The Chairman’s Corner

The question of “would we send our child to a classroom and or school building infected with asbestos” illustrated to me how complacent and or desensitized we have become to the problems of drugs and gangs in our schools and community. What does a family do that can’t afford private school? I don’t believe public education is a loss cause. The data presented here is as loud and as startling as a severe weather horn. Now that the alarm has been sounded - it is our responsibility to move to safety. Our public schools need to be drug and gang free.

Joe Califano is 100 percent right! His perceptive message should be mandatory reading for all school authorities who currently are being brainwashed by the false messages of professional drug legalization lobbyists who dominate the internet and media coverage of school drug/violence issues.

In addition to being excellent documentation of current school drug problems, Mr. Califano’s article provides the perfect introduction for two other recent drug prevention documents that together provide the key for how to end this nation’s long-term schoolchild drug health crisis:

1. The U.S. drug czar office’s 2010 National Drug Control Strategy categorically confirming that the nation’s drug crisis is a national health issue and that drug abuse/addiction is a treatable disease that needs to be addressed by public health strategies.

2. The U.S. Education Department’s new study confirming the effectiveness of Random Student Drug Testing as an effective school health-protection program for deterring, preventing and treating schoolchild drug/alcohol abuse.

Teen drug abuse often is the starting point for addiction leading to the massive problems Mr. Califano cites, and often concluding as one of nearly 3,000 drug-induced (mostly overdose) U.S. deaths MONTHLY as documented by the most recent CDC mortality report.

Parents can help protect their children by forwarding these combined messages to their local school officials and demanding changes in current failing school drug prevention policies that are continuing to perpetuate this preventable health crisis among their community’s schoolchildren.

Thanks to the patriotic leadership of Joe Califano and his CASA staff for jerking the cover off one of the most shameful failures of public officials in the history of mankind; the massive betrayal of parents and their kids to the benefit of the drug traffickers by turning a blind eye to the preventable conditions cited by Mr. Califano.

Timing is everything, and parents need to take charge. Parents need to do their job and protect their teens from themselves. Be vigilant, be clear that you will not tolerate any drug abuse, and strong, that you will do what is necessary to prevent it.
Parents, even divorced parents, need to stand together to protect the child. If one parent suspects a problem, both parents need to act together, united for the sake of their child. They could be on the cusp of addiction.

To “cure” the addiction to tobacco products, as a nation we have focussed on the initial factor: stop smoking. This was done through a massive campaign publicizing the harmful effects of smoking and raising taxes on cigarettes, cigars, etc. to reduce their availability. What have we done to treat the potentially harmful effects of sex addiction? There is little need to describe the results. In addition to the basic human drive, our culture has glamorized the right to behave with little or no restrictions. The causes are several. Increasingly, movies, magazines, TV programs, newspapers, and other media that depend on paying customers, advertise and dramatise the joy of largely uninhibited sexual practices. In this way, there is an “entertainment world” that depends on the theme of sex to succeed. Young people are thus heavily influenced. A resolution I introduced to the United Church of Christ in 1993 which was passed, called attention to the hazards of substance abuse to personal, social, economic, health and moral conditions. It also described actions to counter the growing presence of factors which encourage substance abuse, particularly to young people. The coorelation of substance abuse and sexual “abuse” was clear. Unfortunately, other than a couple of written statements, no actual steps were taken to implement the resolution. Apart from this negative situation and without any further reference to sex, I feel that CASA and other organizations concerned with human health should concentrate on methods to PREVENT substance abuse as a primary action rather than on actions to treat addiction. One further comment: Where would we be if the medical profession over the ages disregarded methods to prevent diseases and instead only promoted ways to ameliorate pain?

Thank you.

Stigma means different things to different people. Making all or most substance use problems a disease rather than being “bad” or immoral behavior may remove the stigma for some but not all. I think it has helped many to seek out treatment where they might not have if was still seen as immoral. However for other people being labeled “sick”, “ill” or “dysfunctional” is still not without its own stigma and risks. Who really wants to be labeled as sick?

Less than 10% of those with substance use problems get treatment. Most have to be mandated to get help. Why is that? What does this say about the value of what we have to offer? Cost is a huge factor that we all know and resources are becoming more scarce by the minute. On another note when consumers were polled about why they wouldn’t seek therapy surprisingly “stigma” is not at the top of the list. The number one reason given why people who do not seek treatment is that they do not believe it will work for them: it’s ineffective! We the Treatment Professionals have a credibility and a cost problem more than we have a stigma problem. But still if services were non-stigmatizing (no negative labels applied and no iatrogenic effects) and we treated people with the same dignity, respect and welcoming attitude that any person deserves and if it were available (affordable) to everyone who wants it then we might be able to act like we are better than the medical profession at getting people the help they need and want!

Spot-on to these comments about public health and the medical profession. However there is another colony of culprits out there impeding appropriate public health policies and services. That “colony” is our state and federal governments that refuse to provide appropriate public health funding for dealing with the downsides from the sale of tobacco, alcohol and prescription drugs. They are the only ones with the “deep pockets” for addressing this issue.

Unless another Bill Gates who is championing AIDS prevention and treatment willing to take on tobacco, alcohol and the pharmaceutical industries emerges our government has the responsibility. With the billions governments collects from taxing these products there is no excuse for not diverting some of these tax revenues to the public health programs and services charged with the responsibility for reducing the harmful consequences from their use. Thankfully there are some public health advocates trying to turn this around. Thank you Joseph A. Califano, Jr.

Yes, we are still in the Puritan age when it comes to stigma of addiction. However, doctors are as responsible for creating addiction as anyone — doctors who give out opiate pain killers like candy, doctors who prescribe benzodiazepines for longer than their standardized use of 3 months. There is a movement afoot to have all PCP’s ask their patients about substance use/misuse. I say, physicans, heal thyselves! Don’t be hypocrites. Look to your own practice standards first before trying to target your patients.

