A Just-Say-No Joe : In His Battle to Rid the Nation of Substance Abuse and Addiction, Joseph Califano Uses a Most Potent Weapon: Himself

When you are sitting in a room with Joseph A. Califano Jr., you don’t dare have another thought. You don’t think about the decline of the dollar or the devastation in public schools. You don’t worry about accumulating parking tickets. You don’t even look over his shoulder out the window past a maze of mid-town Manhattan high-rises at a tiny patch of Central Park.

There is only one thing to think about: the evil that substance abuse and addiction have wrought upon American society.

Everything must be seen through that prism when you’re with Joe Califano.

After spending most of three decades in America’s peripheral vision, he is now using his celebrity and his high-powered connections to spotlight this worthy subject.

The hyperbole is stunning.

“There is no place in the country like we’ve created,” Califano starts off, describing the Center on Addiction and Substance Abuse (CASA) that he started in May, 1992. “There is no place that looks at addiction in all parts of society--health care, crime, prison, courts, homelessness, the workplace.”

He describes the experts who work at CASA as among “the best minds in the business.” Their studies demonstrate that “to deal with health-care costs, the single most important thing you can do is go after cigarettes, drugs and alcohol.”

Yet Califano talking and writing this way is considered CASA’s best asset. In newspapers, on TV, before critical congressional committees, at dinners with foundation presidents and teas with First Ladies--he’s relentless.

An academic researcher in substance abuse begrudgingly acknowledges Califano’s impact in just three years: “Even the snobbiest researcher sees that Califano’s media and political savvy are great for all of us. We write the papers, do the studies and he translates them.”

Califano calls it giving “panache” to the issue, perhaps the way Don Henley did for Walden Pond or Magic Johnson did for AIDS or Ralph Nader did for consumer affairs.

In fact, Califano has created his own $24-million bully pulpit. CASA is also aiming grants at analytical projects--some original, some not.

What remains to be seen is if CASA can become the great institution Califano would like it to be. Can CASA liberate the national will to put tax and other dollars into fighting addiction as well as educate the public and policy-makers to remove the stigma from the problem?

“In getting public awareness, we’ve notched it up a little bit already,” Califano says of his impact so far. “We still have a ways to go.”

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The first time Califano runs through the high points of his 36-year career, he sounds as if he’s pitching a television special about “Great Moments in American History: The 1960s-1980s.”

He was John F. Kennedy’s general counsel to the Army; Robert McNamara’s assistant when he was defense secretary; Lyndon Johnson’s domestic policy chief when they designed the Great Society; Jimmy Carter’s Health, Education and Welfare secretary; the Democratic Party’s lawyer when it sued Nixon’s Committee to Reelect the President three days after the Watergate break-in; the Washington Post lawyer for Woodward and Bernstein, and lawyer to corporate America during those crazy heady days of the 1980s.

“I’ve had God’s greatest life,” says Califano, 64, making it completely obvious that good fortune includes an upbringing in middle-class Brooklyn, raising his three children--Mark, Joseph III and Claudia--by his first wife, and a second marriage in 1983 to Hilary Paley Byers--as in CBS Bill’s daughter.

A little while later, when he’s asked why he started CASA, he recasts his resume, making it clear at every juncture why his life was headed toward this current crusade.

When he was crafting Great Society laws for Johnson, he learned that many doctors were realizing that alcoholism should be treated as a disease, not just as a crime.

And when he was looking for a White House doctor for Carter, Califano interviewed 200 candidates, many of whom argued that he couldn’t have a serious health policy unless he pursued the ills of smoking.

After arming himself with a federal study on smoking, he launched a media campaign that enraged the tobacco industry, which claimed he was a zealous former smoker out to destroy them. (In truth, Califano had kicked a four-pack-a-day habit in 1975 relatively easily after his son asked him to as a birthday present.)

He had just launched a similar campaign focused on alcohol abuse when he was summarily rolled out of the Carter Cabinet in July, 1979, for hogging the spotlight too many times.

Throughout the 1980s he started and merged law firms, ultimately expanding and managing the Washington office of Dewey Ballantine, the powerhouse New York firm where he first worked in 1959, fresh out of Harvard Law School.

To hear him talk, his lucrative legal work was as important to him as his public service activities in those years.

In 1980, he did a study for then-New York Gov. Hugh Carey about the state’s heroin problems. Later, he wrote a book called “America’s Health Care Revolution,” attacking the medical system for keeping costs high and concluding that America needed a national institute on addiction.

“I just saw the problems everywhere and started to think about how the hell we do something about them,” he says.

A Washington warhorse, Califano became disgusted by the whole lobbying and lawyering scene in the nation’s capital.

“You reach a point where you think you can do anything--’Yeah I can call Senator X. I know him; I know everybody.’ ”

Yet without that ability to pick up the phone and get to just about anybody in corporate America, Califano never could have started CASA so successfully.

In the early 1990s he had a meeting with Dr. Steven Schroeder, the president of the powerful Robert Wood Johnson Foundation, with an outline for CASA on a yellow legal pad--and not long after received an $8 million grant. It helped that Califano had done legal work for Johnson & Johnson.

Similar meetings produced equally impressive results. In time CASA had so much money and support from prestigious foundations--Ford, Carnegie, Rockefeller, Hearst, Commonwealth--and big corporations such as Coca-Cola and Chemical Bank, that CASA was the envy of other academic researcher centers.

But people invested in CASA because it was Joe Califano.

“We knew that Joe Califano is a person who could take an issue and give it high visibility,” says Schroeder, who later hooked up Califano with Dr. Herbert Kleber, a prominent physician and researcher who had been deputy to Bush’s drug czar William Bennett and is now CASA’s executive vice president and medical director.

