Harold Pollack is the Helen Ross Professor of Social Service Administration at the University of Chicago and a Special Correspondent for The Treatment.
I recently did a Curbside Consult with deputy drug czar Tom McLellan. I hope that you read it, because he had important things to say about medical marijuana, the need to critically evaluate supply-side interdiction, and many other things. I disagree with of his views. I am more open to harm reduction approaches to the serious problem of opiate overdose. I have a more permissive views regarding marijuana policy. Still, when I compare that interview with past pronouncements coming from that same office, McLellan’s moderate embrace of evidence-informed policy is admirable..
Shortly after that feature appeared, the New York Times ran a nice profile of McLellan by Sarah Kershaw. Kershaw noted one aspect of McLellan’s personal story I didn't mention. McLellan recently lost a son to a drug overdose. His wife and another son have also experienced substance use disorders.
You might wonder why I did not discuss these pertinent and poignant facts. If you are an advocate, academic researcher, or practitioner in drug abuse, HIV, disability, or mental health, you hear many serious personal stories about colleagues, acquaintances, and peers. Some have struggled with drug problems or depression. Others live with HIV or hepatitis C. Others care for a sick spouse, sibling, or child. Many have experienced some other tragedy or challenge among those close to them. I generally put such information in the category: "Hard not to notice, easy not to say."
I don’t want to overstate things or encourage unwarranted assumptions. (My HIV-related columns attract predictable emails warning that I will die of AIDS.) Yet it’s a fact that serious personal trials motivate a surprising number of social workers, public health professionals, AIDS activists and researchers, nurses, and others to do the difficult work they do. That comes with the territory.
This brings important benefits. Personal trials equip people to see things that others would miss, to credibly communicate important messages that might otherwise be dismissed. Such intimate exposure can also be dangerous, when it deprive people of needed critical distance. A key group of drug treatment counselors are former users. Some are overly swayed by powerful personal experiences and pay insufficient attention to available clinical research. An adoption case worker who was adopted herself may deny or overlook the importance of others’ very different experiences.
Related tensions arise among politicians and high-level policymakers. Across the political spectrum, many have been swayed by their experiences caring for a sick parent or a child living with. Bob Dole, Arlen Spector, and many others experienced personal health crises. During the mid-1970s, an invaluable network of liberals and conservatives with personal stakes built and financed the current system of services for children with special needs.
Politicians' personal commitments can be harmful, too, as when sincere but misguided Indiana Congressman Dan Burton held misleading hearings on alleged links between vaccines and autism. The NIH campus is peppered with buildings named for politicos who advocated greater resources to people in white coats who study or treat particular diseases. The cumulative effect can be to neglect more foundational, or simply less flashy and visible work. Through no particular person's villainy, such attachments can also aggravate social and class biases. Compare congressional attention and funding for autism, cystic fibrosis, AIDS, and breast cancer with that provided to sickle cell anemia or opiate disorders.
I'm not sure how McLellan's answers to my questions were different because of what his family endured. People carry these burdens in different ways. It's easy to offer facile and disrespectful speculation when McLellan's issue positions are pretty closely grounded in his clinical and research experience, and the requirements of his office.
I am sure that such personal experiences matter. People like McLellan do not come to Washington for the money or for the opportunity to undergo an FBI background check. They endure the grinding and lousy aspects of policymaking because they want to make a difference on issues that matter to them.
I'm also sure of another thing. It's good for everyone to see how substance abuse affects millions of people in every nook and cranny of this nation. The war on drugs was always a brutal and inaccurate metaphor. That supposed war quickly morphed into a war on drug users--and yes drug sellers--who often turn out to be flesh-and-blood people close to us. After so many years of poor social policy in this area, I find it sadly comforting that central policymakers have witnessed what is at stake.