I have worked in the addiction field for thirty years. What continues to amaze me is the education and information medical and other treatment professionals lack about alcoholism and drug addiction.
Many mental health professionals still see addiction as a symptom of a larger underlying problem. And physicians get little, if any training in addictions.
Last week I was visiting a friend in the hospital and overheard a doctor speaking to a few nurses about a newly admitted patient who was being detoxed from alcohol. She described the medication protocol and how long it would take for the patient’s delerium tremons to abate. She asked them to come to her for any further help because “the other doctor on the floor knows nothing about alcoholism.” That patient was lucky to have a doctor who knew what she was doing.
I have been to several of the educational programs at CASA and each one was excellent. I applaud your committement to educate professionals with cutting edge research and application.

I’m not sure I completely accept addiction as a disease as much as it is a self-medicating behavior indicating a deeper condition like depression. Still, the omnipresence of relapse indicates a chronic condition that many studies have shown can be successfully treated in the manner of other chronic health conditions. Problem is we do not punish people who relapse on their diabetic regimens or send hyper-intensive people to prison for relapsing in their use of salt and causing severe hyper-tension. If we truly want to treat addiction, illicit drug addiction, as a chronic health issue we would have to decriminalize possession of those substances for personal use. We would also need to accept different outcomes from our treatment protocols and accept that successful treatment does not have to be a perfect recovery but also one that includes moderate and responsible use of some substances.

I agree with Raymond, We need a holistic approach to treatment and health care. Unfortunately, our ins. companies don’t lean that way and they are driving the policy. We have too many specialists and not enough GPs and family doctors. I had wonderful health care till I got married and was pushed out into the military CHAMPUS system which operated like an HMO. I didn’t get care unless it was an emergency or I was pregnant.

We will never cure addiction (unless we become computerized droids), because all humans are predisposed to always want that feel good fix. Our social structure also promotes the “always have to feel good” personality. We must teach that it is OK to be sad, upset, and yes even sometimes depressed. A good cry is better than a lot of pills or alcohol.

Response to Chairman Califano.

I couldn’t agree more. My comments come from my experience as a clinical psychologist and personal tragedies. Generally — certainly not across the board — clinicians are very poorly informed about this disease and there is not enough of an effort to education clinicians about it. In my opinion all clinicians should be required to study substance use/ abuse addiction in graduate school as part of their training — even if they are not specialists. That is definitely not the case. Even among the very knowledgeable I have never attended a conference organized by psychologists or social workers in which policy is included in the discussion and analysis. (That has been for me one of the most important aspects of CASA meetings). The attention is not to prevention or to understanding how the substances affect the pathology or mental well being of ones clients but rather how pathology leads individuals to engage in substance use. It strikes me as a limited and skewed view, not particularly useful and often inaccurate. Often, the study of addiction and substance use is not sufficiently valued; there is a kind of class structure. The work of the addiction counselors is not as highly esteem as the work of many others such as the psychologists and social workers. These attitudes affect the delivery of care to patients. How often is a patient told when they seek therapy that the clinician will discuss their conflicts but they must attend an AA meeting or see a drug counselor for the other part? I’m not debating the value of an AA meeting (although the options should be much wider), but a clinician must be able to hear the whole story and treat all parts of the problem. Sending people away simply reifies the shame and hiding. I think the shame of the disease is reflected in the entire profession — what people study, what is valued, who is valued and ultimately who is served and how.

Are you opposed to marijuana legalization, or the manner in which New York is attempting to achieve it?
I don’t believe your laetrile analogy is applicable here, as we already know the use of marijuana is not useless.

Your harsh words make me believe that you are against the legalization of marijuana for medicinal purposes. I hope that you are mischaracterizing your feelings on this.

My husband, Lenny, recently passed away. During his bout with cancer, the only thing that staved off his nausea, assisted him in having an appetite, and made it possible for him to eat was marijuana that he smoked. We talked to his cancer physician about Marisol, but he was clear in saying that smoking marijuana produced a better result than Marisol, if one had access to marijuana. Lenny started out weighing 315 lbs. When he died, he weighed under 200 lbs. If he hadn’t smoked marijuana, he would have lost much more weight. He didn’t die of cancer, he died of unconsciounable medical ineptness - literally dying of sepsis and acute appendicitis after 4 days of “care” in a Florida hospital. I’m sure he lost more weight there because they virtually starved him — not giving he food he could eat and not feeding him via his vein. He could have benefited from marijuana on those last days to help him with the pain they never treated and the food he couldn’t ever tolerate.

Please don’t be against medical marijuana — instead of launching a tirade against the bill, launch a “fix” for the bill so that it is possible for those who need medical marijuana to have access to it.

I agree that medical marijuana should not be legalized without all the appropriate safeguards taken. However, to date both in the USA and here, in Canada, our punitive laws toward drug users have done absolutely nothing to impede the use of all drugs, including marijuana. For medical use, it seems to me that doctors should properly assess the patient and his/her need for that particular drug and then prescribe it, if necessary, through the proper channel. Why, if it is an appropriate drug, is it not dispensed in pharmacies, like all other medications? Clearly, the use of medical marijuana is most desired by those who already use it for recreation and there is a significant blurring of its efficacy for pain and other symptoms. If nothing else, this proposed legislation should encourage intelligent discussion of the “drug problem” which, to date, is growing worse with the current regime.

