Ed. Note: While this article is important for what it says, it is even more important for having originated in the Washington Post, which is slavish in following the prohibitionist party line. This is the second "deviationist" major article to appear in the Post recently.(See: "Hooked on Dogma" Amazingly, Washington Post Deviates from the Prohibitionist Party Line ) Retired Krimlinologists who used to make a career reading between the lines of Pravda could possibly put their skills to work here. Could there be glasnost at the Post? Of course, the original purpose of glasnost was to make communism work, so the Post quotes only one anti-prohibitionist. All the rest are academics determined to make it work. They want prohibition "with a human face."  The truth is very dangerous.

By Jeff Leen
Washington Post Staff Writer
January 2, 1998; Page A01 (Note: page 1!)

As the election season began gearing up in late 1991, President George Bush got an unsettling bit of front-page news:

The number of habitual cocaine users in the United States had jumped an astounding 29 percent in a single year, from 662,000 to 855,000, according to the National Institute on Drug Abuse (NIDA). Bush had aggressively pushed his administration's anti-drug effort. Now, he had little to show for it.

But the bad news, widely reported by newspapers across the country, was wrong. NIDA had miscounted in its annual National Household Survey on Drug Abuse, one of the nation's "leading drug indicators." A year later, without fanfare, the number of habitual users was revised back down to 625,000.

"Problems with statistical imputation," the General Accounting Office concluded in a 1993 report on the miscalculation that received little public attention. "We certainly think that more adequate quality control procedures could have caught findings of such significant policy relevance."

The 1991 cocaine mistake stands out as just one example of the tenuous grasp scientists, politicians, the media and the public have in evaluating America's 25-year crusade against drugs. Different methods of calculating the number of drug users continue to produce widely gyrating estimates, including those contained in the 1997 White House drug strategy report that variously gives the number of habitual cocaine users as 582,000 and 2.2 million.

In spending a proposed $16 billion on the federal drug war in 1998 -- a 400 percent increase since 1986 -- lawmakers will rely on reams of data that often attempt to impose statistical order on a chaotic social problem that defies easy analysis. Extensive federally funded efforts to accurately assess the subterranean drug world have led to contradictory findings and occasional statistical curiosities, such as a 79-year-old female respondent whose avowed heroin usage in one survey resulted in a projection of 142,000 heroin users, 20 percent of the national total.

"It's clear that these things are badly mismeasured and nobody cares about it," said Peter Reuter, the former co-director of drug research for the non-profit RAND think tank and now a University of Maryland professor. "That's because drug policy isn't a very analytically serious business."

Measuring the drug war with any precision is a daunting task. Hard-core drug users are hard to find, much less question, and people frequently lie on drug-use surveys -- one study shows two-thirds of teenagers giving deceptive answers. Since surveys typically receive only a small number of positive responses, analysts risk making substantial errors in creating projections for the entire nation. Survey results sometimes include warnings acknowledging these obstacles, such as "subject to large sampling error" or "great caution should be taken."

But the caveats often are downplayed or ignored, either by those issuing the data or by journalists and others promulgating the information. In reporting the apparent 1991 jump in habitual cocaine use, for example, the White House's Office of Drug Control Policy noted that the statistics were both "cause for concern" and "highly unreliable."

The difficulty in measuring and evaluating the nation's illegal drug problem made it harder to set policy, stoked partisan rhetoric and confused the public, drug analysts say. Many experts, for example, believe cocaine and crack use are in decline, and the federal household survey indicates that overall drug use is down 49 percent from its peak of 25 million monthly users in 1979; yet many Americans still perceive the drug war as perennially lost.

"You really can't tell from the big debate that goes on in public what the big picture is," said David Musto, a Yale University medical historian who has studied drug trends for three decades. "When I tell people about it, they're completely surprised by the fact there has been a decline since 1980."

That big picture can be obscured by drug statistics that are "often incomplete, erratic and contradictory," in the words of two RAND researchers funded by the government to measure cocaine consumption. The first problem of drug war analysis is the sheer number of measurements -- there are more than 50 federal drug-related "data systems" with hundreds of "drug variables" produced by an array of federal agencies.

For cocaine alone there are national statistics on casual use (at least once a year), current use (at least once a month), frequent or habitual use (at least once a week), crack use and use broken down by age, race and sex. There are stats on tonnage consumed, purity, price per gram, price per kilo, patients reporting cocaine problems in emergency rooms, patients seeking treatment and so forth.

