Letter to University Senate
March 25, 1999
Dear University Senate Member:
For the past four semesters
Columbia University NORML communicated
with the Senate regarding the activities
of the Center on Addiction and Substance
Abuse (CASA). Our goal is to persuade
the Senate to reconsider the terms of
CASA's association with Columbia. We do
not seek to have Columbia's ties with
CASA severed, but rather that the Senate
use its influence to encourage CASA to
adopt standards of research and rhetoric
that are more in line with the
traditions and dignity of the
University.
To that end, we ask that the Senate
convene a sub-committee to review CASA's
research, publication practices, and
public relations work. CU NORML would
present its case to that committee,
which presumably would also hear from
CASA.
We are also writing you to respond
to Dr. Herbert Kleber's letter Vice
President and Medical Director of CASA)
to the Senate dated February 11, 1999.
In that letter he wrote: "First, they
[CU NORML] state that CASA is 'foremost
a political advocacy organization that
presents itself as a scientific research
institute to the national media and
policy makers.' Although they state
this, they do not demonstrate it."
Examples of CASA's political
activities abound, as most often seen in
the activities of the organization's
President, Joseph A. Califano. Here are
a few specific examples:
**In October 1996 CASA paid for a public
opinion poll to be conducted on the
issue of medical use marijuana, which
CASA adamantly opposes. The results of
this poll were used by CASA in a public
relations effort it undertook to erode
voter support for a pro-medical
marijuana ballot measure in California
that year.
**On December 4, 1996 and September 30,
1997, Califano had op-eds published in
major newspapers across the U.S.
attacking the supporters of several
medical marijuana ballot initiatives.
These op-eds relied on CASA's research
that promulgates the "gateway" theory of
marijuana use leading to harder drug
use, as an argument to persuade voters
to vote against these initiatives.
Califano also personally attacked George
Soros, one of the financial backers of
the initiatives.
**According to a feature article in the
Washingtonian Magazine published in
1998, which itself referred to a
Washington Post article, Califano was
instrumental in pressuring President
Clinton to continue the ban on federal
funding of needle exchange programs,
despite the overwhelming support of the
scientific and public health
establishment for such funding.
The principle mission of CASA is to
influence national policy on illicit
drugs, rather than to conduct research.
The materials it publishes are designed
to justify its political positions, and
to provide a hook for the media coverage
that gives CASA's views a nationwide
audience. However noble CASA's goals may
ostensibly be, is it an appropriate
thing for an organization to be using
Columbia University's name and
reputation to lend weight to such
activities?
Dr. Kleber is correct in stating
that we find CASA's promotion of the
so-called "gateway theory" to be
galling. This is because that fallacy
has been debunked repeatedly by
authoritative scientific and government
commissions, including President Nixon's
National Commission on Marihuana and
Drug Abuse (1972), The National Research
Council (1982), and the National Task
Force on Cannabis (Australia, 1996).
Just last week, the federally
funded Institute of Medicine released
their study on the utility of medical
marijuana. In an embarrassing
contradiction to CASA's public
pronouncements on marijuana, the IOM
report stated "that although marijuana
use often precedes the use of harder
drugs, there is no conclusive evidence
that marijuana acts as a 'gateway' drug
that actually causes people to make this
progression."
In this Wednesday's Spectator, Dr.
Kleber took issue with the IOM report's
findings, saying that CASA's research
was not taken into account by the IOM
study because "CASA is conducting drug
policy research, not biomedical
research." The IOM commission did not
limit itself merely to medical research
though, examining data from a wide
variety of sources. In addition, Dr.
Kleber himself was a member of an
Advisory Committee that reviewed the
report prior to publication, and must
have had an opportunity to present
CASA's research to the IOM. The
Institute of Medicine commission seems
to have found CASA's evidence
unpersuasive.
On the important issue of whether
or not CASA participates in the
peer-review process, CASA once again
responds with obfuscation. In his letter
to the Senate, Dr. Kleber writes,
"credible peer review takes many forms.
CASA's work is reviewed by distinguished
Scientific Advisory Boards made up of
nationally known experts in the
particular field relative to the study."
Why does CASA prefer this mode of
review to the normal process of
peer-review? Dr. Kleber explains that
the bulk of CASA's work is in a format
that is "too long" to be reviewed
through the publication process. This
excuse recalls their previous
rationalization (in the September 30,
1998 edition of the Columbia Spectator)
that the peer-review process is not
"timely" enough for them.
As we understand it, academic peer
review involves critique from
professional researchers anonymously,
not a review by hand-picked professional
colleagues who are known to those being
reviewed. What Dr. Kleber described does
not in fact appear to be anything like
peer review.
Dr. Kleber also claims that CASA
has numerous peer-reviewed publications
published or in press. A review of
CASA's web site reveals a recently added
section that includes the abstracts of
some of these articles. We would offer
two observations. First, all of these
publications originate in 1997 or later,
mainly in 1998. CU NORML has
coincidentally been raising these
criticisms of CASA since spring of 1997.
Second, none of these articles are in
fact the monographs that CASA relies on
for all of its press conferences,
releases, op-eds, and media appearances
by CASA staff.
However sound these articles may
be, they are irrelevant to CASA's public
advocacy (the bulk of CASA's work), and
thus fail to address our concerns with
their research. We have concluded that
CASA has pulled together this material
in an effort to deflect criticism, not
out of a sincere desire to participate
in the peer-review process.
Despite the uphill battle that we
face, CU NORML shall continue to work to
focus the Senate's attention on the
credibility issues CASA is creating for
itself and Columbia. We are confident
that when the Senate decides to look
into this matter itself that it will
come to share many of our concerns.
Sincerely,
CU NORML Executive Board
President
--------------
(CC 1999)
Vice-President
Gerard Honig
(CC 2000)
Treasurer
Richard Seymour
(SEAS 2001)
Secretary
Benjamin May
(SEAS 2000)
Back to top
Letter to University Senate from CASA
February 11, 1999
Columbia University
Senate Members
Dear University Senate Members:
This is in response to the letter sent to you on November 16th from members of the local chapter of
NORML. It is not surprising that this small group is opposed to CASA's activities, denigrating our
work, and aggressively attempting to confound our relationship with the university. NORML, as you
know, is a political advocacy organization with small local chapters throughout the country that for
over two decades has been trying to change the legal status of marijuana in the United States. CU
NORML is a reflection of this same agenda. Consequently, they take issue with those CASA
statements that clarify that marijuana is not the harmless substance that CU NORML wishes the public
to believe it to be. Increasingly, the scientific community is coming to the conclusion that marijuana is
not a benign substance, but can cause a variety of problems, physical and psychological, including
dependence and withdrawal.
This letter, however, is no the place to debate the issue of marijuana's legal status or pharmacological
effects, but to put CU NORML's anti-CASA stance in perspective. I would urge you not the let the
University Senate be the vehicle for this harassment. In addition, I cannot let certain of their most
recent statements go unchallenged.
