DRUG TRIAL: SHOW ME THE DATA

My personal activities in the field of substance abuse go back about 30
years to my time as a faculty member at the University of Southern
California in Los Angeles. I am, by training and experience, a forensic
pathologist and a toxicologist. The 1960s in Los Angeles were the early
heyday of our modern drug abuse epidemic and provided a natural laboratory
for studying voluntary human street drug experimentation, informing the
academic and clinical fields, albeit with great pain and sadness.

I define drug as any chemical which, when administered to a living thing,
produces an effect. I define drug abuse as the use of a drug in a manner
that is likely to cause harm. This definition deliberately ignores law and
medical practice because most drug abuse is legal (alcohol and tobacco) or
within the bounds of medical practice (e.g., prescription sedatives). For
practical purposes, drug abuse is confined to psychoactive drugs, which are
chemicals that affect the way a person thinks, feels, or behaves. Drug use
is not necessarily a problem; harm from drug use is the problem. Of
course, you cannot have drug harm without drug use, but you can have drug
use without drug harm.

We in the new group called Physician Leadership on National Drug Policy
(PLNDP) believe that scientific evidence should drive American drug policy
and that up to this point it has not. The PLNDP is a group of leading
physician activists and pragmatists who intend to work with the public and
with policy makers to improve the lives of our patients and our communities
by reducing drug harm.

Chronic psychoactive drug use can lead to addiction, which is a chronic
illness. Addiction does not go away. Physicians don't always strive for
cures. We generally don't cure hypertension, arthritis, diabetes, or
asthma, for example, but we can medically manage them quite well. The same
is true with chronic chemical addiction. We cannot cure it, but we can
manage it, often successfully, at a reasonable cost to society.

We in the PLNDP believe that when one considers the tens of billions that
our federal and state governments spend each year on drug control, we
should be getting better results. We should be applying principles of
scientific evidence to the various methods available to intervene in the
drug field - for primary prevention, secondary prevention, treatment, and
rehabilitation. Available evidence strongly suggests that emphasizing
source control, interdiction, and domestic enforcement - methods that
account for 75 percent of drug control spending - is a very inefficient
strategy. It is clear that the government is throwing large amounts of
taxpayer money away each year. We don't have all the answers yet, but we
do know that proven treatment methods offer a more cost-effective alternative.

Drug law enforcement has a place, but not necessarily the premier place,
because the evidence does not support that approach. Now that the U.S.
military (of which I was a loyal full-time member for 11 years) has run out
of real wars to fight, it is getting involved in phony wars on marijuana
fields in Mexico and coca fields in Bolivia. Let's stop playing drug war
games. They are no longer entertaining, and they don't work.

(continues)