"It's not that one thing is better than the other," said Eric Wish, director of the Center for Substance Abuse Research at the University of Maryland. "They all give a different piece of the puzzle, and they need to be put together. But because of federal turf issues, it's more of an adversarial process than a collaborative relationship."

Reuter said he has pointed out discrepancies in the habitual cocaine-use figures in the national strategy report in the past, but the discordant numbers keep appearing. On page 11 of the 1997 strategy, the count of habitual cocaine users is given as 582,000, a number that "has not changed markedly since 1985." But in a chart on page 227 of the strategy's budget summary, the number of such users is given as 2,238,000.

"I can't seem to get the machinery that cranks out these reports to pay attention to these inconsistencies," Reuter said.

An official with the Office of National Drug Control Policy blamed the 1997 inconsistency on "sloppy writing." But the precise reasoning behind it gives a glimpse into the problem of gauging the drug war. The warring numbers in this case come out of different measuring methodologies -- one based on the household survey, the other on urine tests of jail inmates -- that give radically different results.

"The truth is probably somewhere in the middle," said Joe Gfroerer, who manages the household survey for the federal Substance Abuse and Mental Health Services Administration (SAMHSA). "It's just a difficult thing to estimate."

Jared Hermalin, the GAO project manager who uncovered the 1991 cocaine mistake, said: "There's every reason to believe that maybe the numbers are not absolutely correct but the trends are correct. That's the main thing we need to know."

In recognition of the need for better analysis, the office of national drug policy director Barry R. McCaffrey has proposed a comprehensive Performance Measurement System intended, for the first time, to standardize measurement of the drug war.

"Facts should drive policy, but they haven't until very, very lately, with McCaffrey," Sen. Joseph R. Biden Jr. (D-Del.), a longtime critic of the household survey's measurement of hard-core cocaine use, said in an interview.

The proposed system shows just how complex measuring the drug war is. It contains one mission statement with five goals, 32 objectives and 99 "targets" that will be tracked by more than 111 "measures."

Even when the data is not marred by obvious statistical flaws, the sheer profusion of it can baffle those looking for simple answers on whether the drug war has been a success or failure. There is consensus that overall drug use, as well as marijuana and cocaine use specifically, have declined dramatically since the 1970s. But that clarity soon clouds when researchers delve deeper.

For example, according to the household survey, current (monthly) cocaine use decreased in the 1980s -- and was often cited as a sign of success; but, also according to the household survey, hard-core (weekly) use did not drop, and that was cited as a sign of failure. More recently, even as the household survey shows that the overall number of cocaine users has declined (success), emergency room data shows that the number of people seeking medical treatment for cocaine problems is rising (failure) as chronic addicts age and their health deteriorates. And the household survey may show that overall drug use is down (success), but a high school survey shows that teenage marijuana use is up (failure).

For the past 25 years, the nation's most prominent gauge of illegal drug use has been the national household survey, begun by NIDA in 1972 and taken over by SAMHSA in 1992. Government workers annually conduct one-hour, in-person interviews with a randomly selected sample of 18,000 people, age 12 and up. From the answers, statisticians extrapolate the size of the nation's drug-taking population.

The second most-publicized measurement is the NIDA-sponsored, 22-year-old "Monitoring the Future" survey. Each year, more than 51,000 high school students at more than 400 public and private schools are polled about their drug use.

In the 1970s and 1980s, the household and high school surveys were treated as national news on the state of the drug war, particularly in tracking the rise of marijuana and cocaine.

"I've been looking at the household survey and the high school survey for years and years," said Eric Sterling, a former House Judiciary Committee staff counsel now with the Criminal Justice Policy Foundation. "They have an effect like electric shock on a dead frog's leg. There's a spasm people have when they get this data. People, certainly on Capitol Hill, look to respond."

In the mid-1980s, the advent of crack played havoc with the existing measurement system. Simply put, there was no measurement in place for crack use -- crack was so new that the household survey did not start asking about it until 1987.

Faced with an unprecedented national outcry after the overdose death of University of Maryland basketball star Len Bias on June 19, 1986, Congress rushed through a law punishing crack cocaine possession at a rate 100 times that of powder cocaine. Without hard data, lawmakers relied heavily on high-pitched media accounts, some of which "were not supported by data at the time and in retrospect were simply incorrect," the U.S. Sentencing Commission later concluded in a comprehensive study on "Cocaine and Federal Sentencing Policy."

