduce illegal drug use in the United States. Although most government
officials will not admit it, the plan launched in 1989 has not only failed
to meet most of its objectives, but it has also failed to stem disturbing
trends, especially in the area of adolescent drug use.

Despite these discouraging results, the new federal drug policy continues to
focus on law enforcement. Nearly two-thirds of the proposed budget for the
1999 program is allocated to this effort, while education, prevention and
treatment programs account for only a third of the funds. During the past
year, drug czar General Barry McCaffrey announced 97 new goals for the
program. The most notable is that of cutting illegal drug use, as well as
the drug supply itself, by half within the next 10 years.

Seemingly ignored in the announcement of this plan was an important piece of
drug policy history. When the national plan to control drugs was announced
in 1989, it set just nine goals to be met within 10 years, including
reducing by 50 percent the use of illegal drugs, the number of emergency
room visits associated with illegal drug use, the amount of illegal drugs
coming into the United States, the amount of marijuana grown here, and the
number of high school students who report that they do not disapprove of
illegal drug use. The results of these goals are available but have not been
well publicized.

In preparing to unveil these new program goals, President Clinton stated
last year that ``Drug use in America has declined by 50 percent over the
last decade.'' The facts do not support this statement.

According to the National Household Survey on Drug Abuse, the decline in the
use of illegal drugs between 1988 and 1997 was only 16 percent, with
virtually no decline since 1991.

In fact, of those nine original goals, only one, to reduce cocaine use by 50
percent, has been met. Cocaine use has declined in the general adult
population by about 50 percent. Meanwhile, use of hallucinogens has risen 20
percent, and heroin use has more than tripled.

The most notable failure has been in reducing adolescent drug use. Instead
of meeting the goal of a 50 percent decrease, there was a greater than 40
percent increase, including a nearly 75 percent increase in marijuana use.

Similarly, the goal to decrease by 50 percent the number of high school
students who report that they approve of illegal drug use has met with
failure. Indeed, the results show a trend in the opposite direction, with
the proportion of high school students approving of illegal drug use
significantly higher than it was a decade ago.

Efforts by the federally funded Drug Abuse Warning Network to reduce by 50
percent emergency room visits attributable to illegal drugs also failed.
Between 1988 and 1996, drug-linked emergency room visits increased by 21
percent.

The goals targeting reductions in domestic marijuana production and in the
amount of illegal drugs entering the United States cannot be assessed
because there are no reliable estimates.

These discouraging results come during the same period that federal spending
on drug control has more than tripled, from $4.7 billion in 1988 to $16
billion in 1998. The proposed budget for the next four years is $70 billion.

The record of failure for goals set 10 years ago, and the lack of
fundamental change in the approach to drug control, makes it unreasonable to
believe that these 97 new goals will be met. It is time for politicians to
drop expensive programs based on strategies that do not work. If we are to
be truly effective in decreasing drug use, we must demand thoughtful
alternative policies.

Stephen Sidney, M.D., is associate director for clinical research for Kaiser
Permanente's Division of Research in Oakland. His opinion reflects his
personal views and not those of Kaiser Permanente Medical Group.