Why Obama’s Deputy Drug Czar Dropped Out

The Fix snagged an interview with Thomas McLellan. It’s definitely worth the time it takes to read it.

He spends some time discussing the segregation of addiction services, at topic that he and I are not on the same page about.

He briefly discusses his reasons for an abstinence orientation (for addicts):

Do you expect there will be changes as well in the non-drug treatment of people with serious substance use problems? Rehab and A.A. both have such low success rates.

No, I don’t think there will be any effect on addiction treatment programs. I don’t think we’re going to see controlled drinking or drug use achieved, at least in my lifetime, for people who are at the top end of severity. Therefore, I don’t think we’re going to see fundamental changes in specialty treatment. I am one who believes wholeheartedly in abstinence orientation for specialty care. If you interview a thousand people, you’re going to find 30 who used to be addicted and now are drinking “normally” again, but it ain’t the way to bet.

Where I do think we’re going to see change—and again I draw on what’s happened with other illnesses—is at the earlier stages. We’ll see far more engaging kinds of individualized care that’s going to involve combinations of interesting therapies, self-help, mutual help, medications and social services. And they’re going to be offered in the context of other kinds of care.

He also discusses why he left and the very interesting approach his new institute is taking:

Why did you decide to leave your job as deputy drug czar?

I didn’t like it. On a personality level it didn’t suit me. But I was proud of the White House Office of National Drug Control Policy, proud of the National Drug Control Strategy, and the part that I played in it. And no I’m not just being nice or politically correct.

But one of the most important factors for behavioral change in this country is the force of the marketplace. It’s second only to gravity in terms of how it changes behavior. And we really haven’t made much use of it. In my new center we’re working with three schools at the University of Pennsylvania: the School of Medicine, the Annenberg School for Communication, and the Wharton School of Business; we want to take the many good ideas out there—evidenced-based findings, protocols, whatever—and turn them into interventions that can be used by the public, by business, by schools, by government. I’m very excited about it.

Read the entire interview here.