First, they state that CASA is "foremost a political advocacy organization that presents itself as a
scientific research institute to the national media and policy makers." Although they state this, they do
not demonstrate it. Any serious review of the corpus of CASA's work serves as a counterpoint to the
veracity of CU NORML's posturing that CASA is a "political advocacy organization." Our
publications make a number of recommendations to policy makers, recommendations based on careful
analysis of findings. One of the consistent "positions" running throughout our publications is that the
cost of all forms of substance abuse, both that of licit drugs such as nicotine and alcohol and illicit ones
such as heroin and cocaine, is extraordinarily high in human, social and financial terms and compels
the need for serious public and private investment in prevention and treatment of this public health
problem. For example, our study on the cost of substance abuse to New York City, Substance Abuse
and Urban America: Its Impact on an American City, New York, (1996), found that, although the total
direct and indirect cost approaches $20 billion a year, only a tiny fraction of that expense is attributable
to an investment in prevention and treatment. The research and analysis in this monograph is based, not
on "a rehash of federal drug survey data" as CU NORML claims, but on a number of innovative
approaches to primary and secondary data analysis that CASA developed to do this cost/benefit
analysis. The New York analysis has become a model, methodologically, for studies by cities such as
Baltimore and San Francisco on the cost that substance use and abuse imposes on those cities.
CASA's paper, Substance Abuse and the American Woman, (1996), points to the often undiagnosed, but
intrusive role, that substance abuse plays in the lives of many women, urging better training of
physicians in prevention, diagnosis and treatment of these disorders. Again, contrary to CU NORML's
claim of "rehash..." that publication alone reviewed and analyzed over 100 published references.
A recently released report by Dr. Steve Belenko, Behind Bars: Substance Abuse and America's Prisons
Population, (1998), revealed the extraordinarily high percentage of prisoners who, as inmates, have
serious alcohol or drug-related problems and lack access to quality treatment, or often any treatment.
As a result of this analysis, CASA rejected mandatory minimum sentences and strongly pushed for
more treatment in prison, after prison, and instead of prison. This study has been cited by a number of
federal and state agencies in their policy debates on this matter and has helped to galvanize efforts at
change including a major initiative by the federal Office of National Drug Control Policy to review and
modify our nation's approach to prison-based substance abuse treatment.
CU NORML does not take note of these or other examples of our work, such as our national
demonstration projects or our treatment evaluation research. Such an acknowledgment would seriously
dilute the thrust of their narrow, politically motivated attack. In their continuing attempt to cast
aspersions on CASA, they point only to that portion of our work having to do with marijuana and
legalization, areas that constitute a tiny fraction of CASA's body of work, but a portion that is most
galling to CU NORML. CU NORML may disagree, for example, with the "gateway" theory involving
alcohol, tobacco and marijuana, even though ironically it relates to the pioneering work of a Columbia
professor. However, to cite CASA's monograph on this topic as a simple "rehash of federal drug survey
data" is a political polemic, that ignores the serious scientific work that has been done on this topic. A
shortened and updated version of our Gateway monograph has been submitted for publication and we
believe will be accepted shortly.
Another of their complaints is that CASA fails "...to participate in the academic peer review process or
publish any of its studies in peer review journals, it's research is of dubious validity." Credible peer
review takes many forms. CASA's work is reviewed by distinguished Scientific Advisory Boards made
up of nationally known experts in the particular field relative to the study. The intellectual capacity and
credibility of these individuals are certainly equal to those of professionals doing peer review work for
various journals. On these grounds alone, it is scurrilous of CU NORML to so casually claim that our
policy analysis and research is "of dubious validity." But to expand CASA's challenge to this particular
point, I would simply note that CASA does participate in the peer review publication process with 18
articles published or in press and seven book chapters since 1997, and eight articles under review in
peer-reviewed journals.
Another point must be made. CASA is not "...coming under increasing scrutiny and criticism from the
academic and mainstream press for it's fast and loose playing with its facts." A critical analysis of this
assertion leads to a quite contrary conclusion. This criticism is based on public statements made by a
small cadre of individuals who disagree with CASA's work on marijuana and legalization. In fact,
there is little public criticism of CASA's work from "mainstream academia or the press". Critical
individuals are primarily associated with NORML, the Lindesmith Center, or the Drug Policy
Foundation, all aggressive political and policy advocates of pro-legalization or decriminalization
policies. They are certainly not representative of the mainstream. They may dislike our carefully
crafted refutation of their policy preferences, but that is not a justification for their ill-informed carping.
While CASA's work is not without mistakes (there have been occasional errors made or lack of clarity
of interpretation), that is also the case in many scholarly and peer-reviewed efforts. Our work is
readily available for scrutiny and comment by the academic community through our publicly available
papers, our website, and through our participation in the peer review process. For example, our white
paper, Legalization: Panacea or Pandora's Box, (1995) is based in part on an article of mine in the
New England Journal of Medicine and is available in a revised version as a chapter in a highly
respected text book on substance abuse, [Clinical and Societal Implications of Drug Legalization, in
Substance Abuse: A Comprehensive Textbook, edited by Lowinson, et al, 1997].
CASA's publication practices are not dissimilar to those of many of Columbia's faculty who publish
monographs, book chapters and books, as well as peer-reviewed and invited journal articles. The
length of our monographs, usually well over 100 pages does not readily lend itself to the format of an
academic peer-reviewed journal. We have therefore chosen to issue these documents ourselves, with
scientific oversight by our various Advisory Boards.
The description of the publication practices of other drug abuse research centers cited in CU NORML's
letter to the Senate is typical of their misleading assertions. While I am not familiar with all of the
listed biomedical centers, carrying out narrowly defined, controlled studies on prevention or treatment.
They seldom, if ever engage in policy-related work and use primarily journals as an outlet for their
work, rather than lengthy monographs.
When CASA professionals discuss drug issues in the media, it is similar to academics or others
publicly discussing policy issues in such forums. The op-ed pieces noted by CU NORML, as with all
op-ed pieces, are the opinions of specific authors, not of CASA, and are labeled as such when
published. Typical of the propositions of their political motivated letter, the one such statement CU
NORML cites is an op-ed on marijuana, date for which ironically was taken from peer reviewed
articles readily available for their or anyone's analysis.
CU NORML's claim that we dismiss "competing positions as those of legalizes" reveals their singular
concern. Apart from our Gateway monograph, and our white paper on the topic, legalization is rarely
if ever mentioned in any of CASA's work. One wonders whether the CU NORML members have
actually read our numerous monographs. CASA's one paper and chapter on legalization discusses a
variety of positions using facts and appropriate references, not by summarily dismissing "competing
positions."
CU NORML also criticizes CASA for "using the rhetoric of children." When CASA publications refer
to children, [see, for example, our most recent study No Safe Haven: Children of Substance Abusing
Parents,(1999)], it is because one of CASA's major policy conclusions is the detrimental effect of
substances of abuse, both legal and illegal, on children, our most vulnerable and susceptible population.
We would disagree strongly with any attempt by CU NORML to avoid focusing on that reality. We
know that the younger a person begins to use illicit drugs or nicotine, or abuse alcohol, the more likely
they are to get into trouble with such substances and to continue to use for years. Thus, a credible
prevention program must focus on children.
