THE DRUG WAR

Group Targets Cutting Abuse by Youth

In On the Penitentiary System in the United States and Its Application
in France, the work that originally brought Alexis de Tocqueville to
America, he asks, "What is the principal object of punishment in
relation to him who suffers it?" His answer: "It is to give him the
habits of society, and first to teach him to obey."

If this is the ethos of the American criminal justice system, it may
explain why drug addicts are usually classified as criminals and put
in prison until they can be expected to have acquired the habits of
society and learned to obey. According to the Physician Leadership on
National Drug Policy (PLNDP), it also betrays a fundamental
misunderstanding of the "personal nature of addiction" and highlights
what has proven to be a misguided belief in the effectiveness of
incarceration to reform drug addicts.

Kathryn Cates-Wessel is the associate director of PLNDP, started in
1997 at Brown's Center for Alcohol and Addiction Studies.
Cates-Wessel, 45, believes that most people understand that "tough on
crime" approaches to drug addiction don't work. But while public
opinion is shifting, getting politicians to support treatment measures
remains difficult for other reasons. "One of the biggest obstacles
involved is the stigma," she says. "People just don't feel comfortable
dealing with addicts."

Recasting addiction as a medical problem is an integral part of the
mission of PLNDP, a nonprofit, nonpartisan group. Its most recent
report, about adolescent substance abuse, came out in October and
recommends more rehabilitation options and increased use of treatment
programs in juvenile detention centers. The report was distributed to
every state governor and member of Congress.

To change the prevailing dynamic, PLNDP avoids the decriminalization
talk common among many advocacy groups, focusing instead on the
plethora of economic evidence that medical treatment is more effective
and less costly than incarceration. This argument could be especially
effective given widespread state and national budget deficits.

For now, though, PLNDP has found that the Office of National Drug
Control Policy spent 49 percent of its $19.2 billion budget on
domestic law enforcement in fiscal 2003, with the rest divvied up
between prevention, treatment, interdiction, research, and
international projects. Another study in the report finds that
incarcerating a drug addict costs the government $39,600 per year,
while residential treatment costs $12,467 and improves the chances
that a drug addict will not reenter the criminal justice system.

The problem is, if not worse, less visible with adolescents. According
to Cate-Wessel, the primary referral source for treatment for kids is
the juvenile justice system. "Adolescents tend to have less
dependency, tend more toward binging," she says. There are critical
junctures in an adolescent's development when normal recreational use
can turn into abuse -- times when prevention and treatment can prevent
the development of addiction. PLNDP recommends periodic screenings for
mental and substance abuse, so that fewer adolescents find help only
after they are in a detention center.

So far, PLNDP has focused on the state and national levels. On Friday, July
18, the group is co-sponsoring its first Providence event, an
interdisciplinary workshop called, "Adolescent Substance Abuse and Mental
Health Care: A Public Health Priority." As Cate-Wessel puts it, the
workshop represents the "translation of policy to practice."