OUR SUBSTANCE ABUSE POLICY DOESN'T ADD UP

I don't usually like to throw a bunch of numbers at readers because
their eyes tend to glaze over and their attention wanders, but in
this case the numbers are striking and important. So bear with me.

. In 2005 (all numbers are from 2005), federal, state and local
governments spent a total of $468 billion on substance abuse and
addiction. That broke down thusly: federal, $238 billion; state, $136
billion; local, $94 billion.

. Of every one of those dollars, 95.6 cents went to "shoveling up the
wreckage of illness, crime, homelessness and other social ills," says
Joseph A. Califano Jr., former U.S. secretary of health and current
chairman of the Center on Addiction and Substance Abuse at Columbia University.

Califano regards these numbers as "a searing indictment of the
policies of government at every level, governments that spend
virtually all the funds in this area to shovel up the human and
economic wreckage of substance abuse and addiction and little or
nothing to prevent and treat it."

He is correct, not that anyone seems to be listening. Califano
presented the results of CASA's latest report at a press conference
in Washington, D.C., on May 28. I stumbled across live TV coverage of
that press conference on C-SPAN. When Califano finished his
presentation, he asked the smattering of reporters if there were any
questions. After a few uncomfortable moments of silence, he thanked
them for their time (if not their attention to their professional
responsibilities) and left.

Well, if the national press corps is oblivious to the massive
misspending of public money, should it be any surprise that the
politicians who decide how to spend those dollars are also clueless?

In one sense, the CASA report isn't new. We already knew that
substance abuse imposed a heavy financial burden on American society
and, in rare moments of honesty, some have even admitted that the
"war on drugs" had been lost. But CASA went further in estimating the
cost of the "war" by looking at items buried in government budgets,
things such as health care, incarceration, child welfare, criminal,
juvenile and family courts, domestic violence, child abuse,
homelessness, mental illness and developmental disabilities.

Professionals who work in those fields know the profound impact of
the abuse of alcohol, tobacco and drugs on their work. In 2006, Nora
Volkow, director of the National Institute on Drug Abuse, urged more
treatment of addicts to cut the crime rate. She noted numerous
studies that showed treatment cut drug abuse significantly and
reduced criminal activity "by as much as 80 percent." As anyone who
has dealt with addicts knows, lectures and jail time don't
necessarily change the working of the addict's brain. Comprehensive
treatment can.

The problem remains society's refusal to treat addiction as the
disease it has been labeled by the medical and scientific community.
Cost is a factor, but as Volkow said, "Some reject the concept of
addiction as a disease on the grounds that it removes responsibility
from the addict. But in fact, it gives the addicted person the
responsibility for seeking and maintaining treatment for the disease,
just as is the case for other diseases." That's true. And in true
recovery, the addict is expected to assume responsibility for his
behavior -- past, present and future.

But addiction can't be conquered by the addict alone. Society has a
major stake in helping out. In New York, there may be signs of that
happening. Following up on repeal of the notorious Rockefeller Drug
Laws, which filled state prisons with thousands of low-level drug
users, Gov. David Paterson in April created a collaborative of state,
nonprofit and private sector agencies to find "new ways" to look at
how addictions impact public systems. It looks as if CASA may have
saved the collaborative a lot of work.

The collaborative is supposed to also come up with more efficient
ways to organize resources and strategies to "treat the entire range
of problems, not just the addiction," as Karen M. Carpenter,
commissioner of the Office of Alcoholism and Substance Abuse, put it.

Sounds good. But when this study is done, the public needs to pay
attention to it. Make sure it's not just a bureaucratic reshuffling
of money to the same old strategies. Insist that politicians
understand the true economic and social costs of this health issue
and that they start dealing with it that way.

If we treat addiction as a health issue, not a moral issue, we stand
a much better chance of lessening its grip.