|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
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.