It seems clear, however, that no matter how we or the Senate respond, CU NORML will continue to
put forth charges as part of their overall political campaign to discredit CASA's work as a means to
advance their cause. CU NORML is a narrowly focused, political advocacy organization - an
advocacy organization based on personal values and preferences. In contrast, CASA chooses to craft
its findings through careful analysis, translating those findings into policy recommendations and useful
models of clinical practice. Our recommendations are neither liberal nor conservative, but flow from
our honest analysis of data and theory. CASA has not engaged in political advocacy in any federal,
state or local venues. CU NORML avoids this reality and uses simple accusation to discredit those
with whom they disagree.
Sincerely,
Herbert D. Kleber, M.D.
Executive Vice President and Medical Director
The National Center on Addiction and
Substance Abuse at Columbia University
Professor of Psychiatry
Director, Division on Substance Abuse
College of Physicians and Surgeons
Columbia University
New York State Psychiatric Institute
Back to top
December 01, 1998
Activists Demand Results of D.C. Marijuana Initiative
By CHRISTIAN KAUFHOLZ
Spectator Staff Writer
Results of a recent vote on an initiative in Washington D.C.
designed to legalize the medicinal use of marijuana are being
kept secret from its supporters, as a result of an appropriations
bill recently passed in Congress.
The proposed law, known as Initiative 59, would legalize the
medicinal use of marijuana, allowing seriously ill persons in
the city to use the drug upon recommendation by a physician.
In late October, just before the vote in Washington D.C.,
Congress passed an amendment that bars the District from
allocating money to any measure which could facilitate the
legalization of marijuana including the disclosure of the recent
election results.
While proponents of marijuana legalization and the American
Civil Liberties Union have protested what they regard as a
clear violation of voters' rights, opponents fear that the
initiative, if passed, will lead towards the legalization of
marijuana for recreation.
Initiative 59 was recently passed by other states, including
Alaska, Arizona, California, Colorado, and Nevada.
------------, CC '99, president of the National Organization
for the Reform of Marijuana Laws at Columbia University
(NORML), a student group that promotes the legalization of
marijuana, said he is angered by the events in Washington.
"It's un-American what's going on," he said, criticizing
Congress for silencing public opinion. "The drug warriors
cannot stand the public debate."
Congress has not released the results of the vote because it is
dissatisfied with the outcome, --------- said.
"They know the results of the elections. That's why they're not
publishing them," he said. "If the results were the opposite, they
would run around publicizing them."
Money should not be an excuse for muting the people's voices,
--------- said.
"The voice of the people is beyond all cost. It's priceless."
Richard Seymour, SEAS '01, and treasurer of NORML, agreed.
The controversy over Initiative 59, like the Kenneth Starr
investigation, shows that "Congress is not in touch with the
public," he said.
According to Seymour, the success of Initiative 59 in some
states is proof of a changing opinion about the perceived
dangers and myths about marijuana.
However, Seymour said that he is confident that Initiative 59
will also be passed in Washington D.C.
"I have faith that Congress will take a more realistic approach
to the drug war and stop silencing the voice of the people,"
Seymour said.
Opponents of Initiative 59 argue that the medicinal use of
marijuana has not been proven effective and does not justify
the initiative.
According to the New York Times, Representative Bob Barr, a
Georgia Republican who sponsored the appropriations
amendment, said that marijuana is not the answer for the
seriously ill.
"From a medicinal standpoint, there is no legitimate use for
marijuana," Barr said.
Initiative 59 is a "thinly veiled attempt by recreational
marijuana proponents to circumvent drug laws," he said.
On Nov. 7, the Washington Post quoted Representative J.
Dennis Hastert, an Illinois Republican, saying that he agrees
with Barr's amendment and that the District "should not and
shall not make marijuana a legal substance."
Benjamin May, SEAS '00, vice-president of NORML, said that
the medicinal advantages of marijuana have not been proven
because marijuana is a "Schedule I" drug, which means that
testing it on humans is illegal.
In New York State, the use of marijuana for any purpose is
illegal. The New York State Charter does not permit public
votes on initiatives such as Initiative 59.
Back to top
October, 1998
Thou Shalt Not
BY CHRISTOPHER SHEA; Christopher Shea is a senior writer at the
Chronicle of Higher Education.
ONCE A PRESIDENTIAL ADVISER AND LEGAL HEAVYWEIGHT, JOE CALIFANO NOW IS
THUNDERING
AGAINST DRUGS. AND WOE BE TO THOSE WHO DOUBT HIS DATA OR GET IN HIS WAY.
EVEN BY WASHINGTON STANDARDS, the drug debate is uncompromising and
partisan. President Clinton claims that
the number of Americans using drugs has declined by 50 percent since 1979,
and earlier this year he laid out plans to cut drug
use in half again over the next ten years.
House Speaker Newt Gingrich scoffed at the Clinton proposals, which he
called a "hodge-podge of half steps and half truths."
He wanted all drug use eliminated in four years.
Amid all the posturing and confusion, one voice suffers no doubt. When
politicians or journalists need information about drugs,
they often turn to a university-based "expert" who is certain where others
are cautious and who compares drug policies he
dislikes to "playing Russian roulette with our children."
The expert is Joe Califano, former heavyweight Washington lawyer and
adviser to two presidents, now reborn as the scourge
of drugs -- and of anyone who dares to disagree with him.
STARTED FIVE YEARS AGO, CALIfano's drug-research center, the National
Center on Addiction and Substance Abuse
(CASA) at Columbia University, has become the loudest voice in the drug
debates.
If you've heard that marijuana is a "gateway drug" that opens the door to
cocaine and heroin, that's CASA and Califano. If
you've read that marijuana is far more harmful now than it was when Al
Gore, Newt Gingrich, and other politicians dabbled
with it -- so deadly that it should now be considered a "hard drug" --
that's probably because of Califano.
Every few months, Califano sends a fresh series of statistics coursing
through the press. Examples include the claim that the
proportion of female college students who get drunk on weekends has
tripled over the past few decades.
But it's on the Washington Post op-ed page that Califano gets his biggest
play -- and achieves something close to Old
Testament thunder.
When the billionaire philanthropist George Soros contributed $ 650,000 to
the campaigns to make medical marijuana legal in
California and Arizona, Califano crowned him "the Daddy Warbucks of drug
legalization." He accused Soros of manipulating
compassion for the terminally ill as part of a scheme to make marijuana,
cocaine, and heroin as available as tobacco and beer.
When parents told pollsters that they thought their kids might try
marijuana at some point in college, Califano responded with a
Post column that called the parents' attitude "infuriating," adding,
"Instead of chorusing 'We're mad as hell and we're not going
to take it anymore,' too many boomer parents utter a sigh of resignation
that is becoming a self-fulfilling prophecy for their
children."
So deep is Califano's loathing of tobacco that he rejects any deal between
state attorneys general and the tobacco industry as
the devil's work. The resulting compromises, he writes, represent a
"sordid piece of money-changing in the temple of the
American bar."