Your stand against medical cannabis is outdated and unfounded. Cannabis is an ancient medicine and was a widely used medicine in the US until “reefer madness” propaganda got the Marihuana Tax Act of 1937 passed and essentially got it removed from the U.S. Pharmacopoeia. New discoveries of the human endogenous cannabinboid system (ECS) help explain why cannabis is safe and effective for a wide array of indications. In fact, in the past and today cannabis has been helpful in getting persons off more dangerous drugs such as opioids, alcohol, tobacco, and cocaine. I urge you to open your mind to the fact that we have been denied a valuable medicine for more than 70 years - and this prohibition was based on lies, racism, and greed. Please go to http://www.medicalcannabis.com and learn about the research. How do you argue against an herbal medicine that has been used for centuries with therapeutic results and is safer than most medications available today, when patients are allowed the option of using very toxic chemotherapy to fight cancer? Shouldn’t patients have a choice and doesn’t it make sense to allow them this safe one?
I agree with others that the NY bill can be improved - the legislators could look at the RI or NM laws, which are working well and continually being refined. I believe patients should be able to grow their own, but most patients are not necessarily good gardeners. Many patients will need a supply, and I agree with you that the dispensaries should be required to test their cannabis for contamination as well as content.
Unfortunately the press picks up on all of the problems in CA, but dismisses what is working. There are many dispensaries serving the local patients that are very well respected in the community. In fact, local testing in Oakland found that indeed much of the cannabis available was high in THC (the primary psychoactive cannabinoid), but very low in CBD (a non-psychoactive cannabinoid, but with many therapeutic benefits). So this dispensary is working on developing strains higher in CBD (which by the way, helps to mitigate the “high” from the THC).
You state a concern that allowing patients this medicine will put us on a slippery slope towards legalization. That is a separate issue, but it should be addressed. We need to stop treating cannabis as though it were a dangerous drug when you don’t have the carnage you see with other drugs such as alcohol and tobacco. The science says it is a remarkably safe drug. It is a travesty that because of the current prohibition we are willing to lock up individuals simply for growing or using this plant. Whatever happened to our freedom to life, liberty and the pursuit of happiness? Our government should only be concerned if we do harm to others in our pursuit of happiness. For those few who choose to use cannabis and develop an addiction problem, they should be able to get treatment. However, for the patients and yes, even for Joe and Jane Citizen, the social users, the decision to use cannabis should be their own decision - the world will not fall apart. Again, most of your concerns/fears are based on the unjust and unfounded reefer madness lies. It’s time to learn about the science behind this wonderful plant.

The Chairman would support medical marijuana if only it obtained Food and Drug Administration (FDA) approval. This sounds good, but it is really an impossible and unnecessary precondition, no closer to being obtained now than it was in the 1960’s.

It takes hundreds of millions of dollars to get a drug through the current FDA approval process. Pharmaceutical companies spend this kind of money with the expectation that they will be able to patent new drugs and charge exorbitant prices for them. But no one can patent all the different strains of marijuana—it grows wild, and is cultivated, in all 50 states. No company can expect to recoup its expenses after conducting the type of trials of marijuana that the FDA currently considers standard for newly developed drugs. Nor should this be necessary. Marijuana is not a newly developed drug. Marijuana has been used medicinally for thousands of years and was included in the U.S. Pharmacopoeia until the 1940’s.

Even if some non-profit medical center or university was inclined to spend the millions of dollars to obtain FDA approval, the Drug Enforcement Agency (DEA) has been obstructing, and continues to obstruct, scientific research in this area. For the past nine years the University of Massachusetts at Amherst has been suing the DEA to allow it to grow its own marijuana to conduct clinical trials. The DEA refuses to allow anyone but itself to legally grow marijuana even for research or compassionate use programs. With very few exceptions, independent clinical trials of marijuana’s medical benefits simply cannot get done here in America.

Look at New Jersey. In 1981, the New Jersey legislature unanimously passed into law the “Dangerous Substances Therapeutic Research Act.” This law was designed to protect New Jersey patients who were engaged in clinical trials of marijuana. In 29 years not a single New Jersey resident has been able to take part in a clinical trial of medical marijuana. In fact, no clinical trial of medical marijuana has ever taken place in New Jersey. The National Academy of Sciences’ 1999 Institute of Medicine report, which recommended immediate access to clinical trials of marijuana, called the DEA’s death grip on marijuana “a daunting thicket of regulations to be negotiated at the federal level.”

There is only one federal study of medical marijuana currently being done—one, in the entire country–and it has been closed to new applicants since 1992. There are only a few patients still involved in this Investigational New Drug (IND) study. Every month, the federal government sends these patients 300 marijuana cigarettes that they smoke at the rate of ten per day. They have been doing so for over 20 years. In all that time the federal government has never once asked these patients how they are doing. It fell to a private organization, Patients Out of Time, to gather these patients together and study them. Patients Out of Time found that none of the IND patients suffered any adverse effects from marijuana, their conditions were all under control, and marijuana was the only therapeutic agent they were using. The federal government simply does not want to know how effective marijuana is—reality would clash too greatly with its preconceived notions that marijuana has no recognized medical uses and is unsafe for use even under medical supervision.

Your arguments in opposition to medical use of marijuana are simply at variance with the scientific evidence and expert consensus.

From myriad examples;

The American College of Physicians (124,000 members)
Position paper, 2008, at http://drugsense.org/url/RTJp0V7l

“A clear discord exists between the scientific community and federal legal and regulatory agencies over the medicinal value of marijuana … ”

“ACP urges review of marijuana’s status as a Schedule I controlled substance and its reclassification into a more appropriate schedule … ”
———————————————————-
Dr. George Lundberg, editor-in-chief of JAMA from 1982 to 1999, Medscape editorial August 2005 at http://dpft.org/marijuana.htm)

“For many decades, marijuana has been the American poster child for how not to deal with a troubling psychoactive substance.”

“Although far from harmless by toxicological or pathologic criteria, marijuana is much less dangerous than many other substances in less restrictive schedules, like morphine and cocaine, not to mention the unscheduled legal mass killers tobacco and alcohol.”

“Of course, marijuana does have proven medical usefulness for some conditions,” ( citing the New England Journal of Medicine)

“In fact, enforcement of unrealistic laws regarding marijuana has probably caused more harm than marijuana itself.

“People obey laws they believe to be just; they do not obey the marijuana laws because they know they are unjust, even absurd.”
————————————————-
Legalization is a red herring. While I favor regulation - which transfers control from cartels to us - it is a separate issue. Your argument was rejected by the Institute of Medicine in 1999. (http://www.nap.edu/openbook.php?record_id=6376) It was further noted by IOM that such speculation is not a proper ethical consideration for medical decisions. Now the data shows that the first 11 states to legalize medical use did not see a consequent increase in general use just as IOM predicted it would not; all that has happened is that less than two percent of their populations now get marijuana from a legal source rather than funding the cartels.

Please reconsider.

I have read a few other blogs related to this subject in the past few days in doing a research report for school. I have to say that what you’re saying here makes perfect sense and is helping me to get my head around this subject. Do you have any other places you could recommend to help my research?

Thanks,

Chiropractor

Chiropractor Myrtle Beach

I totally agree with you! For the 9 years I was Chief Probation Officer in San Mateo County (just south of San Francisco) 75% of all the juveniles and adults on probation had substance abuse problems.

