McCaffrey is the current [October 2000] director of the Office of National Drug Control Policy, also known as the "Drug Czar." McCaffrey is a supporter of strengthening the treatment and education aspects of the fight against illegal drugs. This is the edited transcript of an interview conducted in 2000.

Well, it's mischief-using data. It's sort of a silly conclusion. The amount of money we're putting in drug treatment today has gone up enormously. It's 3.6 billion dollars. Enormous amounts of funding have gone into prevention, education, treatment. The situation that the Nixon Administration faced was totally unlike today's five million chronic addicts...We have increased and put our money where our mouth is in the national drug strategy.

But people say treatment is not available on demand.

Well, at the end of the day the five million chronic addicts will only respond to effective drug treatment that's linked into the criminal justice system, linked into welfare, linked into health care--no question. And that's of course exactly what we're doing. There have been huge increases--32% in the last five budget years--[in] the amount of money in the federal program that goes into block treatment grants to the states. So we're clearly moving in the right direction with significant resources.

But it is true that treatment is more generally available if you're in the criminal justice system than if you're out? Your health insurance won't cover it, for instance.

Well, I think clearly one of the biggest things lacking in America today is that we don't have parity in health care for both substance abuse treatment and mental health care. That's a shortcoming of our system. It's a lot cheaper to do that than lock people up. But I would also tell you we haven't done too well in the criminal justice system either. The general number we use is about seven percent of the prisoners behind bars who need drug treatment have it available. So clearly it's got to be a national priority. And steadily we're building that capacity.

So drug treatment works?

Well, there's no question that effective drug treatment, with a sanction and a reward applied over time, with a whole range of interventions--not just methadone, not just therapeutic communities--if you do it all together the payoff is enormous to the community.

In the community itself?

Yeah. Well, what you see is the costs that are associated with chronic drug abuse--in terms of health care, criminal justice system, industrial accidents--all of it starts going down and you get your taxpayer money back.

So it's more cost-effective to have treatment than incarceration?

Well, I don't think it's an either/or proposition...For example, in the drug court system, in the space of five years we've gone from a dozen drug courts to more than 750 this year online or coming online. What we see when we have a coercive sanction as well as a reward--when we intervene with treatment in a broad range of techniques--70% of the people respond. But most chronic addicts simply won't respond unless there's a reward/punishment aspect to that treatment.

...What some people say...is [treatment] should be available in the community, not just in prison.

Oh, there's no question. Again, I think what one of the shortcomings in our society is that ... I ought to have access to both mental health care and drug treatment as part of my medical plan.

So why don't we have it? Why haven't the politicians bitten the bullet and done it?

Well, I think a lot of this is state law. And part of it is just gradually beginning to better understand the nature of chronic drug abuse--that it is indeed treatable, that the techniques are more responsive in terms of statistics than currently available cancer treatment.

...Some people have told us that when you first came into office you were, in a sense, an enforcement guy... and that you were in a sense converted to treatment. How did that happen and what did you learn about politicians not wanting to be soft on crime?

Well, again let me sort of add my own background as being an Army officer during the '70s and seeing the terrible, devastating impact of drug abuse on our young people in uniform. So when I came into this job I started with a fundamental commitment that prevention and education would have to be at the heart and soul of our effort. And I also started with an understanding that drug treatment does indeed work and that the magic of Narcotics Anonymous [and] Alcoholics Anonymous has to be part of that program. So steadily, in the last five budget years, we have put huge new resources into treatment. Donna Shalala and I, for the first time in history now have more than 3.5 billion dollars in drug treatment. We're moving in the right direction.

...It's important to understand that Congress has supported us. We've had a bi-partisan consensus. There have been massive increases in funding for prevention education--it's up 52%. Drug treatment programs are up 32%. The research budget is up 36%. The facts of the matter are the resources to do just what we're talking about are steadily flowing into this system.

So you just won't buy the argument that your statistics--your percentages--are related to where your starting point is? That you haven't been able to flip it, let's say, to two-thirds prevention and treatment versus one-third enforcement?

...The bottom line has gone from 13.5 billion dollars up to 19.2 billion dollars. So we can talk percentages, we can talk raw dollars--either way you come at it, drug treatment resources have increased enormously in the last five years. Drug prevention education dollars have gone up enormously. This is in absolute terms, not just in percentage of the total.

Would you take money from enforcement for treatment? Would that be your preference?

Well, again--I think what you've got to have is a system approach...I think what we've seen is significant enhancements of resources in the federal effort that are structured to support our strategy. Prevention dollars are up, treatment dollars are up, and they didn't come out of any other program. They were absolute increases.

So you didn't have to deal with the law enforcement bureaucracy that doesn't want to give up their funding?