"Big Tobacco knows that the way to the hearts of Washington and
plaintiff's lawyers," he said, "is through their pocketbooks."
JOE CALIFANO NOW LIVES IN New York, but he's still very much a Washington
operator. Until the late 1980s, Califano
was a fixture here. A Harvard Law graduate, he did a Defense Department
stint under Robert McNamara during the Kennedy
years and then became Lyndon Johnson's chief domestic-policy adviser and a
co-architect of the Great Society. He would
later write one of the sharpest memoirs of the period, The Triumph and
Tragedy of Lyndon Johnson.
After Richard Nixon's election, Califano settled in at the powerhouse
Williams & Connolly law firm, where he replaced a
lockstep compensation system with an "eat what you kill" approach that
rewarded the partners who brought in the most
business -- notably himself. Eventually he would become known as the
"half-million-dollar man" -- a reference to his
then-stratospheric salary.
It was as Jimmy Carter's Secretary of Health, Education, and Welfare that
Califano made his biggest splash, especially for his
opposition to tobacco, which he deemed "slow-motion suicide" and "Public
Health Enemy No. 1."
Charlie Rose, a former Democratic congressman from the tobacco-growing
state of North Carolina, responded by saying,
"We need to educate Mr. Califano with a two-by-four."
President Carter fired Califano in 1979, mostly because even when he was
right on the issues, Califano's blunt, high-profile,
self-promoting approach cost Carter too many political allies.
Califano returned to the law, first at his own firm, then at Dewey &
Ballantine, which was dusty when he arrived but grew to
be one of the most profitable firms in Washington. In 1992 he left to
found CASA. "I'm not made to practice commercial law,
really," he said at the time. "I've made money at it, but now I wake up
every morning ready to roar."
DRUG RESEARCH IS an unglamorous field that doesn't usually attract the
kind of donations that go to cancer treatments or
AIDS work, but Califano's CASA hums along on a $ 8-million annual budget.
Unlike white-coated researchers and scholars in
elbow patches, Califano can pick up the phone and call buddies like
Michael Eisner, chairman of the Disney company, to help
underwrite a fundraiser featuring Liza Minnelli, the pop star Brandy, and
a keynote speech by President Clinton.
CBS, Chrysler, and Mobil have contributed heavily to CASA, and the board
of directors sparkles with such names as Nancy
Reagan and Betty Ford.
"For decades I have followed the field of substance-abuse research, and I
have never seen a phenomenon like the rise of
CASA," said David Hamburg, president emeritus of the Carnegie Corporation
and a Califano supporter. "In a few years it has
become one of the most respected and significant sources of information
and policy advice. There is nothing like it."
Last spring, Califano may have pulled off his biggest policy coup.
According to the Post, just as President Clinton was
preparing to place the government behind efforts to slow the spread of
AIDS by distributing clean needles to addicts -- a plan
long urged by health officials and backed by the Department of Health and
Human Services -- Califano sent Clinton a letter
pleading with him not to.
That letter, together with the opposition of Califano's like-minded ally,
drug czar Barry McCaffrey, sunk the plan and led to a
backpedaling press conference by Donna Shalala, secretary of HHS.
CALIFANO'S POLITICAL CLOUT, the forum that the Washington Post has given
him, and the luster lent by his
Columbia University title sit uneasily with many scholars who have spent
their careers studying the drug issue.
"I view his work with the utmost amusement," says Joseph D. McNamara, who
served as a New York City cop before
becoming police chief of Kansas City, Missouri, and then San Jose, and who
now studies drug policy at Stanford University's
conservative Hoover Institution. "What CASA does is present information in
a kind of hysterical-crisis mode, which is very
similar to what the government does."
McNamara got a typical Califano scolding after he argued, on the Post's
op-ed page, for shifting the front of the war on drugs
from prisons and border interdiction to prevention and health care.
McNamara said the United States could benefit by looking
at Europe, where drug use is viewed more as an endemic health problem than
as pure crime.
A week later, Califano weighed in with a blistering defense of the status
quo in a Post op-ed. "The first casualty of most
pro-legalization arguments is reality," he wrote. "If these ideas ever
became policy, the next would be America's children."
McNamara's views went beyond playing Russian roulette with children, he
wrote. They were the equivalent of "slipping a
couple of extra bullets in the chamber."
McNamara calls the response "pharmacological McCarthyism."
"It's as rotten and dangerous as the original McCarthyism," he says. "What
he is trying to do is cut out any kind of objective
debate by labeling people who are critical of current drug policies as
'legalizers.' . . . It's hard to call a guy who's been a cop
for 25 years a pothead."
Califano "has so much corporate money that he bought himself a place at
Columbia, but he's not playing by the same rules that
all other faculty and research centers have to play by," says Craig
Reinarman, a sociologist at the University of California at
San Cruz. "It seems to me that he wants to have it both ways. He wants to
be the anti-drug ideologue, to go out there and
make impassioned speeches, and to some degree be a star, but he gets his
money and his connection to Columbia on an
entirely different basis.
"If he wants to do that, fine; but don't pretend you're a Columbia
University scholar when you're not -- you're Ralph Reed."
Other researchers complain that Califano's take-no-prisoners approach to
the drug debate has created a climate in which
raising questions about zero-tolerance arguments, or the likelihood of a
drug-free America, are seen as little short of treason.
I HAD A CHANCE TO TALK WITH Califano last fall at CASA's headquarters.
He's now ensconced in the Carnegie
Towers, a postmodern edifice on 57th Street in Manhattan, on the same
block as Carnegie Hall and 50 blocks south of
Columbia's campus.
Califano's office is decorated with emblems of past glories. A THIS IS A
NON-SMOKING WORKPLACE sign sits on his
desk. On the wall to his left is a framed letter from President Johnson,
commemorating the day he left public service for the
law: "You were the captain I wanted, and you steered the ship well."
At 67, Califano still looks fit and powerful, with a demeanor that carries
a hint of the streets of Bedford-Stuyvesant and Crown
Heights, where, before he went off to college at Holy Cross, he and his
friends used to brawl with gangs from rival
neighborhoods. He is sharp, with a gruff voice and a no-bull tone.
"I don't think there's any right or left in the drug war, or if drug war
is even the right term," he says. "Basically, I think substance
abuse and addiction is one of the greatest threats to this country. You
know, Toynbee said of the great civilizations -- he
studied 16 civilizations -- he said that the only thing that ever happened
from an enemy without is that they gave the coup de
grace to an expiring suicide.
"This is a really internal problem for the United States, and it's an
enormous threat to our young people, and it's also an
enormous threat to our political system because of the corruption issues."
He brushes off the idea that his center's work is colored by ideology or
personal predisposition -- or anything but research.
"The first step here is to get the facts out and to get people to
understand the facts, and where they lead, they lead," he says. "I
have absolute conviction that if we can get the facts out, and if we can
get enough bright people interested in this subject, we
can deal very successfully with it.
"The field is full of very dedicated people, counselors and others, but
it's not full of the kind of brilliant people who are working
on cancer and heart disease, or the kind of brilliant people who are
selling automobiles or cereals or what have you. I think we
have here at CASA the brightest group of people that have been ever put
under one roof on this planet to deal with this
problem."
