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Drug War Chronicle Book Review: "High Society: How Substance Abuse Ravages America and What to Do About It," by Joseph Califano (2007, Public Affairs Press, 270 pp., $26.95 HB)

There's an old saying that there's nothing worse than a reformed smoker, and Joe Califano is making a strong bid to be the mother of all reformed smokers. The former four-pack-a-day, chain-smoking Secretary of Health Education and Welfare in the Carter administration who helped orchestrate the country's first major anti-smoking campaign has since gone on to create the National Center on Addiction and Substance Abuse (CASA), nominally at Columbia University, which for the past 15 years he has used as a base for lecturing the nation on the dangers of drug and alcohol use.
a younger Joe Califano
For Califano, it seems, there is no such thing as non-harmful drug use. Oh, he will, hidden far down in some paragraph deep in the middle of a chapter, admit that most teen smokers or drinkers don't become pot smokers or most pot smokers don't end up as heroin addicts, but such a tiny admission comes only after he has besieged the reader with a relentless barrage of factoids suggesting just the opposite. One gets the impression that if Joe Califano had his way, it would be a tee-totaling world.

"High Society" is both Califano's argument for a massive offensive to reduce substance use and his blueprint for how to get it done. As a self-appointed leading advocate for public health adept at getting public attention, he deserves to be read by people interested in drug law reform, not least because they will invariably encounter his ideas among those too often on the other side of the issue.

Importantly for drug reformers, Califano explicitly articulates what is perhaps the most serious obstacle to ending drug prohibition: The argument that drug use is immoral because it enslaves drug users and robs them of free will. While that argument is rarely articulated in policy circles, one gets the sense that it is percolating beneath the surface. How can you legalize drugs when drug use is just "wrong"? (Forget for now the inconstancy and hypocrisy of arguing that pot-smoking is "wrong" but beer-drinking isn't, or it's only "wrong" if you're an alcoholic.)

But Califano deserves attention too because although he is often wrongheaded, he isn't always wrongheaded. Yes, substance abuse is a serious social problem. Yes, alcohol and tobacco kill lots of people. Yes, we can't arrest or imprison our way out of the problem -- for certain. Yes, drug treatment is under-funded, under-studied, and too often little more than a money-making racket. He's spoken out against mandatory minimum drug sentencing and called for repeal of the Higher Education Act's infamous drug provision.

Unfortunately for the cause of scientific rigor (and science-based drug policy), Califano and his CASA caliphate have proven more adept at advocacy and press release-writing than statistics. Califano has been famously caught out distorting youth drinking figures and over-hyping college drug use figures. Just last week, he was on CNN falsely warning that prescription drug abuse could be more popular than marijuana among kids.

With its barrage of factoids disguised as argumentation, "High Society" suffers from some of the same flaws as Califano's and CASA's other work. Some of his factoids are just plain deceptive, as when he lumps the cost of enforcing the drug laws, which is a policy choice, in with the costs of substance abuse or when he notes the rapid increase in teenagers in drug treatment for marijuana without mentioning that a majority of them were sent there by courts or schools as a reflexive response to getting caught smoking pot. Some are simple truisms disguised as scientific breakthroughs. "Alcoholics are likely to abuse other drugs!" he exclaims. That's more exciting (and scary) than noting that people who like one drug might like other drugs too.

Califano uses his onslaught of statistical half-truths and deceptions to push for more prevention, more and better treatment, more law enforcement (and certainly not drug legalization!), and a general crusade against substance abuse. No one is going to argue against more drug prevention -- if it imparts accurate information and not just scare tactics -- or more access to better drug treatment -- as long as it is not coerced treatment. But while Califano criticizes programs like DARE as ineffective, his own work suggests a certain susceptibility to the propagandistic impulse. And he is certainly a proponent of forced treatment. He thinks we have too many people in jail for drugs, but while we have 'em, we might as well force drug treatment on them, parole them on the abstinence model, and throw them back in the clink if they fall off the wagon.

He would also like to see more marijuana arrests. In fact, he points to former New York City Mayor Rudy Giuliani's jihad against pot-smokers, when New York accounted for almost 10% of pot arrests nationwide, as a good model.

