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

"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.