CASA’s office opened in a high-rise on 57th Street, wedged between Carnegie Hall and the Russian Tea Room. Within a short time there was a 40-person staff and a $7 million annual budget.

An important element in giving CASA instant clout in scientific circles came from its association with Columbia University, which Califano made happen after a 10-minute conversation with its then president, Michael Sovern.

Yet while some of CASA’s key staff come from Columbia’s faculty and all press releases prominently feature the Ivy League college’s name on the stationery, there has been little else done with the university in the last three years.

“We’d like to do more,” says Califano eagerly, launching into a description of his “vision” to make Columbia “the intellectual research demonstration capital of the world for substance abuse.”

CASA has kept a tight focus on how much government spends on people who are ill from substance abuse and addiction. For example, in February CASA released a computer analysis that showed that substance abuse and addiction accounted for $77.6 billion of entitlement payments--Medicaid, Medicare, Social Security disability insurance, veterans health and other federal health programs, and welfare--with 92% to treat the “consequences” of abuse and only 8% for prevention. There have been several of these types of cost-benefit analyses and they have produced a blitz of good media for CASA.

Yet CASA has also taken some heat for its reports, most notably one on drinking on college campuses, which included startling statistics culled from various journals and documents. Issued last June and widely covered in the media, including the Los Angeles Times, the study concluded that “binge” drinking had dramatically increased on America’s campuses, leading to a rise in death, violence, rape and the spread of sexually transmitted diseases.

A Forbes MediaCritic magazine article and a professor at the State University of New York savaged the report, accusing CASA of exaggeration and of using unreliable sources, and blaming the media for uncritically examining CASA’s statistics because they came from Califano.

He bristles at the whole incident. The MediaCritic article was wrong, he insists. Then he calls in an aide to deliver a point-by-point rebuttal as well as quotes from college administrators and governors praising the report.

The CASA project to receive the most praise--Children at Risk--has been its one effort to provide tangible help to the troubled poor.

A six-city project financed by the Justice Department and grants, Children at Risk pays for a torrent of services for a child and his or her family at an annual cost of about $4,000.

This project was created by William J. Grinker, former New York City Human Resources Commissioner and an adviser to Mayor Rudolph Giuliani on welfare issues during his campaign. When Grinker joined forces with Califano in 1992, he brought Children at Risk and another plan to examine addiction problems of former inmates.

The union was intended to bring prestige and money--$12 million--to CASA. But in less than a year Grinker and Califano clashed both personally and philosophically--with Grinker committed to long-term, traditional research projects and Califano eager for a faster turnaround on projects that were less costly and involved some existing research.

In fact, it was easier to compromise on philosophy than personality: A year after he arrived, Grinker left CASA, although his programs and staff remained.

In an interview, Grinker said his separation agreement prohibited him from commenting publicly on CASA’s work. Califano would say only that the relationship with Grinker “didn’t work out. It was personalities.”

People who worked with both men say they had similarly oversized egos but that ultimately CASA was Califano’s creation and shop, and Grinker left in a huff.

Califano is a famously difficult boss and colleague, say people who have worked with him in government and law firms.

A Washington friend explains: “He’s very political, very driven, and fundamentally well-meaning. But he’s also impossible. He doesn’t ask questions once he asks them five times.”

Although some friends claim that in his new incarnation in New York City, Califano might be mellowing, a former CASA staff member who also admires him says he still can be difficult.

“Joe is brilliant and forceful,” says the former CASA official. “But as much as I learned from him I had to leave. When you’re in the room with him you worry there won’t be enough air left for anyone else.”

Califano is used to the complaints. “When I want to get something done I drive to get it done,” he admits. “We have talented people here and everyone of them can do more than they think they can do, and they can do it better than they think they can do it. My job is to pull that out of them.”

In the meantime, CASA is launching more studies, including an evaluation of 200 alcohol and drug treatment programs nationally financed with a $3.1-million federal grant. And Califano is also spending more time raising money. He has pledged to stay at CASA for 10 years and hopes to leave behind a substantial endowment.

But as critical to CASA’s future as fund-raising is the impact Califano makes with that money--and with successful demonstration projects such as Children at Risk. For demonstration projects are often like mayflies--thousands of them are born; they flutter; they die--and no one weeps.

Califano says his staff wants to put together a manual on how to run Children at Risk so it can be replicated. Beyond that he doesn’t have a strategy to replicate the program on a larger scale except that he hopes to lobby the government for financing: “There’s no question the program has had an impact. We’d like to get Congress to do something with it.”

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There will always be skepticism about well-funded foundations like CASA because it still mostly involves academic and policy research for problems that get down to a very personal level. And there will always be cynicism about people like Califano--Joe Q. Citizens out there stumping for temperance and understanding from a high-rise office in mid-town Manhattan.

But in a mixture of altruism and power-mongering, Califano’s friends and critics alike see a lot of devotion and Catholic ideology in what he has chosen as his life’s work.

“We’re never going to have the Garden of Eden,” Califano says. “I have no illusions about that. But we can certainly make tremendous strides by reducing costs and reducing illness, by getting a lot of people to quit smoking or to drink in moderation and not to use drugs. We can deal with a lot of these problems and we shouldn’t focus all our attention on the end. It’s shoveling up after the elephant.”

Later, when he is asked about his own legacy, he doesn’t mention the White House years or the million-dollar fees he earned as a lawyer or the country house in Connecticut.

“Listen, I still want to do something with my life. I hope I can really put this subject in the mainstream.”

Again, he returns to the grand scheme.

“This country really needed something like CASA. And in starting it, I am reborn.”