Assaying Clinton's Drug Policy

DURING last year's presidential campaign Bill Clinton said his anti-drug policy would include ``treatment on demand.'' To his critics in Congress, the national drug strategy the president actually announced seems a thin echo of the campaign promise. Many speculated that Mr. Clinton's commitment to solving the drug problem had evaporated.

The strategy statement was enough, however, to generate some tentative optimism among drug-treatment and drug-policy experts who have pored over the document since its release late last month by Lee Brown, head of the Office of National Drug Control Policy.

``It's a grown-up document,'' says Mark Kleiman, a professor at Harvard's Kennedy School of Government who has followed drug-policy leaps and starts since the ``war on drugs'' was renewed by President Reagan in 1982.

At this early point in the administration, with Mr. Brown in office only about four months, ``what's important is to get the concepts right,'' Professor Kleiman says.

So far, the strategy has little but concepts. Funding details, the heart of a viable drug strategy, are expected to come next year as the administration prepares its next budget.

Still, Kleiman ticks off several reasons why he found the Clinton/Brown strategy ``path-breaking'':

* It sets priorities among drugs to be targeted (cocaine and heroin).

* It sets priorities among users to be helped (the so-called ``hard core'').

* It acknowledges that some current programs aren't working (international interdiction, among them).

* And it includes alcohol abuse among the problems that have to be addressed.

The goal of expanded treatment, especially for hard-core users, is welcome, says Herbert Kleber, executive vice president of the Center on Addiction and Substance Abuse at Columbia University. While calling the strategy a ``well-intentioned document,'' he comments, `My concern is, where's the money?'' `A disaster'

Those sentiments are shared by Mitchell Rosenthal, president of Phoenix House, the country's largest provider of private residential care for drug addicts. Dr. Rosenthal found ``some very, very helpful language and positioning'' in the drug strategy. He praises the ``targeting of heavy and high-risk users'' and the statement that drug-abuse policy ought to be a ``cornerstone'' of the administration's broader domestic policy, since drug use affects health, criminal justice, housing, and welfare.

But beyond this ``conceptual framework,'' Rosenthal continues, the administration's strategy document was ``a disaster.'' There are no provisions for funding, he says, no outline of what's needed to achieve the broad goals.

It's important to keep in mind that drug policy is like an ocean liner, says Eric Sterling, president of the Criminal Justice Policy Foundation in Washington. First you have to fix the new bearings, ``then get people to make the appropriate changes.'' What worries Mr. Sterling is not the lack of funding details - they should come early next year - but Clinton's low-profile role in announcing the new policy.

``I'm concerned more because I see it developing in a political context,'' says Sterling. ``The Republicans are salivating at the prospect of attacking the president on this issue.''

He foresees continued attacks on Clinton's commitment to solving the drug problem - an attack some Democrats, such as Rep. Charles Schumer of New York, may join. He also expects ``soft on crime'' attacks if the administration decides to scale back mandatory minimum sentences for drug users - a policy currently under consideration.

The big question is: Will Clinton use the resources of his office to build public and political support for increased investment in drug treatment?

The added investment doesn't have to be huge, says Dr. Kleber. His center has estimated that the boost in treatment programs needed to serve some 2.3 million hard-core users across the country would require an additional $2 billion in federal spending beyond the $4.5 billion being spent for treatment now - out of a $13 billion federal anti-drug budget.

William Butynsky, executive director of the Association of State Alcohol and Drug Abuse Directors, notes that the president's health-care plan includes coverage for some substance-abuse treatment. That benefit might help the middle-class user who's trying to kick a habit, says Mr. Butynsky, but for homeless addicts on the streets it's ``woefully inadequate.''

``It's not so much whether drug abusers will be covered,'' says Rosenthal, ``but if you're not providing them with some mechanism, some new money, then their spread of disease, unwanted pregnancies, child abuse - all of this - will be having a tremendous impact on hospitals and health-care costs.''

New funding for drug treatment is usually thought of as taking away from drug interdiction. That's wrong, Kleiman says. The money could come from health care.

``There's no reason it has to come out of the law-enforcement budget,'' he says. Legalization debate looms

While there's some disagreement about the government's current approach, brewing over the horizon is a storm over whether much more radical measures - such as drug legalization - are needed to stem the crime associated with the illicit narcotics trade.

Sterling, echoing the views of critics from columnist William Buckley Jr. to Baltimore Mayor Kurt Schmoke, says: ``I'm skeptical about the effectiveness of continuing to rely on prohibition.'' He suggests that only a legal, regulated, and policed market will reduce the bloodshed that now accompanies the drug trade in American cities.

Kleber, like many law-and-order advocates, rejects that reasoning. He points out that there are 18 million Americans addicted to alcohol at present, and 2 million to cocaine. If the latter were legal, he says, the number of people hooked on this much stronger drug would rise toward the current addiction level of alcohol. That would be ``absolutely devastating to society,'' he says.