Of all the Americans in jail and prison in the U.S. a very high percentage (approximately 65%-75%) of them also have addiction problems.

I recently lost my only 22 year old son to a heroin overdose. My heart is broken and my world collapsed. He was a fine and sensitive young man who wrote poetry.

I am in agreement to march on Washington, anything I can do, just let me know. We are totally mishandling or not handling the addiction problem in this country.

This article is, unfortunately, not a revelation, and in fact somewhat understated if one admits that the drug tobacco kills one half a million in the USA and the President puts two tobacco executives on the FDA tobacco control panel.
The much touted “War on Drugs” is following the same path as every other war we have participated in since World War !!, we loose!
One might suggest the, may I say obvious, starting point by assessing what in our society is lacking that so many seek escape and or surcease through substances. I might also point out that instead of seeking answers to the problem, we just lock people up, stock pile them and brand them as, “Less than”.
Part of the problem is money, that is another discussion, the other part is poverty and education. as A simple solution, beginning simple solution rather, parental education on how to raise a mentally healthy child? What about drug dependent adults having children, good idea and if not, how to stop it?
A little food for thought,
Regards,
Barry

An addendum please. To blame the drug problem or the lack of a solution to the drug problem at the feet of the President is pure sophistry, clean and simple. let’s keep politics on a separate page and call it like it is, please.
Sincerely,
Barry McMillen

Nice analogy. It would be nice if our political leaders would take on the drug addiction problem with the same zeal as the oil addiction problem. I believe part of the problem lies in how to address the drug addiction problem. The moral control patrol, many of whom are legislators and religion leaders, simply want to pass laws against using psychoactive substances for anything other than health care purposes. With there zeal to prevent anybody from using psychoactive substances for recreational or pleasurable purposes, as well as health care purposes, they do not have the support from large segments of the population. Also, the government’s support of the pleasure & personal choice prohibition mentality has been the 70/30 ratio of law enforcement/interdiction vs prevention & treatment. And we’ve seen how well this prohibition/law enforcement/ criminalizing approach works since the implementation of the Harrison Act in 1914 in this country!
Until we allow people to self-medicate and self-recreate and support a 100% government & private priority for drug prevention and treatment , which includes funding support, we will continue this murky substance abuse mess that well exceeds any oil spill mess.

addedumn

PLEASE DONT BLAME OBAMA FOR THE DRUG DRAMA

We live in a society that makes decisions and forms beliefs around things that give pleasure. Whether it is watching athletes making multi-millions to play games, shopping for a suit or new shoes to supplement our wardrobe, sipping coffee that is produced at the expense of depleting lands of impoverished countries or using a mood altering substance that releases chemicals in the brain to make us feel good instead of engaging in healthy behaviors that will give the same effect…it all amounts to the same things…skewed and misplaced values. Without values we will continue to pursue life, libertiy and happiness without thinking about the consequences of our behaviors and looking at the long term effects on our families, our ecology and our world. We have a long way to go before we get to where we can thrive and survive as a civilized people, but I am an eternal optimist and believe that I can make a difference one person at a time. The president and other people like yourself can point out the discrepancies, but it is up to me as an idividual to beginning making changes.

Respectfully, sir, it’s not going to happen — at least not in my lifetime or yours. Americans are too busy either stigmatizing or glamourizing addiction to put stopping it in the forefront of public policy. Too many Americans are addicted to the so-called “legal” drugs of nicotine, alcohol and xanax, who will never admit it, or consider their use inappropriate.
Cigarettes need to be illegal — period. Primary care physicians need to be banned from prescribing xanax and other benzodiazepines for longer than their intended use — and then prosecuted if they do. Bars and other alcohol providers need to be more strictly policed to control under-age and other inappropriate alcohol use.
“NIMBY-ism” is rife in upper and middle-class America today. Addicted persons who want to get help often can’t because of a lack of clean, well-run treatment and sober living facilities.
You want to talk about “chump change?” Respectfully, sir, many of the people at the policy level earn much, much more than those of us on the “front lines” of treatment. Do any of you have any idea of how much the average public sector substance abuse worker is paid? Nurses and teacher finally got the respect and pay they so justly deserve. Why not accord the same pay and respect to substance abuse counselors?
Addiction’s power will not lessen until Americans deem it a disease worth their while to fight as hard as we currently fight cancer. Even if a person exposes himself to the sun, we don’t blame him for developing skin cancer the way we blame substance users for developing addiction. We will not make a dent in the “frightful” occurrence of addiction until education about it is as valued as math, science and social studies are — rather than being allocated to the occasional assembly with a DARE-trained cop.
You, sir, appear to be forgetting one of the basic laws of our Western culture, that of supply and demand. As long as the disease of addiction is allowed to flourish due to prudish and outmoded cultural attitues, inadequate research, treatment and sober living funding and availability, there will be a demand that no amount of laws or blockades will be able to quash.

The coach should be fired! All schools need firm rules about substance abuse. Sports celebrities should be held to the highest scrutiny. Instead they are given free reign and are untouchable when it comes to discipline. As long as the team is winning and the money is coming in all is oK. After all, that’s what sports is all about now - the $. Forget about good character, team building, and good sportsmanship, say what?. I see the same thing in High Schools. It’s all about the fame and fortune.

Nothing has been said about the alcohol and team binging in the press. Your alcohol beverage industry $ at work?

UVA has had an alcohol problem for a long time. My daughter graduated from a VA college 10 years ago (not UVA, thankfully) and there was a problem then.

Some colleges are stiffening the rules about substance abuse. I would be interested to know if it is only the ones who don’t get a lot of corporate funding.

We in the field are working and living on table scraps.However, communities have got to take ownership.Start embracing treatment and transition centers rather than resisting. You would be Churches,Civic Organizations, business, and individuals.Get these people out of prisons and hospitals. Residency in Treatment/transition centers is 30% less dollars and by living in a ChemFree environment many can pay their own way and save money. We are our Neighbors keepers. Then we will have a lobby!