Califano deserves to be read by drug reformers because he is going to be widely read by well-meaning people with an interest in substance abuse. His exaggerations, distortions, and hyperbole will need to be countered. And, as I noted above, he isn't all wrong. Still, he and CASA are pernicious enough that if you're going to read "High Society," I encourage you to do so at the library or to order a used copy. Califano has vowed to turn all profits from the book over to CASA, and we don't want to encourage them.

Permission to Reprint: This article is licensed under a modified Creative Commons Attribution license.
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Califano and CASA

Here is a link to an interesting article about these folks:

and here is an excerpt that speaks volumes:

"Even more troubling than CASA’s results, though, is its methodology. CASA’s institutional refusal to participate in the academic peer-review process has made it the butt of jokes at Columbia. Peer review, normally an integral part of publishing scholarly documents, involves a neutral party selecting a fixed number of an author’s colleagues (without regard to ideology) in order to verify the legitimacy of a study’s methods and conclusions.

This is the way that real science works, and it’s the best tool we have to make sure that half-baked and ill-informed conclusions stay out of the mainstream of scientific thought. CASA has consistently chosen to avoid this process like the plague, leading some in the public health field to suggest that its findings would never survive such concentrated scientific inquiry. Dr. Herbert Kleber, CASA’s medical director, has written that the length of CASA’s monographs “does not readily lend itself to the format of an academic peer-reviewed journal.” Accordingly, Kleber says, CASA has “chosen to issue these documents ourselves.”

CASA would obviously garner tremendous prestige if even a short paper were accepted for publication by the likes of Nature, JAMA, or the New England Journal of Medicine. All it would take is an acknowledgement that CASA’s work should be subject to the same scrutiny as everyone else’s at Columbia University. The fact that they’ve chosen not to try speaks volumes."

he's such an alcohol supremacist bigot

a level playing field between alcohol and cannabis would be more than fair to alcohol.

Califano and substances

I believe that if you buy tobacco, you are wasting your money. I also believe that if you smoke or chew tobacco products, you are endangering your health. That said, if someone wants to waste their money or endanger their health, it's their business.

Same with alcohol and drugs. We should treat abuse of drugs the way that we treat alcohol abuse.

puregenius's picture

This morning on C-SPAN

Califano was a guest on the Washington Journal morning show. When he started talking it wasn't that bad. He talked about addiction as a disease and not a moral failing. That was the last decent thing he said.

When referring to the organization CASA, he immediately said something that wouldn't hold up to scrutiny. He said, "We don't have a drug war to wage or defend, we are not liberal or conservative, we are practical." Not surprisingly, for the rest of the segment he was defending the drug war against knowledgeable reform-minded callers. He used standard drug warriors tactics. Fear and lies. He implied that children's access to alcohol and tobacco is greater than illicit substances. We all know how false this is. The implication was used to deflect a caller promoting cannabis legalization. He promoted Marinol as a suitable alternative to medical cannabis.

He is certainly an alcohol supremacist as 9.56 states. He holds hard and fast to the flawed theory that the only psychoactive that can used in moderation is alcohol. While saying this out of one side his mouth, he acknowledges that alcohol abuse results in more domestic violence and many other severe problems. Hypocrites are always sickening.

I am above the influence, the influence of drug war propaganda

Joe Califano

I just saw him on lou dobbs and while intelligent I could seamlessly tell that he had an agenda. Right there I discounted anything else he said. He did have a nice suit on though. lol

Nobody read the book

I find the comment from 2007 , “Just last week, he was on CNN falsely warning that prescription drug abuse could be more popular than marijuana among kids” to have been sadly misinformed. You see, history has proven Califano to have been correct all along. I am writing from downtown Vancouver, post-legalization, and I can tell you for an absolute fact that permissive attitudes about drugs has led to an absolute drug disaster here. In just 24 hours we saw needles practically everywhere downtown, homeless smoking dope, panhandling, incoherent screaming people rampaging down the street, endless ambulances and paramedic vehicles rushing from emergency to emergency, one angry man 4 blocks from False Creek sobbing that he hates his life and he’s going to jump off the Granville Island bridge. Speaking of Granville street, probably 1/4 of the store fronts are shut, another 1/4 cater to bongs, cannabis, liquor, tattoos, sex shops, nightclubs, and the rest have to guard themselves from the homeless vagrants and panhandlers who aggressively beg and hound passers by. As permissiveness grows, the drug abuse problem becomes more and more out of control.

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