We've got 1.8 million people behind bars. And the reason they're behind bars, contrary to a lot of the stereotypes, isn't simple possession of drugs. If you're in the federal prison system for simple possession of marijuana, you were arrested with more than 200 kilograms on you. So by and large what you find is if you look at those behind bars, 85% of them have a chronic drug or alcohol abuse problem. The charge sheet reads burglary, male street prostitution but the problem is the guy's a chronic drug and alcohol abuser. That's the central challenge, not simple possession of drugs.

... Part of the problem is your fundamental hypothesis is dead wrong... You can do percentages. You can do raw dollars. You can come at it from any way you want. The facts of the matter are the drug treatment budget has gone up enormously in the last five years. This is simply a nonsense hypothesis.

...The drug budget, FY'96-2000, is unarguable. The dollars are there to support drug treatment, prevention, education, local law enforcement, "Break the Cycle." The media campaign is a billion-dollar five-year effort to talk to our nation's children and to the adults who mentor them. This is new. It's science-based. It's working.

So these realities are crowding in on an old sort of stereotypical view of "either we do law enforcement or we do drug treatment." In fact we've said it's a payoff to us, given the huge cost of drug abuse in America, to do all of it in a balanced science-based way.

But only five percent of the inmates in our prison system have treatment available to them.

Well, of course we're changing that. Now, in the last three years we say that ... probably all of the 42 federal prisons now have some nature of drug abuse treatment available. And in the state system, we're making remarkable progress. But there are about 900,000 people behind bars at the state level. There is inadequate drug treatment. And even more importantly than that, if you don't have a follow-[up] component to this, it simply won't work.

...Why don't the politicians simply appropriate enough money...so that all of these people have treatment available on demand?

Well, of course "treatment available on demand" is probably a misnomer but I think the central concern is appropriate. If we're going to deal effectively with five million chronic drug addicts when they are amenable to treatment--when they're down, when they're under arrest, when they're miserable and they ask for help--at that point, we have to be capable of intervening. I think you're quite right. And that's the kind of capacity that we are building. But this is state law, not federal law.

I understand. But why don't the politicians understand this logic and act on it the way you're describing it? What's the resistance?

Well, it's sort of interesting because the people that do understand it are experienced law enforcement officers, hospital emergency room physicians, judges, people that work in the welfare system. By and large there's great unanimity of view that effective drug treatment--if it also has a coercive element--clearly can turn people's lives around in the criminal justice system. . . .

Jack Lawn, former head of the DEA...commented on the creation of the drug czar's office and said that the problem with it is that there's no real power there. There's no real accountability and there's not budget control. It's like being a General without an army.

Well, he was under a different law. We've got enormous authorities. The law was rewritten two years ago. It's given me considerable power to influence budgets. I can de-certify a department budget and order them to put more money into it. I think there's a huge level of authority in terms of my ability to coordinate the interagency process, to be the principle spokesperson to Congress. I wouldn't agree.

Now, more importantly, the numbers are there to indicate that over the last five budget years we have steadily increased in a massive way dollars going to drug prevention education, treatment and research. So we think we are getting a supportive response.

So you believe then that spending 80% of 1.6 billion dollars on Blackhawk helicopters is going to make a difference in the availability of drugs on the streets in the United States?

Well, of course when you look at the federal counter-drug budget, 3.6% of it goes to any international program. Overwhelmingly, our dollars go into domestic activities. Around 11% of that total budget goes into some form of air, land or sea interdiction. So it's simply not the case that huge percentages of this total flow into foreign cooperation.

At the same time, I will tell you the good news is in the last three years we've actually reduced cocaine production in the Andean Ridge nations by 19%. It's working. Drug production in Peru is down by 66%, in Bolivia by 52%, and there's an overall net reduction. The problem is poor Colombia. 40 million people sliding toward the edge and 140% increase in coca production in the last two years alone...They're now producing 520 metric tons of cocaine last year alone, and some six metric tons of heroin. So as we look at it from an American perspective, 90% of the cocaine in our country originated in or transited through Colombia. Probably 70% of the heroin seizures were out of Colombia.

...Is this military appropriation basically for Colombia for equipment going to make any difference in your mind? How would you judge its success--less cocaine on the streets of the United States?

...We're going to get this 1.6 billion dollars... And it's not just for Colombia. It's for Peru, Bolivia, Venezuela, Ecuador. There's 270 million dollars in there for alternative economic development, support for the judicial system. It's a very balanced program. It was put together in cooperation with regional government, so this is Plan Colombia, not Plan America. And by the way, their plan is 7.5 billion dollars. It's 4 billion dollars of their own money. 3.5 billion of foreign support--European Union, United States. Our piece of it will go for a lot of things--including, for example, 6 million dollars for human rights security monitors. So this is coherent, long-range, and multi-national.

But 80% of the 1.6 billion is for hardware?

No. Absolutely not.

And support of that hardware?

No, I think you've got your numbers wrong. What we can say though is the Colombia package itself--about half of it is mobility factor. So it boils down 63 helicopters to support the police and the armed forces, re-establishing law and order in their two southern provinces. That's about half the program.

