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Parental Involvement Is Crucial In Treating Drug Problems

Joseph Califano Jr., founder of the National Center on Addiction and Substance Abuse at Columbia University, is calling for a cultural revolution to address the nation's drug problem. He served in the Johnson and Carter administrations, and started the country's first anti-smoking campaign in 1978.

Califano is an advocate for more investment in addiction treatment and prevention.

During a phone interview, Califano talked about many of the issues he raises in his book "High Society: How Substance Abuse Ravages America and What to Do About It." Here is a condensed version of his comments.

Q: Why does America have a drug problem?

A: From the earliest times, we're subjected to a lot of advertising, a lot of sense that there are drugs to change your mood, there are drugs to change your pain, help you get rid of headaches, help you ease arthritis,if you're down, if you're tense to help you relax. . . . There's the constant merchandising, particularly with respect to alcohol. . . .

I think you can't separate alcohol from drugs. I think most people who are using drugs are abusing alcohol: it's very much of our young people. If you get a kid through age 21 without smoking, without using illegal drugs and without abusing alcohol . . . that child is virtually certain not to abuse substances in the future. There will always be exceptions.

Q: What needs to change?

A: We need a revolution. Parents do have to get involved. We have to recognize this is a major -- if not the major -- public health problem -- Two, we've got to get the stigma off of this stuff.

Q: Do you think more money needs to be devoted to treatment?

A: We need to learn a lot more about (treatment). That's particularly true in respect to adolescents. There's a tremendous absence of good treatment for adolescents all over the country. We need a major investment. If this were any other disease, we'd have a major investment in the National Institute on Health Research. The availability of treatment is very important. This is a complex problem. At the moment when somebody says, "I'm going to try to get this monkey off my back,' not to have someplace to go is devastating . . . because those moments are rare and far between. If you miss that opportunity, that person can be condemned to more years of suffering and addiction.

Q: The reasons that people get into drugs in the first place are complex and it sounds like the ways to fix it are, too.

A: Parents really (need to be) engaged in their children's lives. If I could wave a wand and create a new world, that would be a big part of the new world. Because getting those kids through high school, through age 21, without getting into this stuff is critical. And that is mostly the function of parents. That's the biggest prevention potential we have. Parents don't understand how great their influence is on their kids. Kids do listen and parents should be talking to their kids about it. It's not simply a matter of saying to your child, "Don't use drugs." If you haven't built a relationship, that's just a hollow statement.

Parent power is the most under-utilized tool we have in the war on drugs. I hate that term, "war on drugs." I think that we have to get the message out to parents that they are where the action is. That's where it's at. They can do more about it than any senator, congressman, any cop or counselor.

Q: What do you tell a parent whose child is already using drugs? How can parents help those children?

A: It's awful. If they had the resources, they could put them into treatment. That's one of the tragedies of insurance. Insurance doesn't cover most of this treatment, not just the absence of public programs, but private insurance for the most part doesn't adequately cover substance abuse treatment. . . .

If somebody has diabetes or hypertension, they can go to the doctor and they have to have continuing treatment. . . . If an alcoholic or drug addict needs continuing treatment, we don't give it to them. If they fall off, we condemn them. The length of time someone needs in treatment varies enormously, depending on their situation. . . . We need a revolution in the way people look at this problem. It's doable.

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