Joseph Califano sees drug abuse as destroying the very ramparts of American society.

In a keynote speech to a two-day multidiscipline, multicollege-sponsored addiction conference at the University of Utah, the former adviser to two U.S. presidents said drugs — prescription, illegal, alcohol and tobacco — are a "scourge ravaging the health, minds and souls of Americans at every social and economic level."

Califano, a reformed smoker — "four packs a day when I was advising Lyndon Johnson; the required amount to deal with being an adviser to Lyndon Johnson" — said the United States at the start of a new century is a "high society."

"If Moses would have been from today, he would have returned from Mount Sinai with Vicodin and Prozac, not the other kind of tablets," Califano said.

The rising tide of dependency and addiction, according to the outspoken former U.S. secretary of health, education and welfare under President Jimmy Carter, is revealed in an array of statistics that amounts to $1 trillion in damages to the economy and wreaks an untold cost on the psyche of families, communities and the country.

"The human misery it causes cannot be measured," he said. "The time has come for a fundamental change in our attitude about the pervasive and pernicious role drug and alcohol abuse play in our society and a revolution in the way we deal with it," Califano told conference attendees, noting that parents clearly have the most influence on whether their children become drug users.

"There was a time not so long ago when smoking was cool, when seat belts were for sissies and when AIDS was seen as a death sentence. Today our attitudes are profoundly different, with powerful and beneficial consequences. Smoking has been cut sharply, and so have the related deaths from lung cancer and heart disease. Auto safety measures have curbed the highway death and injury rates. AIDS is recognized as a serious illness rather than a social curse."

Califano, who amid significant protest even at his own workplace in Washington, mounted the nation's first anti-smoking campaign, still considers smoking "public enemy No. 1." He is the founder and chairman of The National Center on Addiction and Substance Abuse at Columbia University.

Research at the center shows:

• Americans, making up only 4 percent of the world's population, consume two-thirds of the world's illegal drugs.

• Nearly a quarter of the nation's college students meet the clinical criteria for alcohol and drug abuse and addiction.

• Every American child will be offered illegal drugs before graduating from high school, most on several occasions.

The reason people are using and abusing drugs like never before, Califano couldn't say. But because the use is so widespread, the only way to counter it is "if all of us — politicians, parents and physicians, teachers and clergymen, cops, judges and lawyers, journalists and entertainers — do our part to create the cultural revolution to sober up."

His book, "High Society," is a combination call to arms and a manifesto of specific actions people can take. First and foremost is a 180-degree switch from "our denying it's that big a deal."

The drug culture is the dominant culture, he said, noting he was including abuse of prescription drugs in the category. "It is a plague that has maimed and killed more Americans than all our wars, natural catastrophes and traffic accidents combined."

Approaches such as the war on drugs have been ineffective because Americans haven't been willing to see the scope of the problem, he said.

"When all the king's horses and all the king's men couldn't put Humpty-Dumpty back together again," he said. "there's no point in calling for more horses and more men."

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