As the Clincial Coordinator for the Eastern District of New York Probation and Parole Department, we see the tragic effects of addiction on offenders and their families. There are also collateral effects in addition to the well known poor health, arrest, homelessness, poor parenting. Most people do not realize the enormous opportunities that are lost forever when one has a serious criminal record. Jobs, careers, licenses etc that are no longer viable options. When an addict or alcoholic wakes up to the wreakage of their lives, they find they are unemployable on top of everything else. If you want to find the way from a middle or working class lifestyle to poverty, and do it with luge run speed, then amass a couple of arrests on top of your addiction.
While we all work hard to assist offenders to reach whatever potential they have left, there is not enough affordable, good quality treatment.
Bravo for a thoughtful and informative blog.

Nice analogy but the rest of the big picture might provide an unbiased perspective. First legal beverage, second vital part of our economy… Third-jobs, and more jobs are directly related to the beer industry…incomes that help families survive, tuition’s paid, and communities gain from the profits. Granted cutting the tax is absurd at best…in fact it should increase in direct proportion to the cost of living index, and inflation…but this “drug” use by teens is clearly in direct correlation to the lack of prevention resources allocated by Congress, and the limp parenting that exists.

Looking at Congress in a wholistic manner at it relates to a myriad of waste might be the way to redirect resources to help everyone understand the real ins and outs of being wasted! Better understanding and more resources for prevention, treatment, and recovery.
Nice pointing out the hypocrisy but maybe it is really members being truly uninformed as there plates over flow… many members may note have read the bill! “Maybe if they sit down and have a beer and discuss it they could figure it out”, leadership said. Common sense and education is the mother of responsible use, at a legal age, and for a life time. Hats off to the teens that get that…they are our hope. Thanks for helping to make people think. Best to you.

There are many such ridiculous stories. In our little town the town councillor for health is in private a tabacco farmer who gets subventions for his tobacco from the federal state. The same state gets taxes on tobacco and makes prevention for smokers. In the national parliament the coucillor was just active in the debate which ended in a bill allowing alcohol advertising for beer and wine at Swiss television, which was so far always banned since the beginning of tv.

I am a Certified /License Addictiion Sp. at 80 years old active
Recovering alcoholic, still AA member
I wonder what Bill W and Dr. Bob would say about the taxes
The way we see it in the field, they are getting younger, using more alcohol, the Government makes it easeier/they make the youngeralcoholic, drunk drivers/ My last session Client asked “why do they do they make the stuff, if its bad”

When a special interest group or, a self interest group, lobbies they are exercising their right and should be allowed to do so. However we need to remind each other that they are motivated by self interest and that their perspective has self limited value. Yes, beer is legal, entrenched and keeps people employed in making a product that many use socially and responsibly. But, the responsible and social drinker can easily cut back if the price is high. The alcoholic will, on the other hand, increase consumption by sacrificing anything - period. They only stop when they hit a bottom harsh enough to pierce their denial which will happen more readily if taxes keep the price up. Harsh; yes. True; also yes. What of jobs? If the taxes are not lowered jobs remain secure. If taxes are lowered then the product is more available and jobs increase but, at what price. Would it be like the price of making opiates, cocaine and crystal meth as legally available as beer? I don’t know and am interested in the opinion of anyone who logically disputes what I say but, I am very un-interested in the opinion of anyone who claims that something is a farce (or otherwise incorrect) without logical dispute.

Mr. Califano,

As a former CA Dept of Alcoholic Beverage Control officer, I’m now a consultant to beverage retailers here in CA. My focus is on risk assessment, policy development and responsible beverage service training… helping licensees sell alcohol safely, responsibly and legally.

When I told one of my former colleagues what I know do, he said, “So, you’ve gone to the OTHER SIDE!” I didn’t have a response at the time, but now I would respond, “No, I’m right in the middle of the road, where I can have an influence.”

By this I mean, I’m networking with those in the alcohol industry online and putting out responsible beverage service messages wherever I can–on my blog and on the groups I’ve joined on LinkedIn.

I think too often those involved in prevention stick together in a tightly-knit group and don’t attempt to get to know the manufacturers, distributors or retailers and see things from their perspective, and establish relationships–however deep–that can help them gain their trust.

Those working in prevention, including governments, need to do a better job of marketing their message, all the way down to good copywriting, and citing research to back up their messages. After all, the alcohol industry spends untold dollars in marketing.

Your blog is a great way to get your message out. I hope those involved in prevention will use, or increase their use of, effective online marketing strategies to get the message out about what the research says.

As an emergency physician for 30 years with a parallel career in addiction medicine I couldn’t agree more. And there is also the issue of access to qualified professionals and coverage for addiction care. In Massachusetts we are blessed that outpatient methadone is covered by Medicaid but inconsistently by private carriers. In Florida methadone is strictly a cash business. This lack of and inconsistency of coverage is a national disgrace. The American Society of Addiction Medicine coined the mantra, Treat Addiction/Save Lives. In the spectrum of American illness and injury nothing should be more important or morecost effective

I agree with increasing the taxes and regulation of alcohol and tobacco sharply and mounting a massive public campaign. But, raising the insurance cost for this patient group is discriminatory. Addiction is a disease – let’s don’t punish them for their ailment. Let’s spend more money to treat them (compare 46.7 billion to the amount spent in treating cardiovascular diseases). If that’s what is going to happen then lets break down the whole thing to over eating, poor life style, people not doing exercise, diabetics not sticking to their dietary advice etc. charge them more too. Let’s don’t forget that this cohort is disadvantaged in many ways and they have a tendency to drift socially and economically downwards. Increasing the cost would make the situation worse. Perhaps decreasing the cost of the insurance policy for this group might encourage them to seek help.

Increased tax on tobacco and alcohol sounds good. Perhaps considering ban on advertising these products would also do some good.

There is evidence (Fellitti study, ‘Adverse Childhood Experiences’) that childhood trauma, particularly sexual abuse, correlates to many self and other destructive behaviors. Smoking and other addictive behaviors are symptomatic of deeper wounds– criminal behavior. We would be wise to invest in the prevention of child sexual abuse and ending other violence, particularly domestic violence.

Long have we known that education was the golden path to a drug free life for our children and we haven’t done very well, have we?
Why?
It is not blame that will rescue our failing family systems. I do not believe a specific religeous doctine is the answer, check your history books on that idea. So what then?
Politics? Please, give me a break!
We the people of this country need to take our country back and toss out the money changers who profit from the addiction of our children. It is our, yes our, responsibility to seek help, learn how to deal with our own problems, share our vulnerability with our children and connect in positive communication that is based on unconditional positive regard for others. A big job! One that we can accomplish if we work together.
Oh, and put a big cap on the drug companies and government protected drug dealers, i.e. Tobacco Cartel.
Thank you for listening.