Some would say it's using the drug war as a fig leaf to cover a counter-insurgency war in an attempt to stop Colombia from falling apart, and we don't want to say that straight up-front, so we're using the drug war to cover that.

Well, look. We've got to look out for our own self-interests. And our self-interests are 52,000 dead a year from the drug problem, and 110 billion dollars in damages. And ...90% of those drugs that come into America originate in [Colombia]. So it's worked in Peru. It's worked in Bolivia. There's no question but that Colombian democracy is at stake. This is standing behind an ally three hours' flight from Miami. There are a million internal refugees. A half million have fled the country. In our view, they deserve our support as part of a hemispheric operation.

But it is true then, as one CIA official said to us, that the drug war and the counter-insurgency war here come together as one?

Well, I think more appropriately what you'd say is that in the year 2000 when you look at 26,000 armed narco-insurgents in Colombia from the FARC, the ELN, the AUC--what they're really struggling over isn't ideology. It's drug dollars, probably a half billion dollars a year, fueling this corrosive, violent insurgency against their democratic institutions.

...We interviewed a lot of federal law enforcement people along the border with Mexico. A universal complaint--the Brownsville Agreement. They say that the Brownsville Agreement signed by Janet Reno with Mexico has basically tied their hands and they cannot investigate, let's say, the Arellano-Felix organization in Tijuana. It's too difficult...What do you think of the Brownsville Agreement?

Well, the facts are we're doing pretty well now operating against the Arellano-Felix organization in Tijuana. We locked up their operations officer three weeks ago. We got one of their principle operatives last week. We're without question moving in the right direction.

You know there are 100 million Mexicans. The border is nearly open. 350 million people a year cross that frontier. The Mexicans correctly believe the principal threat to their national security is the drug cartels that they're trying to overcome. Violence, corruption is enormous on both sides of that border. So we say an agreement between the two Attorney Generals--[Jorge Madraso] of Mexico and Janet Reno--is a step toward partnership. We can't operate unilaterally in any nation of the earth--not Canada, not France, certainly not Mexico.

Yeah, but the procedures--we've never really operated unilaterally. The procedures that have been put in place require, let's say, bureaucratic steps that we never had to go through before in order to gather information or even cooperate with someone on the other side of the border...And people are saying their hands are tied. They can't get anything done. And they're afraid to share some of the information because of the level of corruption with the police.

Well, there's no question in my own mind. If you look back five years ago and then look at the situation today, the level of cooperation's gone up enormously. In fact, we are sharing intelligence. We do work in partnership. We do have a significant U.S. FBI/DEA/Customs/Coast Guard intermittent presence in Mexico with their authority and support. We do work across that border with bi-national law enforcement agencies.

So I think in fact the two sides of the border are struggling to confront this tremendously violent criminal threat we face.

Is there anything going wrong then? From everything you've just said, everything seems to be getting better. Is there anything you're worried about then?

Well, in fact, drug-related murders are down by 50%. Cocaine use is down by 70%. General drug use is down by 50%. Adolescent drug use last year went down by 13%. In fact, things are moving steadily in the right direction. Compared to 1979, we're doing pretty well.

6% of the country last month used an illegal drug. And it's polydrug abuse. It's booze and pot and other things. And it causes us 100 billion dollars in damages a year. It's outrageous and we're worried about our middle school children. We've got more eighth graders using heroin than twelfth graders. So if you want to understand the chronic drug abuse problem in America ten years from now, look at your middle school children. That's why we're working the Boys' and Girls' Clubs, YMCA sports programs. That's the heart and soul of the national drug strategy.

Why should we care? If the crime rate is way down and the chronic drug abuse population is basically stable, why should we care about that?

Well, the chronic drug abuse population is costing us a lot of money. It's 36 billion dollars a year to lock them up in a criminal justice system with 1.8 million prisoners. So it pays off for you and I as taxpayers if we get effective drug treatment that's community based and we engage those in the criminal justice process with not only prison-based treatment but follow-[up] care. It's a taxpayer's initiative.

And doesn't that group also fund the international narcotics business, basically?

Well, I think one of the problems is a lot of Americans think we are the predominant drug users in the world. We're not. We probably use three percent of the world's heroin. There's 980,000 Americans who are chronically abusing heroin. That's a tiny fraction of the total population. Our problem is we have too much money--so money out of Western Europe and the United States in particular fuels this corrosive international drug criminal operation. That's something we've got to confront.

You say 980,000 heroin users, but only 20% of them apparently have access to treatment.

Well it's hard to say. The stigmatization of heroin abuse is so intense, they hide cleverly. They're in denial themselves. So is their family and their communities. We're trying to move steadily to increase the access to methadone and [LAN] treatment, to try and get physician office-based treatment available, to certify the health care community. I think in the coming years we can bring a lot more of their chaotic, miserable lives under control and get them back in their families and back to work.

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