Los Angeles Times Interview : Mathea Falco : Finding the Right Road to a Drug-Free America

As many as 5.5 million Americans have a drug problem serious enough to need treatment. That includes at least half of the 1.1 million people in the country’s prisons and jails. The annual cost of drug abuse--in crime, accidents, lost productivity, health care--has been estimated at $300 billion. And the federal government is spending another $12 billion a year trying to keep the problem in check.

If Americans are gloomy about the drug problem, they have good reason. Yet the pessimism is prompted in part by ignorance, some experts argue. They say few Americans understand how much is already known about preventing and treating drug abuse; as a result, anti-drug efforts have been misdirected.

With that in mind, drug-policy specialist Mathea Falco spent four years exploring what works and what doesn’t. In her new book, “The Making of a Drug-Free America,” she describes what she found--drug-abuse prevention programs that actually prevent drug abuse, treatment programs that successfully treat addiction and community organizers who have driven drug dealing from their neighborhood streets.

A 1968 graduate of Yale Law School, Falco served as assistant secretary of state for international narcotics matters between 1977 and 1981. She is a former chief counsel to the Senate judiciary subcommittee on juvenile delinquency. Currently a visiting fellow at New York Hospital-Cornell Medical Center in New York, she has been mentioned as a possible drug czar in the Clinton Administration. She is married to Peter Tarnoff, the newly appointed under secretary of state for political affairs.

A small, animated woman behind a large pair of glasses, Falco sat amid the drug-policy tomes in her bare office one recent morning and discussed what she sees as the shortcomings of the country’s approach to illegal drugs. The problem will remain uncontrolled, she believes, “until we begin to build on what we know, rather than on what we feel.”

*

Question: So, how are we doing in the war on drugs?

Answer: Fortunately, there have been declines in marijuana and cocaine use, particularly among better-educated Americans who are concerned about their health. Unfortunately, drug addiction and drug crime have reached the highest levels we’ve ever seen in this country. . . . And they have continued to increase in spite of the billions and billions of dollars spent in this war on drugs.

*

Q: What are we doing wrong?

A: The initial strategy that President Reagan implemented focused almost entirely on trying to cut off the supply of drugs through foreign eradication and interdiction programs. Since 1981, American taxpayers have invested $100 billion testing that theory. Unfortunately, heroin and cocaine are more readily available at cheaper prices than ever before. We can conclude that the strategy is not working and that it could never work--no matter how much more money we put into it.

At the same time, we have learned through extensive studies . . . that there are ways to reduce the demand for drugs through prevention, education, treatment and community law enforcement. But these approaches are still very limited.

*

Q: What should the Administration do?

A: . . . At the present time, fewer than 20% of the nation’s addicts can get drug treatment, unless they can afford to pay for private care. And that is at the heart of a lot of the problems that we see, particularly in the criminal-justice system, because these addicts continue to get recycled through the courts and the prisons. Their behavior doesn’t change, and they are in that endless cycle of crime and addiction.

(Clinton) also indicated during the campaign that he would put 100,000 new police officers on the streets for community-policing programs. And these programs have been very effective, in the places that they’ve been tried, in preventing both crime and drug abuse. He’s also talked about creating a national service corps so that young people can pay back their college education by working for law-enforcement agencies and social-service agencies. I think that will make a huge difference in terms of providing people to help in prevention and treatment programs.

*

Q: Anything he should be doing that he hasn’t mentioned?

A: In the past, the major focus of international efforts has been on drug- crop eradication--trying to wipe out the coca fields in Peru and Bolivia. Those efforts have not been successful. Coca production continues to increase every year, and there is no end to the possible drug producers around the world. In fact, in the former Soviet Union, many states have now become major producers of opium for the heroin trade. . . .

So I don’t think it’s a viable strategy to think about trying to pull up every drug plant around the world. But I do think there are some valuable international initiatives that could be undertaken, particularly those that target the major financial networks that support the traffic. The U.S. should take the lead in going after money-laundering internationally. We now have a treaty that was adopted in 1988 that provides a framework for this. But it will take real leadership to make it a meaningful tool in the fight against the drug lords.

*

Q: What is the proper balance between funding for law enforcement and funding for prevention and treatment?

A: I’m not sure that there’s an ideal percentage. But I do know that until 1981, both Democratic and Republican administrations had kept the balance fairly even. Actually, Richard Nixon put two-thirds of the federal drug budget into treatment. So this is not a partisan issue.

But since 1981, more than three-quarters of the federal drug budget have gone to supply-control efforts. That has to change. . . . We need to figure out what kind of approach works best, and that’s where we should be putting our money. Because the American taxpayer cannot afford to invest money in approaches that are not paying off. Nobody’s winning.

*

Q: Why have we clung to this approach?