Chairman Joe, I beg to differ with your statement that Hillary got it right on blaming her fellow Americans for causing the mayhem in Mexico. You and I are both old enough to remember when the “feminists” complained that we should not blame the victim for the crime of rape by saying things like “she deserved it” or “she was wearing the wrong clothes or said the wrong thing, etc.” The feminists were right and, today, we hardly ever hear such insensitive and sexist remarks. Better still, we place the blame where it belongs: squarely on the shoulders of the criminal, not the victim. Hillary’s statement in Mexico the other day may have been an attempt by her to ingratiate herself with her hosts by parroting a common refrain offered by all leaders of drug producing countries to excuse their failure to deal effectively with their criminals. She fell for one of the world’s oldest canards. Indeed, at the 1909 Shanghai Opium Commission meeting, the British used pretty much the same excuse to justify their involvement in the Asian opium trade. Compared with most other developed nations in the world, our drug control policies have worked quite well to reduce drug-related morbidity and mortality. Instead of recognizing this, Hillary belittled the efforts and achievements of millions of her fellow Americans like you and me who are fighting every day in every way to keep our kids safe from drugs. Instead, she blamed us for causing the murderous criminals in Mexico and elsewhere who produce and smuggle drugs to our cities and towns. Maybe it was something we were wearing or said that provoked these international drug thugs. I agree with the rest of your analysis and I thank you and your colleagues at CASA for doing an otherwise fine job of telling it like it is (most of the time).

Excellent points of view, Barry. It does indeed start in the family system. This is why I fell head over heels for CASA. I will soon have earned my Bachelors degree in addiction counseling, and though I have a problem with the assembly line of treating addicts, CASA has given my hope with their ideas to help troubled youths and their families. Even with CASA, I still won’t be able to help a youth until they have had 8, 9, 10,? years with their family system. Plus, I’m leaning heavily towards the science of addiction. Unbelievable what is being discovered today. Oh, by the way, I really thought Mrs. Clinton would be a fresh outlook on my children’s future. However, she is married to Bill (Skull and Bones) Clinton. Seriously, think about it!

In over 25 presidential debates, no candidate from either party mentioned drug abuse as a national problem. Yet I would be willing to bet that the problem exists in many of the candidates’ own families.

The United States demands and consumes more illicit drugs per capita than any other nation. The human toll is compelling. A recent Gallop Poll reported that 1/3 of all Americans reported a loved one with an alcohol problem, ¼ had a loved one with a drug problem. Over half of all inmates in the correctional system were convicted of a drug offense. For the most understandable of reasons, Alcoholics Anonymous is based on creating a therapeutic “community” outside of easy visibility.

In our local schools here in western Massachusetts, surveys that ask about alcohol or pot reveal that more junior high and high school teens are regular users than the average nationally. By high school, 57% of students are using alcohol regularly and 39% are smoking pot. Our challenge is indeed close to home.

While many of these kids will mature out of their drug use, 10% to 15% will become addicted to alcohol, pot, or harder drugs. A recent study followed a group of teens for 10 years who either drank or smoked pot heavily. Researchers concluded that pot was “the drug of choice for life’s future losers,” with pot smokers 6 times more likely to use other drugs than those who drank alcohol, and 3 times more likely to be unemployed or drop out of school.

Drug use and addiction pierce into our fears too much. As parents, children, siblings or partners, we just close our eyes.

Take the sad story of the actor Heath Ledger, found dead in his Manhattan apartment this past January. His toxicology report measured shelves-worth of narcotics like oxycodone, mood effecting drugs, and hypnotics….all in the brain of an otherwise healthy 27-year-old. Like millions of Americans of all ages, Heath Ledger had a life-threatening and debilitating substance problem. Yet the media and his family chose to focus on the accidental nature of the overdose, presumably because the more likely explanation was simply too revealing and stigmatizing.

Heath Ledger died because others, friends or family, tried in vain to put an easy face on an ugly wound.

It seems beyond reason that despite all that molecular neuroscience reveals of the basic mechanisms of addiction, we continue to regard it largely as a personal failing meriting moral judgment and marginalization. Drug addiction has become a “brand,” not a diagnosis, with the label conveying more about the person than about brain chemistry.

Only a generation ago, cancer was a barely –spoken word: it predicted its own inevitable finality. Today, cancer survivors can celebrate advanced medical science and a compassionate society. Imagine a time when survivors of “addiction” are so welcome that families like Ledger’s embrace the truth at the earliest possible moment of diagnosis, optimistic that full remission is possible.

Substance abuse remains the true third rail of American political discourse. And when the problem is kept in the shadows, solutions are much harder to find.

As with most difficult problems, a missing ingredient is “will,” individual, local, and political. With it we can traverse the barriers of fear and shame. Parents, partners and other significant others can be taught how to modify day-to-day behaviors that can have a profound effect on their loved one’s addiction. It is through political will that treatment-on-demand will become a reality.

At the core though remains the stigma. There are no ribbons to wear, no marches to join, and no telethons to raise money. Stories about local kids who “ overdose “ or “ binge “ to death or run away into lives of risk and despair remain as frightening as looking through the microscope at a slide of our own cancer. With compassion, clarity and some courage, we can move drug addiction from a place of fear to the prospect of real progress.

Dominique Simon-Levine is the Director of Allies in Recovery, a center in Northampton, MA that provides family members of those with substance problems research-based trainings, resources, and support.

Dear Joe,

Secretary Clinton was right on target, and after 25 years of working on this subject it is music to my ears to hear an American government official tell the truth. But I’m wondering why you jump from this statement to the issue of our children. Sure it’s important to keep kids from misusing alcohol and illicit drugs, but let’s not blame our nation’s habits on our kids. They haven’t taught adults how to misuse drugs and their flow across the border won’t stop if kids stop demanding them. We adults are the root of the problem. And the problem lies in a group far larger than those who are addicted.

