June 25, 2018
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Violence, drugs in Mexico

It is a stunning juxtaposition of numbers — Americans make up 5 percent of the world’s population, yet we consume two-thirds of the world’s illegal drugs. That statistic was thrust into the face of U.S. policymakers last week after Mexican President Felipe Calderon addressed the rampant drug violence in his country. The origin of Mexico’s problem, the Mexican president noted in a newspaper opinion piece, lies with the world’s biggest drug addict next door.

If concern for Mexicans were not enough reason to confront this appalling truth, concern for the health and productivity of our own people ought to generate action. Above all, drug addiction and abuse is a health problem and the terms by which it is addressed must reflect that fact.

Joseph Califano, chairman of the National Center on Addiction and Substance Abuse at Columbia University and former secretary of Health, Education and Welfare, told National Public Radio last week that the federal government’s 40-year-old “war on drugs” is spending its resources unwisely.

“The rhetoric of the administration is good, but the dollars haven’t changed,” Mr. Califano said. “ We’re still putting roughly two-thirds into interdiction and enforcement, and one-third into treatment and prevention.” Yet when President Richard Nixon first launched the war on drugs, Mr. Califano said, “his first budget was two-thirds for prevention and treatment, and one-third for interdiction.”

Adding options like drug court, in which nonviolent users plead guilty to possession in exchange for avoiding jail time, then beginning treatment and counseling, are promising approaches. But not nearly enough users are getting that treatment and counseling. A logical place to begin treatment and counseling, Mr. Califano said, is with those now in jail and prison. He said 65 percent of the people now incarcerated “meet the medical criteria for drug or alcohol abuse and addiction. That’s a wonderful — in a sense — captive audience.” Currently, just one in 10 who need treatment get it in jail or prison.

Another population to target, according to Mr. Califano, is those receiving Medicaid benefits. He said 30 percent have drug and alcohol problems. Some have said those receiving such government social services should have to prove they are drug-free to continue getting benefits. A better approach would be to offer substance abuse counseling as a step toward a more meaningful life.

With California considering in November a referendum that would essentially legalize recreational marijuana, it might seem like time to wave the white flag of surrender in the war on drugs. But in fact, a sensible and reality-based policy should be based on distinguishing between casual use and addiction, and it should begin with education.

Mr. Califano compares drugs to AIDS. “AIDS was a social curse. In a matter of three years, the medical profession and the public health profession educated this country to the fact that it was a disease,” he said, and behaviors changed.

The American appetite for drugs will never disappear, but if the number of abusers can be limited, consumption will decline.

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