Invitation to comment

This blog is for researchers, providers, users, community groups, policy makers, and others who are interested in reframing America's response to drug use using the approach exemplified by the 2nd National Conference. The conference is designed to be the "table" where the stakeholders and those most affected by methamphetamine can come together to create solutions that are based in science and compassion. We invite law enforcement and criminal justice professionals as well as treatment providers and harm reductionists because they all have a role to play, and by working together, we hope to reduce the harms associated with drug use and the harms associated with bad drug policy. We invite you to comment and send us news and information to post. Weclome to the table!

Wednesday, December 20, 2006

Jonathan Caulkins:
A mathematician looks at what works and what doesn’t in America’s war on drugs

Posted on Carnegie Mellon Today, Dec 18, 2006

For more than 15 years, Professor Jonathan Caulkins has turned his mathematical model-building talents to one of the most intractable and emotion-laden social questions of all: drug abuse.

“America’s drug problem is more severe than that of any other developed country,” Caulkins says. “America has more drug dependence, more overdose deaths, more drug-related HIV-infections, and more drug-related violence. Its impact is widespread and costly; it taxes our criminal justice system, our hospitals, our schools. The cost in dollars and in lives is enormous.”

Yet, despite these high stakes, Caulkins believes that much of U.S. policy is distorted by wishful thinking, bureaucratic silos, and simple misinterpretation of the data. “When you have such a long term and costly problem as drug use has been, it makes sense to root strategies in objective evidence of what works and what doesn’t,” Caulkins says. “We have not always done that.”

After leading the Drug Policy Research Center at the Rand Corporation and designing innovative and influential efforts to assess cocaine control strategies, Caulkins became concerned that the lessons from cocaine were being generalized too broadly to other drugs at different stages in the cycle of adoption. When experts in dynamic modeling approached him about marrying methods from mathematical biosciences, epidemiology, and product diffusion modeling with traditional drug policy analysis, Caulkins jumped at the opportunity.

He now brings this dynamic modeling perspective to a range of problems pertaining to drugs, crime, violence, delinquency and prevention to understand the effect of policy initiatives on those problems as they evolve over time.

The markets for drugs are in some crucial respects not really that different from markets for other types of consumer products. Consumer product marketers, of course, want to expand product sales, while drug policy makers want to curtail them, but the underlying math of the models is the same, Caulkins says.

Drug use follows well-documented cycles of introduction, growth, and maturity. A newer drug, such as methamphetamine, requires a different response than does a “mature” product such as heroin or cocaine. Just as marketers use different tactics with brand new products and established brands, so the approaches to curbing drug use must differ.

“We need to make data-driven decisions about when to emphasize prevention and when to emphasize enforcement,” Caulkins says. “No one approach is the single right answer at every point. In the early phase of a drug epidemic, for example, treatment programs are not as important as they are in the later stages, when users are older, have more health problems, and may be more compliant with treatment. On the other hand, law enforcement has a much more dramatic impact on containing the spread of a drug early in the cycle, but almost none once a drug is in widespread use.”

Caulkins’s fresh approach is attracting attention. He was named a Robert Wood Johnson Foundation Health Policy Fellow in 2006, which is supporting his current project, “Synthesizing Lessons for Drug Policy and Policy Research.”

“We will not have more success in coping with drug abuse until we have a more dispassionate debate,” Caulkins says. “We must look more systematically at what has worked and when it has worked.

“Let’s take a more dynamic approach to respond to a dynamic problem.”

No comments: