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The impact of substance abuse
  1. Joseph A Califano Jr
  1. Center on Addiction and Substance Abuse at Columbia University, 152 W 57th Street, New York, NY 10019, USA
  1. Correspondence to: Joseph A Califano Jr

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The new Democrats and the Newt Republicans want to reform welfare, reduce crime, cut taxes, reshape Medicare, increase worker productivity and international competitiveness, house the homeless, and free state and federal budgets from the shackles of prison and Medicaid costs. The greatest obstacle to this proposed reinvention of America is abuse and addiction involving all substances: tobacco, alcohol, pills, and drugs. American leaders can soft-pedal the gravity of the addiction epidemic because so many individuals are content with their own self-denial. Yet, it is hard to find an American whom substance abuse has not touched directly.

The anecdotal evidence is everywhere, even among society’s most successful members; in the addiction to alcohol and pills of megastars like Elizabeth Taylor and Liza Minelli, in the death of Maryland college basketball star Len Bias from a cocaine overdose just as he was about to embark on a promising professional career, in the destructive cocaine and heroin dependence of Eugene Fodor, the first American to share top honours at the Tchaikovsky violin competition in Moscow, in the life threatening alcohol and drug addiction of Robin Williams, and the overdose death of Williams’ friend, John Belushi, in Cy Young Award winner Dwight Gooden’s cocaine abuse, and addiction-plagued pro football stars like Dexter Manley and Lawrence Taylor, and in the death of rock star Kurt Cobain.

Those who work the halls of national and state legislatures know how treacherous the lure of alcohol and pills can be in the corridors of political success. We have seen this in the political wives Kitty Dukakis and Betty Ford, and in the long line of alcohol abusing politicians, including at the peaks of their careers two of the most powerful congressional committee chairmen ever, Wilbur Mills and Russell Long.

And is there an American without a family member …

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