"It was really the opposite of science," said Sterling, who wrote the draft version of the crack law when he served with the Judiciary Committee. "It was mythology-driven. It was said repeatedly that there were 3,000 new crack addicts every day. These kinds of numbers would get thrown out and repeated without anybody doing the arithmetic or asking: `How does this number relate to anything we know about the usage?' "

The lawmakers believed -- erroneously, it would later turn out -- that crack had killed Bias. (Testimony from someone who was with Bias when he died pointed to powder cocaine.) Congress reacted so strongly to crack in part because it believed it was dealing with a rapidly spreading "crack epidemic."

Yet the household survey eventually estimated that crack use stabilized almost immediately and never approached the levels that powder cocaine had -- crack stood at 668,000 monthly users in 1996 compared with more than 5 million for powder cocaine in 1985, according to survey figures.

But the statistical data eventually provoked just as much criticism as the absence of data did. Crack use turned out to be harder to measure than powder cocaine use. Like heroin, crack quickly concentrated among poor urban addicts. Many of them lived on the streets, where they would not be counted by the household survey.

"The household survey and the school survey are pretty useless for measuring hard drug use in the population," said Wish, the University of Maryland research center director.

By the late 1980s, drug researchers like Wish thought that the nation's cocaine problem was breaking into two distinct groups: mainly white suburbanites who used cocaine casually on weekends and mainly black urban addicts who used crack or cocaine daily. For casual users, Bias's death seemed to have the effect of scaring millions off cocaine; the household survey indicated that after 1985 the number of monthly cocaine users plummeted 70 percent.

Yet the trend in hard-core usage is still being sorted out.

In 1990, just as the Bush administration had begun touting the decline in casual use, then-Senate Judiciary Committee Chairman Biden produced a report counting habitual cocaine users at 2.2 million. That was nearly triple the household survey's estimate.

Biden's numbers had come from what would eventually emerge as a third leading indicator of the nation's drug use -- the Justice Department's Drug Use Forecasting (DUF) program, started in 1987. The DUF program collects voluntary urine samples from 30,000 jail inmates in 23 cities across the country each year to test for cocaine and other drugs. Biden's figures were extrapolations from these urine tests.

Mark Kleiman, a Harvard researcher who supervised the Biden committee's work, subsequently acknowledged that the methodology was "not precise." But he said conservative assumptions were used to come up with numbers that gave a clearer picture of the nation's cocaine use.

But the GAO and household study researchers like Gfroerer say that the DUF urine tests cannot be used to extrapolate larger numbers because they are not part of a randomly selected scientific sample.

"DUF really isn't representative of anything," Gfroerer said. "The way it's collected, you can't project it out to any population."

Although the household survey is based on a randomly selected sample, it also has limitations, according to some researchers. Only a tiny percentage of people admit to heroin and cocaine use, and they must then become the basis for projections into the millions of users. For example, of 32,594 people surveyed in 1991, only 127 admitted to using heroin in the past year, according to the GAO. From this number the survey projected 701,000 heroin users nationwide.

Thus, small errors in the way the survey is carried out can be magnified. That means yearly shifts of a few hundred thousand in a projected user population of a million are statistically insignificant because they could be explained by possible errors in sampling, reporting or extrapolation, Gfroerer said.

The GAO found such problems in the 1991 cocaine and heroin figures. For heroin, further investigation revealed that 53 of the 127 users counted in the survey were inappropriately "imputed" -- researchers made a subjective decision to count them even though they gave contradictory answers. When the error was later corrected, the number of heroin users dropped 46 percent to 381,000.

Moreover, of the 701,000 annual heroin users originally estimated in 1991, 142,000 were derived from the survey response of a lone 79-year-old white woman. Her answer was weighted in an effort to make the survey result more representative of the nation's population; but the resulting statistical projection accounted for one-fifth of all the estimated heroin users in the United States that year, according to the GAO.

"The bottom line is [that] to make projections from the household survey to the number of heroin users in the country is probably not a good idea," said Hermalin, the GAO project manager. "Cocaine [estimation] is dangerous, too."

In 1994, the household survey was revamped to make it more accurate at counting hard-core drug use, but Gfroerer said the difficulty was "only partially" corrected.

"The basic issue of understating of hard-core drug use, those problems are exactly as they have been," Gfroerer said. "We still feel it's important to collect these data as part of the survey. The real issue is how you report them."