CALIFANO'S COLUMBIA DRUG center has 55 staff members, but only one is a
tenured member of the Columbia
University faculty -- Herbert Kleber, a psychiatrist with a top research
record, who served as a drug-policy adviser under
William Bennett. Other university professors and administrators sometimes
advise on projects.
The official line at the center is that editorializing and policy advice
amount to only a fraction of what CASA does.
CASA sponsors a program called "Opportunity to Succeed" that brings
together parole officers and social workers to help
prisoners with drug problems in four cities. It is undertaking a
nationwide evaluation of 200 treatment programs, from intense
residential regimens like Phoenix House to outpatient centers that offer a
few hours of counseling weekly.
It is also exploring nontraditional alternatives, such as acupuncture,
which has a large following among ex-addicts. A site
director for the acupuncture study, a doctor at the University of
California at San Fransciso, calls it "as good as anything
funded by the National Institutes of Health."
The research process is a slow one, often with ambiguous results -- which
makes it unsuited to Califano's style. CASA's big
splashes in the press usually come from research reports that cobble
together the most alarming data on drugs, which Califano
then goes on the road to promote: Highschool students say marijuana is
easier to buy than alcohol. Forty percent of
13-year-olds know someone who uses acid, heroin, or cocaine. Forty-five
percent of college students go on drinking "binges."
In many cases, the findings aren't new, but drawn by Califano's star
power, newspapers report them -- even though, in almost
every case, they ignored the more-nuanced scholarly articles from which
they are drawn. Only the New York Times
occasionally ignores the CASA reports, frustrating CASA's PR people.
"Their usefulness has been that they have the capacity to take hundreds of
studies and condense them," says one public-health
professor at Columbia, who confesses some awe and envy of Califano's
influence with the press. "But their condensing
process has the tendency to throw out at least half of the baby with the
bathwater."
AS HE DID WITH MCNAMARA, THE ex-cop, Califano often slams his critics as
"legalizers," suggesting that they would
like to see marijuana and cocaine sold from Good Humor trucks parked
outside schools. But the debate, most protest, isn't
really between those who want to protect children and those who don't care
about them -- everybody's "for" children. The real
debate is between two different ways of looking at the war on drugs.
>From 1980 to 1997, the federal drug-control budget rose from $ 1 billion
to $ 16 billion, and the number of people imprisoned
for drug violations rose from 50,000 to 400,000. The chief indication that
we're on the right path, Califano says, is that the
number of people who use illegal drugs regularly has dropped by half since
1979, from 25 million to 13 million. Marijuana
accounts for almost all of the drop.
Over the same period, the number of hard-core cocaine addicts has stayed
steady at about 2 million, and drug use has
become far deadlier. "In 1980 . . . no one had ever heard of the cheap,
smokable form of cocaine called crack, or
drug-related HIV infection or AIDS," writes Ethan Nadelmann, the director
of the Lindesmith Center, a drug-policy research
institute in New York, in a recent issue of Foreign Affairs. "By the
1990s, both had reached epidemic proportions in
American cities."
Half of all cases of AIDS -- the second highest cause of death in the
United States for people ages 25 to 44 -- stem from
injected-drug users sharing needles. Most researchers think that's a
devastating problem, at least as important as the number of
people who occasionally smoke marijuana. The American Medical Association,
the National Academy of Science's Institute of
Medicine, the National Institutes of Health, and President Bush's National
AIDS Commission have all endorsed
needle-exchange programs to attack it. The message they are trying to get
across is that drug abuse is bad, but dying of AIDS
is worse. Califano helped undermine the chance to put their proposals into
action.
"The tragedy of Joe Califano," says Nadelmann, "is that his anti-drug
fanaticism has made him indifferent both to the scientific
evidence and to the broader consequences of demonizing drug users."
AS A LEADER OF THE WAR ON drugs, Califano sets himself apart from other
experts who seem willing to step back from
their political passions to point out where policies don't square with the
research. In 1972, for example, Richard Nixon brought
together a commission of experts to examine the US approach to the
problem. Headed by Raymond Shafer, a former
Republican governor of Pennsylvania, the commission was far from leftwing,
yet it advocated pretty much what Califano now
calls Russian roulette: acknowledging that drugs cannot be eliminated from
society, treating drug use as a social problem as
much as a crime, and recognizing that law enforcement sometimes has high
financial and moral costs that bring few returns.
In the case of marijuana, the Shafer commission argued, the millions spent
on law enforcement, the time diverted from
investigating violent crimes, and the ruining of people's careers through
prosecution outweighed the harm of using marijuana.
In the late 1970s, President Carter was still able to endorse that view,
and in 1982, a National Academy of Sciences
commission echoed it. Today, almost no politician on the national level
would dare concede the validity of such views, and for
that, Califano deserves a large share of credit.
After Califano wrote a damning book about the Carter administration,
Governing America, Jody Powell, Carter's press
secretary, called Califano's book the ultimate example of the "if only
they'd listened to me" memoir: "His criticisms of others
might have been taken more seriously if he had been somewhat more willing
to acknowledge that somewhere along the way
he, Joe Califano, might have made a mistake, a misstep, or even a judgment
that could be reasonably questioned with the
benefit of hindsight."
CALIFANO HASN'T BEEN IMMUNE to mistakes and missteps. Take his proposals
to curb health-care costs -- a topic,
like drugs, that has been a long-standing interest. In the 1960s, he hit
upon the idea of driving down health costs by radically
increasing the number of students graduating from medical school in the
United States: from some 8,000 to 16,000. The more
doctors, the more competition, his argument went. The move had the
opposite from intended result. Since all those new
doctors were getting reimbursed by insurance companies for whatever they
did, the "reform" only increased the number of
doctors doing expensive procedures.
Don't look for any apologies from Califano. His writing on health care,
which he continued through the 1980s and '90s, has the
same tone of confidence and scorn for enemies as his talk on drugs. He
calls doctors "the medicine men" and blames high costs
on their greed.
FORMULATING DRUG POLICY IS at least as complex as combating health-care
costs. Often, the problem is
oversimplification. Much of Califano's polemical fury is directed at
marijuana because it is the most popular illegal drug and
also the one that people tend to shrug their shoulders at.
There's also the fact that most of the people fighting the war on drugs or
commenting on it -- Al Gore, Newt Gingrich, Dan
Quayle, CASA's Dr. Kleber -- have tried it.
Teenagers who smoke marijuana, Califano argues, are 85 times more likely
to try cocaine than those who haven't. Until a few
years ago, he would note that this relationship is "only statistical," but
then note that we used to think the connection between
smoking and lung cancer was statistical, too.
Lately, he has dropped all equivocation. In a press conference last fall
and in a Post column titled "Marijuana: It's a Hard
Drug," he said that CASA's research had, at last, weeded out any
confounding factors -- poverty, depression, single parents,
grades -- and proved that marijuana leads people to crave other drugs.
