In another clear break from past policy, President Obama announced Friday that he intended to nominate as the nation’s No. 2 drug czar a scientist often considered the No. 1 researcher on addiction and treatment.
A. Thomas McLellan, a University of Pennsylvania psychologist, will be charged with reducing demand for drugs, a part of the foreign-supply-and-domestic-demand equation that many policy experts say has been underemphasized for years.
“We’re blown away. He understands,” said Stephen J. Pasierb, president and chief executive of the Partnership for a Drug-Free America, that addiction “is a parent, a family, a child issue.”
If confirmed by the Senate, McLellan will be deputy director of the Office of National Drug Control Policy, which advises the president and coordinates anti-drug efforts. Obama last month nominated Seattle Police Chief Gil Kerlikowske to head the office.
Kerlikowske’s reputation for innovative approaches to law enforcement and McLellan’s stature as a treatment scientist make them “a perfect match,” Pasierb said.
Although hardly known outside his field, McLellan is regarded as a leading researcher on a range of addiction-related issues.
As a scientist at the Veterans Administration Medical Center in Philadelphia in the 1980s, he led development of two measures, known as the addiction severity index and treatment services review, that characterized multiple dimensions of substance abuse. The tools, used worldwide, help determine the type and duration of treatment.
In 2000, he was lead author of a groundbreaking paper that compared drug addiction with chronic medical conditions.
When diabetes or asthma patients relapsed after treatment ends, he argued, doctors concluded that intervention worked and that treatment needed to be continual.
“In contrast, relapse to drug or alcohol use following discharge from addiction treatment has been considered evidence of treatment failure,” the authors wrote in the Journal of the American Medical Association.
McLellan, 59, grew up outside Harrisburg, Pa., and did his graduate work at Bryn Mawr College, earning a doctorate in 1976. In 1992 he cofounded the nonprofit Treatment Research Institute to study and adapt promising scientific findings into clinical practice and public policy.
He worked with the State of Delaware, for example, to implement a system that tied part of the payments to state-funded treatment centers to predetermined measures for success.
“I think his long and rigorous examination of how drug-abuse treatment is delivered is pretty unique,” said David Friedman, director of addiction studies at the Wake Forest University medical school.
People in the field have long been frustrated by drug policies under both Democrats and Republicans that they say were driven not by science but by ideology — essentially, arrest the drug suppliers and get the users out of sight.
Friedman was buoyed several weeks ago when Secretary of State Hillary Rodham Clinton made an unusual acknowledgment of the role played by domestic consumers of illicit substances.
“Our insatiable demand for illegal drugs fuels the drug trade,” she said in Mexico.
Friedman said that “if that’s the way the administration feels about this, then all of a sudden the deputy for demand reduction” — McLellan’s job, in addition to being the second in command — “becomes a very important position.”
– Article from The Chicago Tribune on April 10, 2009.