Prevention, treatment go together


CRIMINOLOGIST Michael Dana argued eloquently in Friday's Sun about the need for drug-abuse prevention. However, "and" rather than "or" is the operative word here -- whether we're talking about anti-drug television commercials and entertainment initiatives, drug education in homes and schools, or the proverbial debate over demand-reduction vs. supply-reduction. No single approach, to the exclusion of others, will be successful in overcoming the threat posed by illegal drugs. Prevention and treatment, like local and national efforts, must work in tandem. False dichotomies divide and conquer resources.

Baltimore has made significant progress against drug abuse. Findings just released by the Maryland Department of Education indicate that over a two-year period, twelfth-graders in the state were less likely than their peers nationwide to have used alcohol and cigarettes during the 30 days preceding the survey. This study parallels research conducted by the U.S. Department of Health and Human Services, which found that adolescent drug use has decreased slightly in recent years. With respect to drug treatment, identifying effective approaches is the key. Numerous studies demonstrate that drug treatment works. In 1997, the Center for Substance Abuse Treatment(CSAT) sponsored pilot studies of treatment facilities in 14 states, including Maryland. The following year, Maryland's Alcohol and Drug Abuse Administration was among various organizations in 19 states that received legislative health mandates to continue this research.

Maryland was at the forefront of drug treatment even before winning CSAT funding. Maryland established an Alcohol and Drug Abuse Treatment Research Advisory Committee, which recommended a methodology for comparative studies. Maryland's Alcohol and Drug Abuse Administration (ADAA) and the Center for Substance Abuse Research (CESAR) collaborated on three projects to discover features shared by successful treatment programs. Baltimore's treatment facilities will be ranked in terms of outcome, and recommendations will be made for improving less successful programs.

The Office of National Drug Control Policy just released the 2000 Annual Report for the National Drug Control Strategy, which includes prevention and treatment along with interdiction and law enforcement. The strategy defines reduction in demand as the main focus. Prevention of drug, alcohol and tobacco use among 68 million American kids is our most important goal. The strategy ties public policy to a scientific, research-based body of knowledge. A performance measurement system permits periodic adjustment as conditions change.

Our signature program is a five-year, $1 billion national anti-drug media campaign. Because mass media acts like a "proxy-peer" to our youth, identifying what's "cool" and what's not, a broad-based anti-drug campaign can counteract pro-drug messages that youngsters receive from many sources. A minimum of four exposures a week reaching 90 percent of the target audience is changing attitudes and behavior. Drug use among adolescents declined 13 percent from 1997 to 1998.

Ads must be reinforced. Accordingly, we are working with the entertainment industry, school systems, families, faith-based organizations and athletic groups to send a unified anti-drug message while creating positive alternatives for alienated and disadvantaged youth.

We have begun shifting federal spending priorities in support of the strategy's goals (see Resources for prevention have increased 52 percent since 1996, while treatment has risen 32 percent. Drug courts channel nonviolent drug-law offenders into tough, court-supervised treatment instead of prison. The first drug court was established in 1989. Now, 700 drug courts are in operation or under development.

Mayor Martin O'Malley, Lt. Gov. Kathleen Kennedy Townsend, Rep. Elijah Cummings and others who care about the welfare of children are doing a great job. The partnership between the Office of National Drug Control Policy and Maryland, the Baltimore/Washington HIDTA (High Intensity Drug Trafficking Area), and the drug control policy office's Drug-Free Community Coalitions are among many fine efforts against a problem that costs America 52,000 lives and $110 billion a year. Still, we have made enormous progress. Casual drug use has dropped 50 percent since 1979. Casual cocaine use has plummeted 75 percent since 1985. Nevertheless, 5 million people are chronically addicted in the United States.

The problem of drug abuse, like illness or warfare, won't go away in the foreseeable future. Like education, drug-abuse prevention must be renewed in every generation. In schools we teach the "three Rs" (reading, writing and 'rithmetic); one subject is never enough. Likewise, in the counter-drug area, we follow PTE: prevention, treatment and enforcement.

Barry R. McCaffrey is director of the Office of National Drug Control Policy.

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