Some 80 million Americans -- about a quarter of the population -- have
used marijuana, and yet not many baby boomers
moved on to mainlining. "The Great Pot Experiment produced millions of
conventional, productive, upstanding citizens, plus a
few journalists," Michael Kinsley once wrote. If that's an exaggeration,
it's no more so than Califano's thesis that marijuana
sends people down the road to cocaine addiction.
Califano also claims that cigarettes and alcohol are gateway drugs, but he
doesn't take the step that should follow, given his
logic: that smoking and drinking cause marijuana use.
"What's disturbing about his center is that there are certainly people who
know better, who are experts, who will consistently
lump correlation together with causation and lump all drug users
together," says McNamara, the former police chief. "I don't
know if Califano knows better or not, but the things they say and do are
very hard to justify on a professional level. It's a
propaganda war, and the motivation, I think, is that the ends justify the
means."
A STRIKING EXAMPLE OF CALIfano rhetoric came in a 1995 paper on drug
legalization, where CASA confronted the
arguments made by libertarians such as William F. Buckley and Milton
Friedman that government should take minimal actions
against drug use, except where children are concerned.
Reasonable people can disagree about how far the government can go to
protect people from themselves and from the harm
that some drug users cause, and Buckley and Friedman represent one
extreme. But CASA's dismissal of civil-liberties
arguments was harsh. It pointed out that philosophers have said that
freedom does not include the right to choose to place
oneself into slavery. "Clearly," the report adds, "drug addiction is a
form of enslavement."
When I asked Califano about civil liberties, he stressed his commitment to
them but said drug laws were not an issue. "There
are civil-liberty problems in every aspect of law enforcement, and I spent
a lot of time when I was in government on those
issues," he said. "In the Johnson years, we passed the first bail-reform
acts. We did all that stuff. There are plenty of abuses,
but it's not a question of this law or that law. It's a question of what
kind of cops you have."
His overriding goal, he said, was to protect children, and every law, and
in fact all of CASA's work, has to be evaluated by
that measure. I asked him to set kids aside for a minute. Should a
45-year-old, I asked, have the right to light up a joint on his
back porch with no one around?
He cut me off before I could get it out. "Should a 45-year-old have the
right to shoot heroin in his backyard?" he barked.
"Should a 45-year-old have the right to, you know, snort cocaine in his
backyard? Should a 45-year-old have the right to put
a bullet through his head? Okay?"
In some ways, Califano's style distracts from his genuine accomplishments
in combating the abuse of alcohol and tobacco. He
deserves credit for launching the anti-smoking revolution, and for pushing
for steep taxes on cigarettes and alcohol long before
it was trendy.
LAST FALL, A GROUP OF PROMInent drug-policy experts and law-enforcement
officials sent representatives to
Washington to call for a truce in the debate on drugs. The discussions,
they said, had degenerated into shouting between two
groups stereotyped as "drug warriors" and "legalizers." The 36 signers of
the statement said that they, like most people who
have studied the problem, fit in neither description.
"In this climate," said the group, "every idea, research finding, or
proposal put forth is scrutinized to determine which agenda it
advances." They decried the "symbolic" laws that get passed in place of
policies based on scientific research and called for a
period of calm in which reason could be heard.
Who could oppose this manifesto for common sense? "It's hard for me to
imagine anyone at CASA signing our principles,"
said one of the researchers. "I think Califano's views are sufficiently
wedded to the absolute commitment to the status quo that
I suspect he would have found our statement to be more radical than it
is."
Neither Joe Califano nor anyone else at CASA signed on to the truce.
GRAPHIC: Illustration, no caption, ILLUSTRATION BY NICK GALIFIANAKIS;
Picture, Califano is rarely without a
popular cause. Here he attacks student-loan defaulters while serving as
HEW secretary; Photos 1 and 2, Whether he's
discussing women and substance abuse with Betty Ford or appearing with
Hillary Rodham Clinton at the Concert of Hope,
Califano brings a formidable Rolodex to his fight against drugs. AP/WIDE
WORLD
Back to top
October 3, 1997
In Drug-Policy Debates, a Center at Columbia U. Takes a Hard
Line
Institute's studies grab headlines, but critics call its approach
oversimplified
Christopher Shea
Whatever else you say about Columbia University's National Center on
Addiction and Substance Abuse -- and drug-policy
researchers have a lot to say about it, some of it unprintable -- it knows
how to work the news media.
Take an August press conference in Washington, led by the center's
president, Joseph A. Califano, a former heavyweight
Washington lawyer and Cabinet member who has now devoted his clout,
charisma, and workaholic habits to the goal of a
"drug-free America."
Ten television crews showed up on that Wednesday morning, along with
dozens of reporters. The president of the University
of Notre Dame, the Rev. Edward A. Malloy -- as irrepproachable a figure as
you can imagine to endorse a study --
introduced Mr. Califano by summarizing some of the headlines CASA has
generated: "Binge" drinking among women tripled
from 1977 to 1992. Anyone who makes it to the age of 21 without trying
alcohol, cigarettes, or pot is unlikely ever to become
a smoker or abuser.
Then Mr. Califano, tanned and resplendent in a dark pinstriped suit,
stepped up to the microphone, his raspy voice booming
through the room. "American children are smoking daily, drinking, and
using hallucinogens at the youngest years ever in our
history," he said. "We now have almost a million kids who play with the
fire of cigarettes, increasing the risk of being burned by
heroin, acid, and cocaine."
CASA, he announced, had nailed down its "gateway drug" theory: Teen-agers
who try marijuana are 85 times more likely to
try cocaine than teens who don't. New studies on rats prove that pot
triggers a craving for more drugs because marijuana
activates the same neurotransmitter in their brains that cocaine does --
dopamine. "The days of marijuana as a safe drug are
over," he said. "This research has crowned marijuana a 'hard drug.'"
Reporters scribbled this down, and there were few skeptical questions. A
typical one came from the ABC reporter on the
scene. "I don't want to oversimplify this," he said, "but is the war on
drugs being won or lost?"
ABC's lead story that night relayed CASA's findings without quoting a
single critic of the group. Nor did dozens of articles in
newspapers across the country. But as one young reporter left the press
conference, she turned to a colleague and said, "The
rhetoric they use is unbelievable. I mean, we all know people who tried
marijuana a few times in high school, or even smoked
it regularly, then gave it up and went on to good schools, and went on to
lead normal lives."
More than a few drug-policy experts share the reporter's skepticism about
CASA. From its start five years ago, the center has
been one of the loudest voices in the drug-policy debates. It has
substantial backing from the nation's blue-chip companies,
and makes headlines whenever it issues a report.
Some drug-policy experts have nothing but praise for the center's
hammering home of the cost to America of tobacco, alcohol,
and illicit drugs, and its pleas for more money for treatment and
research. At the press conference, Mr. Califano called
drug-abuse research "the area of greatest neglect" in American public
policy and proposed pumping up federal expenditures by
$ 1-billion a year. He wins plaudits for taking on not only shadowy drug
kingpins, but also alcohol companies and Big
Tobacco. He has, for example, proposed a $ 2-a-pack tax on cigarettes.