Fortunately, we now have an evidenced-based way to reduce this demand, which is driven not just by addicts but by people who occasionally use marijuana, cocaine, and prescription drugs the way they misuse alcohol. Screening, Brief Intervention, or Referral to Treatment (SBIRT) has not only been tested successfully in over 50 clinical trials, it has also been demonstrated in a huge, ongoing Federal program. It is the 21st century revolution in this field to reduce our adult and adolescent demand from misused substances. But we need CASA’s support for expanding its dissemination through many Federal agencies and within the healthcare reform process. So let’s get that support through your board room so it can get into medical practices and hence into everyone’s living rooms!

Great discussions, and on target for the most part. I think that Hillary was right in her statements that we, in USA are the responsible parties for the drug epidemic and trade across the borders.
As parents and community coalitions we must work together, supporting one another in education and parenting skills as Joseph Califano, Jr reported. It begins with the parents, who do have the most influence on their children (negative or positive).
My dad began smoking at 10 yrs of age, and smoked 2 to 3 packs when he came home from WWII. My two brothers and I began to swipe a cigarette or two from his pack when we were in grade school and he found the butts in the milk barn. He took us aside all together-age 12, 9 and 8 and told us his story about how he began smoking, and how he had tried several time to stop (without success). Among othe things, he said that if we wanted to smoke, we would need to sit in the house with our mother and/or with him present and we could smoke his cigarettes, but if he had to do it all over again, he never would have begun smoking. He did warn us that if he caught us sneaking a smoke elsewhere, he would “tan our hides”. None of the three of us ever smoked or used alcohol after that “father to son” talk we received that day.
I believe that parents do have the strongest influence. I also believe that communities can come together and with planning and assistance from trained professionals, and a task force which includes all sectors of the community, with support from schools, churches, city councils and concerned persons, lowering in the rising drug and alcohol use can be obtained. It is difficult work; it takes patience and persistance; it take cooperation from parents, who unfortunately are often the ones who supply prescription drugs and alcohol to their children and their children’s friends–sometimes unknowingly. Lack of supervision and too often easy access and ignorance or a false sense of trust (that their child would never do anything wrong), open the opportunity for abuse by teens and even those in elementery schools.
As a Minister of the United Methodist Church in a small community in Kansas, I am part of a “task force” - which is making progress, working together to reduce abuses in our community of 3600 people.
Thanks for the opportunity and the comments on this serious topic which we all need to pray can and will be brought under control for our next generation of children–my grandchildren.

The solution to our drug epidemic lies not “across kitchen tables” but ON kitchen tables. We are a malnourished nation in spite of our girth due to impoverished soil and daily diets of white flour, white sugar, fried almost-foods and precious few whole grains, fruits, seafood, and vegetables. Our adrenal glands are taxed to the max by incessant emotional and physical stress. According to Kenneth Blum, PhD, a pharmacogeneticist with pioneering research on the genetic link to alcoholism, about one third of all Americans are genetically deficient in the feel-good neurotransmitter dopamine, leading to the revolving door of our treatment facilities, prisons, and pharmacies. Talk therapy can no more cure or even treat neurotransmitter deficiency than a good counseling session can return a diabetic’s blood sugar to normal.
Some of the remaining two thirds of drug users are malnourished because their drug use led to nutrient-deficient meals or no meals at all. Others are not malnourished, just using as a part of their social system. They are the ones who can “Just Say No” and who respond so successfully to motivational interviewing, cognitive behavioral therapy, and all the excellent work of the counselors in our programs.
For the biochemically deficient, only biochemical restoration allows their minds to focus and to receive our best efforts at counseling. Restoration begins with wholesome food and is quickened with individualized nutritional supplements and acupuncture.
Stimulant users and the fatigued among us who can’t concentrate need the amino acid tyrosine to build more dopamine. People in emotional and physical pain need phenylalanine to maintain endorphins. People who are obsessive-compulsive, suffer panic attacks, nightmares, low self-esteem, afternoon cravings, and suicidal thoughts need tryptophan or 5HTP to produce more serotonin. And, people who are anxious and tense need GABA to produce more GABA.
Yet, even a cheap multivitamin makes a difference. Stephen Schoenthaler, PhD of California State University Stanislaus proved inmate violence and rule infractions reduced so dramatically within three days from a daily multivitamin-mineral that a $1 investment returned $1,000 in one month to the California Department of Corrections.
We will successfully empty our prisons of the parolees returning from blowing their parole due to drug use and produce productive, tax-paying, healthy citizens when we give every client who walks in our treatment program door a nourishing meal, food to take home every day, and nutritional supplements that match the biochemical need of the individual. That’s what the Sacramento County Probation Department is doing with its Drug Court and we saved our county $20 million our first ten years.
Anyone interested in learning more, come to a conference cosponsored by the State of California Department of Alcohol and Drug Programs and the nonprofit Community Addiction Recovery Assoc. (CARA) at the Hilton Sacramento Arden West Hotel April 17-19th 2009 in Sacramento. It’s called Brain Repair for Addictive Disorders: Cost-Effective, Successful, Drug-Free Therapies. All details at http://www.carasac.org/Conference/index.shtml or call 916-485-2272 or carolynreuben@carasac.org. You can read about nutritional restoration in The Mind Cure by Julia Ross, MFT or Seven Weeks to Sobriety by Joan Mathews Larson, PhD and books by other speakers at the conference.

Parents are the one’s who should be screaming for the regulation of cannabis. Regulation IS law and order. Prohibition is a free-for-all. We should have learned that by now.

In addition, ALL advertisements pertaining to alcohol and tobacco should be heavily restricted or banned in public venues, and available on the internet only on “18 or older” sites; and absolutely no direct marketing of prescription medication to consumers should be allowed. Children become curious about prescription drugs because they learn about them on television and through magazine ads.

It is our love affair with unfettered capitalism that is our downfall. Even suggesting that a company should not be allowed to advertise a product (tobacco) which is essentially no more than a slow-acting poison sends certain folks into paroxysms of indignation.

Thank the Goddess (yes, I am one of “those” feminists) that we are finally taking a long delayed look at Drug Policy Reform, and as a result may finally have a chance of saving our civilization.