MEASURING THE DRUG WAR: For the last 25 years, progress in America's battle against illegal drugs has been measured primarily by four "leading drug indicators."

SURVEY: National Household Survey on Drug Abuse

BEGUN: 1972

SPONSOR: Substance Abuse and Mental Health Services Administration (SAMHSA)

FREQUENCY: Every three years since 1972, yearly since 1990

YEARLY FUNDING: $5.7 million

METHODOLOGY: Questionnaires given to a randomly selected sample of 18,000 households; answers are reported anonymously

STRENGTHS: Best measure of overall national drug trends, especially marijuana and first-time users

REPORTED LIMITATIONS: Undercounts hard-core heroin and cocaine users who don't live in households; some people lie on surveys; sampling errors distort results

OVERALL TRENDS REPORTED: Overall drug use down 49 percent since 1979 peak; cocaine down 70 percent since 1985 peak; marijuana down 58 percent since 1979 peak; crack stable since 1988

SURVEY Monitoring the Future Study

BEGUN 1975

SPONSOR National Institute on Drug Abuse

FREQUENCY Yearly

YEARLY FUNDING $4 million

METHODOLOGY University of Michigan researchers poll more than 51,000 eighth-, 10th- and 12th-grade students at more than 429 schools

STRENGTHS Best early warning system for drug use among youth

REPORTED LIMITATIONS Doesn't count dropouts; undercounts non-white students; some students lie on surveys

OVERALL TRENDS REPORTED For high school seniors, overall use down 37 percent since 1979 peak; cocaine use down 70 percent since 1985 peak; marijuana use up 84 percent since 1992 but still down 41 percent since 1978 peak; heroin use up sharply since 1985

SURVEY Drug Abuse Early Warning Network

BEGUN 1978

SPONSOR SAMHSA

FREQUENCY Yearly

YEARLY FUNDING $2.5 million

METHODOLOGY Data collected from patients in more than 500 emergency rooms in 21 cities

STRENGTHS Best measure of people with chronic or acute drug problems

REPORTED LIMITATIONS Not a representative sample; counts people seeking treatment along with people who overdose; counts suicide attempts with legal drugs. Ed. Note: There is another serious problem not reported here, especially for marijuana. These numbers are about "mentions" of a drug, not necessarily the cause of the emergency.
See: Shalala Uses ER Stats to Lie About Marijuana --Again -- as "Drug-related" ER Visits Decline )

OVERALL TRENDS REPORTED More and more drug users are ending up in emergency rooms -- a record 531,827 in 1995, up 43 percent since 1990

SURVEY Drug Use Forecasting program

BEGUN 1987

SPONSOR Department of Justice

FREQUENCY Quarterly

YEARLY FUNDING $2.4 million

METHODOLOGY More than 30,000 jail inmates at 23 U.S. cities submit to voluntary urine tests

STRENGTHS Best measure of drug use among the criminal population

REPORTED LIMITATIONS Isn't a scientific sample; can't be used to extrapolate national figures

OVERALL TRENDS REPORTED Crack and cocaine use declining among U S. arrestees; 17 cities reported declines in percentage of positive cocaine urine tests in 1996

SIX WAYS OF LOOKING AT COCAINE USE

Over the past 10 years, different efforts funded by the federal government have produced wildly different estimates of the number of hard-core (weekly) cocaine users in the United States.

The most conservative estimates come from the National Household Survey on Drug Abuse, which was revised in 1994 to better measure hard-core use. (A mistake in 1991 led to the report of an erroneous single-year jump of 200,000 hard-core users.)

Other studies combining the household survey findings with urine-test data from jail inmates have produced larger figures but differing trendlines.

A RAND study released in 1994 showed a slow upward trend.

A 1995 study by Abt Associates Inc. showed falling and rising trends. When Abt improved and revised its methodology in a 1997 study, it counted more hard-core users than ever.

SOURCES: National Household Survey on Drug Abuse, Office of National Drug Control Policy, General Accounting Office, RAND, Abt Associates Inc.

THE BIG PICTURE (Extrapolated from highly flawed numbers.)

The number of illicit drug users has declined sharply since 1985.

IN MILLIONS

1996: 13 million

The amount of federal money spent on drug control efforts continues to increase rapidly.

IN BILLIONS

1998: $16 billion requested

SOURCE: Office of National Drug Control Policy, National Household Survey on Drug Abuse