Tackling America's Drug Addiction

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Michele Norris speaks with Joseph Califano, founder and chairman of the National Center on Addiction and Substance Abuse at Columbia University, about the appetite for drugs in the U.S. and what's being done to curb it.


Earlier this week, Mexican President Felipe Calderon defended Mexico's war against the drug cartels, and cast some blame on his neighbor to the north: the U.S. The origin of our violence problem begins with the fact that Mexico is located next to the country that has the highest level of drug consumption in the world, Calderon wrote in a newspaper editorial. It is as if our neighbor were the biggest drug addict in the world.

Harsh words, to be sure. It got us wondering about the appetite for drugs in the U.S., and whats being done to curb it.

For answers, we turn to Joseph Califano, the former secretary of Health, Education and Welfare, and now director of the National Center on Addiction and Substance Abuse at Columbia University.

Mr. Califano, welcome to the program.

Mr. JOSEPH CALIFANO (Director, National Center on Addiction and Substance Abuse, Columbia University): Nice to be here.

NORRIS: Now first, any truth in President Calderon's statement? Is it fair to characterize the U.S. as the biggest drug addict in the world?

Mr. CALIFANO: The U.S. is 5 percent of the world's population. We consume two-thirds of the world's illegal drugs. So there is a lot of truth...


Mr. CALIFANO: what President Calderon said.

NORRIS: Let me ask you about the war on drugs right now. The current administration is trying to focus on a balance between interdiction and treatment: drug courts, for instance, followed by mandatory treatment, things like that.

Will that shrink the domestic market for drugs - since when you're talking about treatment, there are so many issues surrounding access to treatment?

Mr. CALIFANO: You're absolutely right. The rhetoric of the administration is good, but the dollars haven't changed. We're still putting roughly two-thirds into interdiction and enforcement, and one-third into treatment and prevention. Interestingly, when President Nixon started the war on drugs, his first budget was two-thirds for prevention and treatment, and one-third for interdiction.

NORRIS: Oh, so it's flipped.

Mr. CALIFANO: It's flipped totally. Now, we have to look at a lot of systems to really do something about this. The drug courts are great. We've analyzed them at our center. They work. And the prison population is important because 65 percent of the people in prison meet the medical criteria for drug or alcohol abuse and addiction. Thats a wonderful - in a sense, captive audience. But we dont provide much treatment for them.

NORRIS: So it's just a wasted opportunity. They're not getting treatment.

Mr. CALIFANO: About one in 10 that need treatment gets some kind of treatment. But most of it is not good.

There's a Medicaid population: 30 percent of the beneficiaries of Medicare have drug and alcohol problems. We have to go after those populations. Thats the short-run - in a sense - solution to this problem.

There's a longer-run solution. We know from our research that if you get a child through age 21 without getting into this stuff, that child is virtually certain to be home free for the rest of his or her life. And when you say a drug-free society - and there will always be drugs being used - what you're really talking about is that population of children - and thats parents, thats schools, thats people that are dealing with that. And theyve got to get focused on it.

NORRIS: Is the U.S. serious enough about the war on drugs?

Mr. CALIFANO: No, we're not. Ill tell you - and we're not serious. The government is not serious enough. You can barely hear any of the leaders in the government talk about it. The medical profession is not serious enough. The public-health profession is not serious enough.

Let me give a comparison. AIDS was a social curse. In a matter of three...

NORRIS: AIDS, you're talking about?

Mr. CALIFANO: 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; we should treat it; we should seek a solution to - we dont have one yet, but we should.

Their failure to do that with addiction and substance abuse is, to me, the greatest mistake theyve made - the greatest failure of medicine and public health. So they dont take it seriously enough.

You know, when I was secretary of HEW, I went after smoking. I started the anti-smoking campaign. Everybody said, my God, it will never happen. It's all smoke and no fire. Look at the country today. If we get some leadership, we'll have a real impact. And this is the country's biggest disease, the biggest cause of cancer, strokes, accidents, murders, violence. We've got to do something about it.

NORRIS: Joseph Califano, thank you very much for coming in to talk to us.

Mr. CALIFANO: OK, been great.

NORRIS: Thats Joseph Califano. He is the former secretary of Health, Education and Welfare. He is now director of the National Center on Addiction and Substance Abuse; thats at Columbia University.

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