But CASA has also been accused of playing fast and loose with statistics,
skirting the academic peer-review process in favor
of grandstanding, and acting as an unskeptical cheerleader for the war on
drugs. It gets criticism both for what it says and what
it doesn't say. Mr. Califano, for example, has railed against proponents
of medical marijuana as charlatans who are trying to
sneak full-scale drug "legalization" in through the back door -- even
though advocates of loosening restrictions on marijuana for
cancer and AIDS patients have included such respected scholars as the
editor of The New England Journal of Medicine.
And although he is a frequent author of muscular op-ed pieces for various
newspapers, he has been conspicuously quiet about
needle-exchange programs, which many experts believe to be the most
important drug-policy issue on the table today.
Several federal commissions have said such programs could save thousands
of lives by reducing the spread of AIDS among
users of injected drugs. But because needle-exchange programs would not
necessarily reduce drug use, hard-core drug
warriors say they "send the wrong message."
"Califano is essentially a reincarnation of the old temperance warriors,"
says Ethan A. Nadelman, director of the Lindesmith
Center in New York, one of CASA's harshest critics. "It's 'demon alcohol,'
'demon cigarettes,' 'demon drugs.' It's Carry
Nation and the old anti-alcohol warriors, given a gloss by his association
with Columbia University and this 'sophisticated'
research center."
Dr. Nadelman, a former assistant professor of politics at Princeton
University, was lured to the Lindesmith Center, a
drug-policy research institute on the same city block as CASA, by the
philanthropist George Soros, who is using his fortune to
broaden the debate about drugs.
CASA says the success of the war on drugs can be measured by the number of
Americans who use marijuana and other illicit
substances, which dropped roughly by half in the 1980s. Dr. Nadelman looks
at the war through a different prism: As the
federal budget on the war on drugs rose from $ 1-billion to $ 16-billion
from 1980 to 1990, AIDS became pandemic among
injected-drug users, and crack addiction and violence took over major
cities. The number of hard-core drug addicts has not
decreased, and courtrooms are overwhelmed by people accused of drug
crimes.
Dr. Nadelman's focus is on "harm reduction" -- acknowledging that a "drug
free" America is a fantasy, treating addicts rather
than incarcerating them, and persuading those who can't quit to stop
sharing needles. Because he has argued for the regulated
decriminalizing of even hard drugs, Dr. Nadelman is considered far to the
"left" in the drug-policy debate. But many scholars
who balk at legalization agree with much of what he says about harm
reduction.
Some 70 million Americans have tried marijuana -- including many of those
leading the war on drugs -- so part of CASA's
agenda is to convince baby boomers that the drug is not as innocuous as
they remember.
The argument that marijuana is a "gateway drug" is key to that goal. Some
scholars say the gateway theory -- a "risk ratio," in
technical terms -- is a Statistics 101 kind of mistake. Sure, they say,
most cocaine users have tried marijuana. But look at it
another way: For every 100 people who have tried pot, 28 have tried
cocaine, and only one uses cocaine weekly. "It's a hard
job to convince people that marijuana is a hard, dangerous, highly
addictive, gateway drug," says Lynn Zimmer, a professor of
sociology at Queens College, the City University of New York, and
co-author of Marijuana Myths, Marijuana Facts (the
Lindesmith Center, 1997). "They are asking people to deny their own
experiences."
CASA's medical director, Herbert D. Kleber, responds that the risk that a
marijuana smoker will try cocaine is no different
from -- and even greater than -- the risk that a smoker will get lung
cancer. "The people who say most marijuana smokers
don't try cocaine either don't understand risk ratios, or disingenuously
pretend not to," he says. He is convinced that there is a
biochemical trigger that leads marijuana users to seek other drugs. "We
just haven't found it yet."
The Columbia center is an odd half-breed, trading on Columbia's prestige
while remaining mostly independent. Located 50
blocks downtown from Columbia's main campus, in a vaguely postmodern
skyscraper next door to Carnegie Hall, it has 50
staff members, only one of whom -- Dr. Kleber -- has tenure on the
Columbia faculty. Its annual budget is $ 7.3-million, with
the "core" financing coming from the Robert Wood Johnson Foundation, one
of the nation's largest health-care philanthropies.
It also gets checks from Mobil, CBS, Chrysler, Walt Disney, and dozens of
other corporations. Nancy Reagan and Betty
Ford serve on its board of directors alongside Columbia's president,
George Rupp.
Sitting in his office 12 floors above 57th Street in New York, Joseph
Califano explains how combating drug and alcohol abuse
came to be his calling. "Basically, I think substance abuse and addiction
is one of the greatest threats to this country," he says.
"You know, Toynbee said of the great civilizations -- he studied 16
civilizations -- the only thing that ever happened from an
enemy without is that they gave the coup de grace to an expiring suicide.
Substance abuse is an internal problem for the United
States. It's an enormous threat to our young people, and it's a threat to
our political system because of the corruption issues."
A plaque reading "This is a smoke-free workplace" sits front-and-center on
his desk. On the wall over his left shoulder is a
framed statement announcing his appointment as a domestic-policy adviser
to President Johnson. He takes special pride in a
more modest memento, a letter Johnson wrote him when he resigned to
re-enter private life. "You were the captain I wanted,"
it reads, "and you steered the course well."
Mr. Califano's story is a case study in how much American cultural
attitudes toward alcohol, tobacco, and drugs have shifted
in the past 30 years. In his years with L.B.J., he was the kind of smoker
that is hard to imagine today. He smoked four packs a
day, carrying two packs of Kents in one pocket, two packs of mentholated
Salems in the other, "for when my throat got sore."
Under Johnson, he helped push through the first Drug Rehabilitation Act,
which set aside $ 15-million for treatment and
research.
Mr. Califano quit smoking in 1975 as a birthday present to his son, Joe,
now an ear, nose, and throat doctor at the Johns
Hopkins University. He still drinks, slightly undercutting the Carry
Nation analogy. ("Sure I drink. Yeah, every day I drink. I
usually have a scotch at night, one or two scotches all the time.")
President Carter called him back from legal work to head the
Department of Health, Education, and Welfare, where he became intrigued by
studies showing that few people start smoking
after age 21. He set in motion what The Washington Post called in 1978
"the most energetic anti-smoking blitz ever,"
ferociously attacking ads aimed at children. This earned him the hatred of
politicians from tobacco-growing regions, and
planted the seeds for the federal regulation of cigarettes, a movement
that gains momentum every day. "The passion is real,"
even Dr. Nadelman concedes. Mr. Califano's outspokenness did him in,
politically: President Carter fired him in 1979, and he
went back to law.
Later, serving on the board of the Chrysler Corporation, which was trying
to cut its health-care costs, Mr. Califano was unable
to make a dent in the company's losses from alcoholism and drug abuse. "I
began to see, you know, it's everywhere," he says.
"This problem is just affecting everything." He needed little prodding
when James Burke, the chairman of the Partnership for a
Drug-Free America, approached him to found a research center. At CASA, Mr.
Califano says, his goal was to assemble "the
brightest group of people who have every been put under one roof on this
planet" to deal with the problem.
