April 2, 1999

The new federal drug control strategy, which comes with a $17.8 billion price tag, has at least one provision sure to be warmly greeted by APA members-a call to extend parity insurance coverage to substance abuse disorders.

This is the first time the federal drug control plan has included a call for parity for substance abuse, observed Richard Suchinsky, M.D., vice chair of APA's Council on Addiction Psychiatry. The call for parity "merits significant praise," said Suchinsky.

Another positive aspect of the federal plan is a new emphasis on seeing that "prevention efforts have a scientific base," Suchinsky said. In the past, he added, "so much of prevention was based on what people thought might be good as opposed to what the data would support. The fact that they are supporting science-based prevention efforts will, I think, have a very positive impact on the field."

The inclusion of tobacco in the strategy is a plus, but the exclusion of alcohol, except for a specific youth prevention initiative, is a shortcoming, Suchinsky continued. "I think one of the big holes in the entire strategy is that alcohol, our [society's] generic drug, is not in the strategy. Alcohol has as much or more of an impact on the overall health of the nation as many of the illicit drugs targeted by the strategy."

Mindy Fullilove, M.D., a member of the APA Council on Addiction Psychiatry, expressed frustration over the federal drug control strategy's continuing emphasis on law enforcement. She cited a recent series in the New York Times that focused on how efforts to fight crack cocaine had led to the imposition of a virtual police state in some communities and a general assault on civil liberties nationwide.

The epidemic of crack use "was neglected as a health problem and seen entirely as a law [enforcement] problem," said Fullilove. "It seems the current budget continues the overemphasis on law [enforcement] without correcting the under-emphasis on the prevention and treatment of addictive disorders. This is a sorry state of affairs."

The federal drug strategy also sparked criticism from a variety of drug policy reform advocates. The antidrug strategy announced by Office of National Drug Control Policy (ONDCP) Director Barry McCaffrey "betrays his promises to stress treatment and prevention as the central elements of an effective drug control strategy," remarked Eric Sterling, J.D., president of the Criminal Justice Policy Foundation. "The latest strategy still nourishes the prisons, the military, and failed overseas tactics at the expense of prevention efforts and treatment programs to protect American families and neighborhoods."

He noted that the federal budget's percentage increase for enforcement programs is 30 percent greater than that for prevention and treatment programs.

Common Sense for Drug Policy, a Washington area drug-policy think tank, issued an alternative national drug strategy put together by a coalition of reform groups. "The current model of drug control relies primarily on law enforcement to seize drugs and imprison drug offenders," the report notes. "While these efforts have produced large numbers of arrests, incarcerations, and seizures, drug overdose deaths have increased 540 percent since 1980, and drug-related problems have worsened."

The Web address of ONDCP is www.whitehousedrugpolicy.gov; Criminal Justice Policy Foundation's National Drug Strategy Network: ; and Common Sense for Drug Policy: www.csdp.org. -R.B.K.