I think we are overlooking another addiction that is a product of the times. Computer gaming/internet addictions. These are specifically targeted at our teens and we need more research and controls on the gaming industry.

The biggest problem about kids and drugs is that parents don’t know how to talk to kids about drugs.

Dear Chairman Califano:

Good article! If we we prevent the problem of ATOD use and abuse we won’t have to pay for it later, in lives or dollars.

On the question of how best to prevent it, is a federal mandate for non-punitive random drug testing for all students grades 6 through 12 not only desirable, but necessary?

I know parents are most important, but based on your own research at CASA, 56% of kids are at moderate to high risk due in large part to parental shortcomings. We know also that on average, a kid uses drugs for two years before parents even know, and too often, its too late then to get them help.

America is not only in the economic abysss, but one if four or five students don’t even graduate from high school …. and according to UC Santa Barbara each dropout will cost society $392,000 as the burden public health, welfare and the justic system.

Non-punitive random drug testing is the best among many tools to keep kids off alcohol and drugs, keep them safe, in the system until they reach adulthood intact. Certainly the epidemic demands radical action … if this can even be considered radical.

Roger Morgan
Californians for Drug-Free Schools

I teach at a small liberal arts college. One of the things that I notice is that my students who are working their way through college have much less time, interest, or money to party the way their more well-heeled classmates do. Earning your way seems to keep students attentive to the waste of money and time partying brings.

One thing that I do at the beginning of each semester is discuss what it costs to miss a class. We do the Math. I suggest that they might as well flush the $125 down the toilet if they aren’t going to bother to come to class.

One other thought. It is important for parents to gauge whether or not their kids are ready to handle the drinking culture that exists on campus. If an 18 or 19 y.o. is not ready, than seriously consider a gap year or two. The pressure to drink in college is pretty severe and immature kids have a hard time backing away. This is especially true if they drank in high school. I know one parent of a high school senior who put not going away to college on the table when discussing consequences for underage drinking.

I’ve read a lot of literature on higher education policy and reform, and it always amazes how much they tiptoe around this issue. Alcohol and drug abuse on campus is a dangerous epidemic. Particularly in straitened times, this culture of cheap thrills and constant entertainment could trigger an even greater social crisis.

Thank you for your work and may God guide you to all that is good.

Dear Mr. Califano
Last October, I had the privilege of attending, as a representative of the One Day at a Time publication, the casaconferences.org conference on “the Wasting the Best and the Brightest: Substance Abuse at America’s colleges and Universities”. We were thoroughly impressed, and particularly by the panel hosted by Leslie Stahl of “60 Minutes”. The panel was highlighted by a beautiful lady Anna Thomas who is a graduate and now graduate student of Center for the Study of Addiction and Recovery (CSAR) at Texas Tech University, which is a model that is now getting national attention aided by your exposure. This Center is immensely popular, even where previous efforts have due to lack of interest. But times are changing. We were so impressed that our Publisher/Editor/Founder David Palmer went there to do a feature story for our latest edition, available this week. We highly recommend that trustees, alums, parents, and patriots nationwide study this solution carefully and Join casacolumbia.org in this campaign.
The pictures and the statistics demonstrated by your blog, in Wasting the Best and the Brightest serve to prove what we have suspected all along. The “national moral deficit“ that allows this level of addiction is, in all probability, the most debilitating issue in this country. It is also certainly the most politically undefined contributor to the economic drain and lack of productivity that plagues the US today. It is probably safe to say that, as a product of substance abuse, 25 to 30% of our citizens are not capable of making sound decisions. We are at war with addiction and at this point we still have no definable policy or strategy in place. By your accurate model, quantified in your book High Society (Public Affairs, 2007) there is easily a TRILLION ($1,000,000,000,000.00) dollars that we can recapture annually just by cleaning ourselves up, not to mention the expansion of productivity and the return of upscale morality to our communities. With your lead and through your foundation there is no excuse for this society to not immerse itself in these solutions. The positive side is that solutions do exist and it’s primarily a matter of education. At onedayatatime.com we have a stated objective to reduce this national cost by 1 %( $1,000,000,000.00 Billion). We believe that if all related agencies and institutions joined a unified effort to set identifiable goals and monitoring we could set a solid line of defense.
In our next issue of http://www.OneDayAtATime.com we are planning a follow up feature on an absolutely amazing campus transformation initiated by the GREEK fraternity system, led by alumni and trustees of the University of Arkansas.
Thanks for all of your hard work and insight. We look forward to a long, rewarding relationship with casacolombia.org as we spread the word across the nation.
Sincerely,
Jack T. Fryer Jr. business developer

Dear Chairman Califano,

Over 135 Univesity and College Presidents have given up on our youth and am not surprised former President John McArdell leading the charge. I believe in Henry Wechsler College Alcohol Study found college students of New England Universities and Colleges to be leaders in the field of binge drinking. Middlebury College was no exclusion to the findings. It’s a grave day in education when our leaders ban together to form a coalition for the purpose of the destruction of our 18-20 year olds. Do they really believe by lowering the drinking age will solve the nation’s problems of binge drinking? They need to find another job!

Thank you for taking the lead. I welcome you to forward my website to any interested party to help bring about change.

Ann

As a fully credientialled, tenured, special education teacher in a high at-risk, inner city public continuation high school, I see the disease of alcoholism and drug addiction (I consider them two facets of the same coin) running rampart and taking down “The Best and the Brightest”. The students most often see this as harmless, enjoyable entertainment fully denying nothing bad will or can happen to them. There would appear to be a significant disconnect between the kid’s perceptions and reality. In addition, it seems as if very little can be done to get many of them to pay attention to the facts.
Your David Halberstam plagiarism has me reflecting on the fact that they almost appear to not know what to do with the intellect they have been given–too smart for their own good. I have heard it called, “knucklehead”.
The saddest part is that my experience tells of an answer, 12 steps. Unfortunately it only is effective if it is wanted.
As one who just celebrated 21 years clean and sober, I wish I could pour into my students heads some of my experiences so they don’t have to go through what I went through to get to where I am am today.
Be Well

Why doesn’t anyone ever question the fact that 51% of our budget goes to the military and only about 2% for Health and Human Services? A little cutting of the defense budget would go a long way to pay for much of the costs of providing health care for everyone.