By consensus, the brightest academic star at CASA is Dr. Kleber.
Mild-mannered and self-effacing -- in an interview in his
office he comes off, at first, like a kindly family doctor -- Dr. Kleber
spent most of his career in Yale University's psychiatry
department, studying the biophysiology of addiction, before he went to
work for William Bennett, the first U.S. "drug czar," in
1989. He spends half his time at CASA, half in Columbia's psychiatry
department. He is courtly, polite, uncondescending,
with unruly graying hair and rimless glasses framing a pale face. Bring up
criticism of CASA, however, and you see another
side: He's got the debating chops of William F. Buckley, and will follow
you out the door to shoot down the arguments of the
harm-reduction camp.
Public policy, he says, should concentrate on keeping drugs as expensive
and difficult to obtain as possible, while social
opprobrium and criminal sanctions are necessary to combat the
"psychological" lure of drugs. Criminal penalties can also
persuade abusers to seek treatment -- which is why both he and Mr.
Califano oppose mandatory sentences, which reduce the
leverage judges can exert on drug offenders.
CASA has devoted much of its work to documenting the cost to the American
economy of drug use. In a 1994 report, it
announced that smoking, alcoholism, and illicit drug use would cost the
Medicare system $ 1-trillion over the next 20 years --
most of it from smoking. In spring 1996, it announced that substance abuse
was costing the city of New York $ 20-billion a
year.
In the summer of 1994, CASA took on the subject of drinking on college
campuses. "What was once regarded as a harmless
'rite of passage,'" the report said, "has in the 1990s reached epidemic
proportions." The news that binge drinking among
women had tripled made news nationwide. But the report also caused trouble
for the center when Forbes MediaCritic, a
now-defunct journal, said the rhetoric of the report was wildly overblown,
its statistics were all drawn from other people's
work, and some of its numbers were fudged.
The report, MediaCritic noted, buried the inconvenient fact that, over
all, binge drinking at colleges had remained steady for
decades. The journal also caught CASA out on a few statistics. One federal
study, for example, had found that 55 per cent of
female rape victims on campuses, and 74 per cent of male rapists, said
they were under the influence of drugs or alcohol during
the assaults. CASA translated that to say that 90 per cent of all rapes
involved alcohol, a strange bit of math.
"I wasn't inclined to leap to their defense," says William DeJong, a
lecturer on health communications at the Harvard School of
Public Health. The MediaCritic charges, he says, were "pretty serious
allegations, and in my view gave the alcohol industry an
opportunity to undermine their overall effort, which I think has been very
constructive." Henry Wechsler, also at Harvard's
public-health school, on whose work the CASA report was largely based,
says that "the gist of CASA's report was absolutely
accurate."
In 1995, CASA issued a "white paper" on drug legalization, which took on
the arguments of such groups as the American Civil
Liberties Union. The A.C.L.U. has pointed out that the drug war has turned
the United States into the nation with the highest
incarceration rate in the world, and that widespread urine testing and
seizure of "drug-related" property represent a drastic
curtailment of basic rights.
CASA dismissed civil-rights concerns by quoting John Stuart Mill, a
favorite of libertarians who oppose drug laws. Mill said
individuals did not have the right to enslave themselves. "Clearly,"
CASA's report said, "drug addiction is a form of
enslavement."
"Very thin," is the verdict of Peter Reuter, a professor of public affairs
at the University of Maryland at College Park who
studies drug policy. "It was hard to distinguish that paper from something
put out by the Drug Enforcement Administration."
He and others say that CASA's estimates of the costs of drug use are
pretty good guesses, but not much more than that.
"They've released a number of studies that ought to have been
peer-reviewed," Dr. Reuter says.
As hard-hitting as the CASA reports can be, Mr. Califano turns up the
volume in his op-ed pieces. In December 1996, he
said that voters in Arizona and California who had voted to give doctors
the right to prescribe marijuana had not exercised
informed judgment on the topic, but were "bamboozled" by "a moneyed,
out-of-state-elite" that paid for advertising promoting
the referenda. He described George Soros, the philanthropist who gave $
550,000 to the cause in California, as "the Daddy
Warbucks of drug legalization." Mr. Soros has since said he does not favor
legalization, although he thinks penalties for
marijuana possession are too severe.
Last February, in another opinion piece, Mr. Califano compared medical
marijuana to laetrile, a quack cure for cancer in the
1970s. Hundreds of people were taking laetrile, despite no evidence that
it worked. The government reluctantly tested it and,
to no one's surprise, found it to be ineffective. "As with laetrile, we
should count to 10" on medical marijuana, Mr. Califano
wrote.
William London, the director of public health for the American Council of
Science and Health, based in New York, says he
was "outraged" by the analogy. Laetrile didn't work at all, he notes, but
as early as 1982, the National Academy of Sciences
said marijuana "has shown promise in the treatment of a variety of
disorders." The only question is whether medical marijuana
works better than existing drugs.
"I think CASA does some impressive presentations," he says. "They collect
data that are important to consider. But my
bottom-line concern is that this is a group that is interested in painting
the most alarming picture possible about the drug
menace, and I don't think that's the most constructive approach to dealing
with the problems of drug abuse."
Mr. Califano has also come down hard on those who propose that the United
States try some of the experiments of Western
European countries, such as the Netherlands's allowing the sale of
cannabis in coffee shops, under tight restrictions, to separate
it from the "hard" drug trade. CASA notes that marijuana use by teens has
risen in Amsterdam -- a statistic that others dispute.
Its critics counter that, whether or not there's been a rise in Amsterdam,
many more American than Dutch teen-agers smoke
pot. "They go around attacking people with other points of view," says
Craig Reinarman, a professor of sociology at the
University of California at Santa Cruz. "As if we don't need a more
pluralistic debate about drug policy! The reason we need a
more robust debate is that we've had the most punitive form of drug
prohibition in the industrialized world for most of the 20th
century, and levels of drug abuse don't go away."
Last month, 36 drug experts and policy makers made a plea for just such an
open-ended discussion. "The current drug-policy
debate," they wrote, "is marked by polarization into two positions
stereotyped as 'drug warrior' and 'legalizer.'" The statement
calls for a drug policy, rooted in science, that weighs the risks of drug
use against the equally real risks of overzealous law
enforcement.
CASA, which most scholars would place firmly in the warrior camp,
complains that calling it a polarizing force is unfair. Much
of CASA's work is in the field, not on opinion pages. Dr. Kleber, for
example, is overseeing a comparison of 200 treatment
centers, drawn from a nationwide sample of 5,000, ranging from long-term
residential programs like Phoenix House to
outpatient programs that counsel patients only a few hours each week. CASA
is also evaluating the efficacy of acupuncture in
curbing addiction, a popular treatment that has sketchy scientific
support.
The University of Maryland's Dr. Reuter credits Dr. Kleber with building
up a credible research program. "The combination of
Califano's fund-raising ability and Kleber's competence is a powerful
one," he says. "Whether this justifies the lavish institution
and a simplified message, I'm not sure."
"There's a lot of noise that comes out of there that seems unrelated to
any research activity."
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