SOURCE: The National Center on Addiction and Substance Abuse at Columbia University

May 07, 2007 00:00 ET

Califano Calls for Fundamental Shift in Attitudes and Policies About Substance Abuse and Addiction

Illegal Drug Use Up From 1992 Lows; Americans, 4 Percent of World Population, Consume Two-Thirds of World's Illegal Drugs

NEW YORK, NY -- (MARKET WIRE) -- May 7, 2007 -- Calling substance abuse and addiction "a chronic disease of epidemic proportions with physical, psychological, emotional and spiritual elements that require continuing and holistic care," Joseph A. Califano, Jr., chairman and president of The National Center on Addiction and Substance Abuse (CASA*) at Columbia University and former U.S. Secretary of Health, Education, and Welfare, calls for a major shift in American attitudes about substance abuse and addiction and a top to bottom overhaul in the nation's health care, criminal justice, social service, and education systems, and awakening the power of parenting, to curtail the rise in illegal drug use and other substance abuse in his new book, "HIGH SOCIETY: How Substance Abuse Ravages America and What to Do About It." The book's call for a revolution in how the nation views and confronts abuse and addiction involving tobacco, alcohol, illegal and prescription drugs is based on 15 years of CASA research.

Americans, only four percent of the world's population, consume two-thirds of the world's illegal drugs. "All the huffing and puffing of the current war on drugs has not been able to blow down the nation's house of substance abuse and addiction," Califano notes, citing these facts:

--  The number of illegal drug users, which had dropped from a high of
    25.4 million in 1979 to a quarter century low of 12 million in 1992, has
    risen to 20 million in 2005.
--  The number of teen illegal drug users, which had dropped from its 1979
    high of 3.3 million to low of 1.1 million in 1992, has more than doubled to
    2.6 million in 2005.
--  From 1992 to 2003 the number of Americans abusing controlled
    prescription drugs jumped from 7.8 to 15.1 million.
--  There has been no significant improvement for decades in alcoholism
    and alcohol abuse, with the number of alcohol abusers and addicts holding
    steady at about 16 to 20 million.
--  One in four Americans will have an alcohol or drug problem at some
    point in their lives.
--  61 million Americans are hooked on cigarettes.
    

The consequences of this epidemic are severe:

--  Almost a quarter of a trillion dollars of the nation's yearly health
    care bill is attributable to substance abuse and addiction.
--  Alcohol and other drug abuse is involved in most violent and property
    crimes, with 80 percent of the nation's adult inmates and of juvenile
    arrestees either committing their offenses while high, stealing to buy
    drugs, violating alcohol or drug laws, having a history of substance
    abuse/addiction, or sharing some mix of these characteristics.
--  70 percent of abused and neglected children have alcohol and/or drug
    abusing parents.
--  90 percent of homeless have alcohol problems; 60 percent abuse other
    drugs.
--  Half of college students binge drink and/or abuse other drugs and
    almost a quarter meet medical criteria for alcohol or drug dependence.
    
"Substance abuse and addiction is a disease, not a moral failing or easily abandoned self indulgence," notes Califano in "HIGH SOCIETY." "We must end the denial and smash the stigma associated with this disease with a cultural revolution of the kind that in the past has reshaped our understanding and conduct concerning the environment, auto safety and global warming." He calls on Americans to recognize that substance abuse and addiction is the nation's number one serial killer and crippler and commit the necessary energy and resources to tackle this epidemic.

MOUNTING THE REVOLUTION

In the Health Care Systems - Noting that the National Institutes of Health spend $13 billion a year on research for cancer, strokes, cardiovascular and respiratory diseases and AIDS, but only one tenth of that amount to study substance abuse and addiction -- the largest single cause and excacerbator of this quintet of killers and cripplers -- "HIGH SOCIETY" calls for creation of a National Institute on Addiction with a budget of at least $3 billion a year to conduct a "Manhattan Project" research initiative to identify the causes and cures of substance abuse and addiction.

Califano urges that the medical profession make courses in substance abuse and addiction a compulsory part of medical school curriculums; physicians be trained to diagnose the disease and refer patients for treatment; states and medical societies establish professional standards for treatment counselors and accreditation systems to certify treatment facilities; and public and private health plans cover substance abuse treatment and pay doctors to talk to patients. "Professionalizing the treatment system is essential to bring it fully into the medical care system which in turn is key to obtaining parity of coverage."

In the Justice Systems - Calling the nation's prison system "as anachronistic as the debtor prisons in Charles Dickens' day," Califano calls for prosecutors, courts and prisons to seize the opportunity to reclaim hundreds of thousands of addicts by using the criminal justice system to offer effective treatment for all who need it and incentives for them to achieve and maintain sobriety. "Successfully treating and training inmates could deliver the greatest reduction in criminal activity in the nation's history," he writes, noting that expert estimates of crimes committed yearly by a drug addict range from 89 to 191.

In the Social Service Systems - Noting that parental substance abuse accounts for $23 billion in the nation's child welfare spending and that most domestic violence involves alcohol or other drugs, Califano proposes a complete overhaul of family court, adoption and foster care systems to deal with alcohol and drug abusing parents and partners. Califano also notes that only by investing in substance abuse and mental health treatment can we rehabilitate the homeless population.

In the Education Systems - Schools -- from elementary through college -- should include age appropriate education about all substance abuse involving tobacco, alcohol and prescription and illegal drugs as they do about other health matters from hygiene to STDs.

For Families, Children and Communities - Califano urges that prevention be laser beamed on children, since a child who gets through age 21 without smoking, abusing alcohol or using illegal drugs is virtually certain never to do so. Prevention efforts should also take account of the scientific research which has found that nicotine, alcohol and other drugs such as marijuana, heroin and cocaine, have similar impacts on the brain through common pathways.

Calling "the power of parenting the most potent, least appreciated, and most underutilized resource available in the struggle to raise children free of drugs and alcohol abuse," he calls for an extensive public health campaign to educate parents and teens, especially about the dangers of alcohol abuse and the increased potency and addictive power of today's marijuana, and for communities to press for sharp restrictions on tobacco and alcohol advertising aimed at children. "At bottom," Califano writes, "prevention is a mom and pop operation."

"HIGH SOCIETY" recommends an end to the "one (male) size fits all" prevention and treatment programs since the reasons why men and women abuse alcohol and other drugs differ, as do the ways in which these drugs affect them.

As secretary of health, education and welfare in 1978 Califano mounted the nation's first antismoking campaign, calling smoking "Public Health Enemy Number One" and "slow motion suicide." He founded CASA in 1992 and has been its fulltime president and chairman since then. "HIGH SOCIETY: How Substance Abuse Ravages America and What to Do About It" is published by PublicAffairs. All proceeds from the sale of this book are being donated to CASA.

CASA is the only national organization that brings together under one roof all the professional disciplines needed to study and combat all types of substance abuse as they affect all aspects of society. CASA has issued 63 reports and white papers, published one book, conducted demonstration projects focused on children, families and schools at 161 sites in 67 cities and counties in 29 states plus Washington, DC and a Native American tribal reservation, and has been evaluating the effectiveness of drug and alcohol treatment, in a variety of programs and drug courts. CASA is the creator of the nationwide initiative Family Day - A Day to Eat Dinner with Your Children™ -- the fourth Monday in September -- the 24th in 2007 -- that promotes parental engagement as a simple and effective way to reduce children's risk of smoking, drinking and using illegal drugs. For more information visit www.casacolumbia.org.

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