Interview with Dr David Lewis 12/17/99

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The Week Online spoke with Dr. David Lewis, director of Brown's Center for Alcohol and Addiction Studies, and project-director of Physician Leadership on National Drug Policy, about the project and his hopes for the PLNDP.

WOL: Tell us a little about the grant, and what you hope to accomplish with it.

Dr. Lewis: The grant allows us to involve the community more in what we're doing, which is making people all along the continuum aware of the effectiveness of drug treatment vis-a-vis other strategies. We're going to connect with a number of community-based organizations, in part by working with Join Together, which is an organization that helps provide advice to community groups. That means they'll be working with law enforcement, and with teachers and with parents groups. That will be a major part.

The second part has to do with working with organizations within the medical profession. The PLNDP itself is not primarily made up of experts in addiction medicine. They are leaders, people who have had high-level positions in government, for instance. As you know, it's a non-partisan, balanced group. So, on this project, we're going to bring in some of the national leaders in addiction medicine.

We're going to be working with the American Society of Addiction Medicine, and the American Medical Student Association, and with primary care groups, so that the primary care national organizations are becoming part of the project. We're also going to be working on expanding our group of 6,000 physician associates and also the level of medical student participation.

WOL: The PLNDP consensus statement is a pretty dramatic document, when judged against the reality of current policy. How were you able to bring such a diverse and esteemed group together behind it?

Dr. Lewis: The group is bipartisan, of mixed political and social ideology. The fact is that the group reached that consensus without any dissent. The consensus statement doesn't really make it a group that is attacking the criminal justice system full-fledged. In fact, it's really very moderate. But, the educational process is dramatic, because what these people have really said is that they want to see the evidence, because the evidence may or may not support current policies. So, it's a not-so-subtle call to put the evidence first. I would reiterate that it is a group that has all kinds of different political views - it's a fascinating dynamic, and they've held together beautifully.

WOL: Have you had success in taking that consensus statement to other groups of professionals for their support?

Dr. Lewis: Quite a number of state medical societies have endorsed the consensus statement, and we expect other major endorsements in the coming months. We also had a meeting this summer out at the Aspen Institute where we invited leaders in the law, police foundation people, business people, judges. It was a super discussion and there was no disagreement at all that we had to work on a better drug policy. That part was a no-brainer.

This is not "drug policy reform" in the sense that that term has developed and has been portrayed in the political arena, nor is it the "war on drugs" approach, and we've been mildly criticized from each end. We're certainly on the reform side of the middle because we are looking to effect change in current policy.

WOL: But in going back over the consensus statement, it was not the typical safe middle ground.

Dr. Lewis: Definitely not. The statement is very proactive. And what has happened in practice is that we've got an action plan. We're advocating for parity for treatment for instance, and two of our members, who never would have done it before, joined the NIH panel on methadone that called for the expansion of methadone availability. They didn't get caught up in zero-tolerance rhetoric or anything. They just went to NIH and played a major role in a very important report.

WOL: What would you like to see happen with PLNDP, in the broadest sense?

Dr. Lewis: I think that the best thing that has happened thus far is that we've legitimized the discussion, meaning that there had been an idea that there was a prohibition of discussion about these issues, even in their most moderate forms. I think that it's significant to have an esteemed medical group of this stature that says "lets take a look at these issues, let's take a look at the evidence." I think that if that continues it's going to have a powerful influence, so I attach a lot of significance to this process and to being able to demonstrate that this is possible.

Second, I think the evidence that we're talking about for public health and medical approaches will be informative, and will ultimately be compared to other approaches, both for its effectiveness and in terms of cost. And by effectiveness, I don't mean purely regarding addiction, in the classical medical sense, I mean the effect on family functioning, on productivity, on crime. So we're not just talking about treatment to help people manage their drug use, we're talking about treatment as an anti-crime measure, as a way to increase productivity... so it's a broad, evidence-based perspective. So, the more we're doing this on the level that we're doing it, the more credibility the discussion will have.

WOL: And by having that discussion, you hope to have an impact on policy?

Dr. Lewis: I happen to think, in my experience, that public policy is based on evidence about 25% of the time. I think that if our group is able to move up that percentage a bit, where research will have more impact on policy, particularly in drug policy, which is so ideologically driven, that we will have done a tremendous service. That's my hope. I can't predict that it's going to happen, but that's my hope.

(Read the PLNDP consensus statement online at http://www.caas.brown.edu/plndp/consensus.html. You can read The Week Online's March 1998 story on PLNDP at http://www.drcnet.org/wol/034.html. Join Together is on the web at http://www.jointogether.org.)

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Issue #119, 12/17/99 Gore Briefly Supports Access to Medical Marijuana, Then Backpedals | Physician Leadership on National Drug Policy Receives Major Support | Interview with Dr David Lewis | DEA Approves Hemp Cultivation Permit in Hawaii | Alaska Marijuana Initiative | Poll Finds Most Blacks, Majority of Whites Believe Law Enforcement Targets Minorities | ACLU Condemns Shooting of Denver Man in No-Knock Raid | UN Narcotics Board, Prime Minister Pressure Australian States on Safe-Injecting Rooms | Grams' Son to Face Misdemeanor Charges | Record Number of Drug Prisoners in California | Mendocino Decriminalization Initiative Needs Volunteers | California Counties Using New Law to Decriminalize Needle Exchange | Job Listing in San Francisco | Editorial: At the End of the American Century
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