Drug addiction is a medical problem that should be treated as a chronic disease, according to experts gathered Friday at the Hyatt Regency Monterey for a national forum on drug and alcohol dependency. Illegal drug use in the United States "has by and large already been decriminalized," said former U.S. drug czar and retired Army Gen. Barry McCaffrey. The problem, he said, isn't that drugs are illegal, but that they cause mental, medical, legal and social problems. McCaffrey served as director of the White House Office of National Drug Control Policy in the Clinton administration and now teaches national security affairs at the U.S. Military Academy at West Point. He and Barry W. Karlin, chairman and CEO of CRC Health Groups Inc., addressed the Western U.S. Summit for Clinical Excellence on Tuesday, which drew 250 health professionals -- social workers, psychologists, addiction counselors, researchers and doctors – under the aegis of the Ben Franklin Institute of Scottsdale, Ariz.
McCaffrey has recently returned from Afghanistan, where the new government has been waging an opium-eradication campaign. Such work has been successful in other countries, he said. In the past five years, Pakistan and Thailand have essentially ended large-scale opium poppy farming, and Peru and Bolivia have halted coca farming, though "there is nothing more lucrative than growing coca or opium."
Success demands a three-pronged approach, McCaffrey said: help from the government to establish legitimate crops by teaching farmers how to grow them, supplying them with seed, tools and other materials and building road networks to get them to market; eradicating illegal crops; and having a nation's leadership publicly denounce drug cultivation as harmful to the country.
In Afghanistan's case, he said, opium use "is non-Islamic, not in accord with their traditions," and its continued presence generates massive drug abuse, addiction, graft, violence and corruption. Afghanistan is now the world's No. 1 heroin supplier, he said. Proceeds from drugs fund terrorist campaigns by al-Qaida and warlords, and destabilizes the democracy the U.S. hopes to see built there, he said.
McCaffrey said he has been supportive of efforts to "create conditions of law and order" on the U.S.-Mexican border, but said that 95 percent of illegal immigrants who cross into the United States have nothing to do with crime or drugs. Canada, he said, is one of the largest producers of marijuana, and the Netherlands is one of the top suppliers of mood-enhancing drugs such as Ecstasy. McCaffrey and Karlin said educating young people from middle school through high school is key.
A youth who can reach age 21 without abusing drugs or alcohol, Karlin said, stands a better than 90 percent chance of having no substance abuse problems as an adult. Drug and alcohol addiction can't be cured with a few weeks of treatment at a detox center, he said. It has to be treated "as a chronic condition, with long-term care, like diabetes, hypertension or asthma." McCaffrey said there have been victories in the war on drugs domestically.
In the past three years, U.S. "current use" – use of any drug within the past 30 days – has declined nationwide 11 percent, he said. During the past 20 years, drug abuse has fallen 50 percent, and crime and teenage pregnancy are in decline. The nation faces a problem with rising use of methamphetamines, pharmaceutical painkillers and artificial opiates, "the new heroin," McCaffrey said. Drugs and alcohol, he said, are involved in most cases where people are arrested and incarcerated for crimes, or hospitalized for traumatic injuries, and cost billions of dollars in lost productivity, health care, material loss and damage.
By Kevin Howe
10 June 2006