A: For a long time, people didn’t understand that it didn’t work. Because, theoretically, it sounds very appealing. . . . I think the public is beginning to understand that this is an approach that is just not going to work, no matter how much money we put into it. . . . And meanwhile, there are approaches that really have proved that they can work: prevention programs that can cut new drug use by half among 6th- and 7th-graders; treatment programs that report a success rate of three out of four if people stay in treatment for a year or longer; prison programs that reduce recidivism by half among released prisoners for three years after they’re released.

*

Q: Why aren’t those programs more widely used?

A: A lack of knowledge has been one problem. . . . And secondly, I think, because the dominant emphasis of public policy was on proving we could cut off the supply of drugs. Therefore, money just wasn’t available. There’s been very little money for prevention, treatment, community organization in the last 12 years.

*

Q: Hasn’t there also been a lack of public sympathy for addicts?

A: Well, there is this notion that we need to get tough on drugs. But what I say is that prevention and treatment--different kinds of approaches aimed at reducing demand--is not getting soft; in fact, it’s getting tough. . . . There’s nothing tougher than an intensive drug-treatment program, as anyone who has participated in one will tell you, because it involves a really profound change in your attitudes and your behavior. What we need is a real combination of compassion and toughness. We now know, for example, that treatment can work for people who are under the threat of court order. My book talks about a number of examples, about diversion programs that instead of sending drug offenders to prison, put them into these very structured, rigorous drug-treatment programs which also involve job training, education. They are drug-tested every day and if their urine shows drug use, they immediately go to prison. This is a very powerful incentive for them to get clean and to get productive. And in these programs there have been remarkably good success rates.

*

Q: What would it cost to set up the kinds of programs you’re talking about?

A: We could go a long way toward reducing the demand for drugs using the money we’re already spending. We need to redirect it.

A lot of these demand-reduction programs are relatively cheap compared with the cost of the high technology that, for example, the military is using to try to track some of these drug shipments. A prison drug program, for example, costs about $4,000 a year, per inmate, above the regular cost of incarceration. The Institute of Medicine’s big study on drug treatment, that came out in 1990, reported that these programs are cost-effective the day the prisoner walks out, because of the reductions in drug crime and addiction and destructive behavior.

. . . Drug use is now costing America $300 billion a year in lost productivity, in accidents, in health-care costs, in crime. A lot of these costs could be reduced substantially if we were able to deal with the addiction before a lot of these costs were incurred. For example, in the workplace, there has been substantial progress in big corporations in discouraging drug abuse among employees. And these companies have reported substantial savings.

*

Q: Is public opinion ready for a real shift in the way anti-drug money is allocated?

A: The wonderful thing is that most Americans are not wed to a certain strategy. . . . They see how drug crime and drug abuse are really corroding the fabric of American society. They want to do something that works. I don’t think they have any kind of preconceived, ideological commitment to doing it one way or another.

*

Q: But you suggest, in the book, certain long-standing public attitudes about the drug problem.

A: The historical framework that has shaped our attitudes about drugs in this country is at least 100 years old. And, initially, the drug laws were passed in large part as a result of xenophobia toward certain racial and ethnic groups, particularly foreigners. The drug problem was defined largely as a foreign problem. . . . Now we are beginning to understand . . . that the problem is right here and the answers are right here at home, and that if we are going to tackle this problem, we have to tackle it right here in our families and in our schools and in our communities and on the streets of our cities.

*

Q: What about legalization?

A: I oppose legalization. I think it’s a counsel of despair. We have not begun to try to use the tools that could make a difference in reducing the drug problem. I don’t think legalization would reduce the crime problem; it would create different kinds of crime. Anybody who was not allowed to get the drug legally at very cheap prices would help create a black market to supply the drug. . . .

I also think it would substantially increase the numbers of drug abusers and addicts in this country. Crack cocaine, for example, is the most addictive drug we’ve ever seen, and I think that a lot of people, if it were available like sugar or salt, would try it, would get hooked. A lot of people would get into trouble, and I think a lot of young people in particular.

Finally, I think to legalize drugs sends the wrong message completely. We know these substances are dangerous. I think to say that we’re now going to legalize them not only implies tolerance but social approval. And that that would reduce substantially the kind of barriers that people feel about trying drugs. . . . I think the present criminal laws provide enough flexibility to change our focus substantially without legalizing.

*

Q: So why has there been a small groundswell in favor of legalization?

A: Well, I think that drug policy has become so polarized in the last 12 years because of this extraordinarily dominant focus on supply control and law enforcement at the expense of treatment and prevention and community organization, community policing, that a lot of people feel real despair. They think that nothing can work and therefore you might as well legalize. That’s why I said it’s the counsel of despair, which I think would be very costly to this society.