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Town Meeting Sparks Dialogue on Research, Managed Care
April 10, 1998

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Drug addiction is a disease that causes physiological changes in the brain and is best addressed through treatment and science, not stigma and punishment, Dr. Alan I. Leshner told an overflow crowd at the April 2 Boston Town Meeting organized by the National Institute on Drug Abuse and Join Together.

Leshner, director of NIDA, was the keynote speaker at the all-day event, titled "Understanding Drug Abuse and Addiction: Myths vs. Reality." The meeting was attended by a wide cross-section of people concerned about drug problems in Massachusetts and across New England, including representatives from the treatment and prevention communities, educators, law-enforcement officials, policy-makers and ordinary citizens.

NIDA is holding a series of town meetings around the country to gather public feedback on ways to address drug abuse and addiction. The federal agency also used the meeting as an opportunity to release a new research-based guide to drug prevention, called "Preventing Drug-Use Among Children and Adolescents."

The April 2 meeting included discussions on such diverse topics as prevention theory, cognitive behavioral treatment for addiction, managed care, and the effects that drugs have on brain chemistry. Participants also were given an opportunity to provide feedback on their problems and concerns during a series of afternoon community dialogue sessions, facilitated by experts from Join Together.

Helping to provide the local perspective was Mayra Rodriguez-Howard, director of the Massachusetts Bureau of Substance Abuse Services and a Join Together Fellow. Rodriguez-Howard noted that marijuana use in Boston is at its highest level since 1984, and that injection-drug use has risen sharply, as well. "Drug abuse and drug use in Massachusetts are doing very well, and we're working to fight that," she said.

Despite the conference's overriding emphasis on illicit drugs, health care policy expert David H. Mulligan said that alcohol is clearly the nation's biggest drug problem. "Most teens who have problems with addictive substances begin with alcohol, which is so available in our society," said Mulligan, associate professor of health care policy at Stonehill College's Martin Institute and former head of the Massachusetts Bureau of Substance Abuse Services.

Noting that marijuana use and other drug use is on the rise, Mulligan added, "We are not winning this alleged war on drugs." He noted that even as need for treatment has increased, funding and treatment availability has remained flat. Meanwhile, the prison population has increased steadily -- mostly because of drug-related crime. "The war on drugs has become a war on alcoholics and drug addicts," said Mulligan.

Mulligan said that addiction must be treated as a public health problem, not a criminal justice problem, and pointed to the success of the campaign against tobacco as an example to follow. He called on local policymakers to support a campaign slated to begin in May to raise Massachusetts' excise tax on alcohol to help pay for addiction treatment services. "With all the talk about drugs, we don't challenge the alcohol industry," Mulligan said.
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