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Black Eye
The National Center on Addiction and Substance Abuse (CASA) at Columbia University has a track record that makes absolutely no one in the public health field the least bit envious. A long line of questionable pronouncements, based on equally questionable science, have been issued from this well-to-do political advocacy group over the years:
- Through some remarkably transparent statistical sleight-of-hand, a 2002 CASA report entitled “Teen Tipplers” willfully overstated the proportion of alcoholic beverages consumed by underage drinkers in the United States. This despite the fact that CASA’s own numbers showed that underage binge drinking fell sharply during the previous 20 years. Under CASA’s interpretation of the facts, every American who drinks between ages 12 and 20 would have to consume over 4 drinks every day Unrepentant, CASA has stuck by its original claims, despite the fact that every respectable news outlet has roundly denounced the “Teen Tipplers” report.
- A 1994 CASA report alleged that one in four women on welfare (25 percent) were “abusing” alcohol or other drugs. The U.S. Department of Health & Human Services (HHS) quickly debunked this claim, announcing that the very studies CASA used in its report put the number at only 4.5 percent. Government researchers at HHS called the CASA report “seriously flawed” and blasted CASA for repeating one of its most common errors: mistaking use for abuse. CASA had arbitrarily decided that adults who have five drinks twice in any given month could be labeled “alcohol abusers.” Similarly, anyone who used illicit drugs during the previous year – even one experiment with marijuana – counted as a “drug abuser” in the CASA study. In a scathing press release, HHS urged Americans to “read the fine print” and noted that CASA’s work was “susceptible to serious misuse by people who take it out of context.”
- Another CASA report focused on college binge drinking, calling it a problem of “epidemic proportions.” CASA’s key finding, that binge drinking among college women had tripled, made national headlines. But the CASA-of-cards came tumbling down when Forbes MediaCritic, a now-defunct news journal, found that CASA’s conclusions were completely unjustified. It turns out that binge drinking at college campuses had remained steady for decades. A closer look at CASA’s research standards told the rest of the story: MediaCritic senior editor Kathy McNamara-Meis found that many of the “statistics” cited by CASA were merely conjecture by health educators at various universities. One number even came from a student handout that was “not intended to reflect any kind of original research.” Another statistic came from a misquote published in a student newspaper. McNamara-Meis concluded that CASA’s numbers were either outdated, “not credible,” or simply “pulled from thin air.”
- In 1997, CASA published a report on pre-teen drug use that concluded “the percentage of 12-year-olds who said they knew a friend or classmate who used ‘acid,’ cocaine, or heroin more than doubled between 1996 and 1997.” But just one week earlier, the U.S. government had published results stating that rates of teen drug use were unchanged. In some cases, they were actually on the decline. In an interview on PBS’s News Hour with Jim Lehrer, Califano was asked whether any of the kids in his survey might have been referring to “an older, very much older friend, or sibling” who used drugs. Did CASA break down its data to at least distinguish friends and classmates from older siblings? Califano’s reply: “Unfortunately, we didn’t.”
- One of CASA’s more remarkable numerical contortions caught the notice of UC Santa Cruz sociologist Mike Males, who wrote about it in the April 2002 issue of Youth Today. Males notes that a CASA study financed by the Kaiser Family Foundation concluded that a whopping 89 percent of teens who used drugs or alcohol were “at risk” of having unprotected sex. A look at the original survey data, however, reveals that only five percent of high school seniors had actually engaged in unprotected sex after using drugs or alcohol. This, off course, was before CASA and Kaiser cooked the books. In order to inflate its statistics by 1,790 percent, the 15-17 age group was lumped together with those between 18 and 24. In making this “adjustment,” they also included married couples! Lastly, they made allowances for student’s vague guesses about whether “people my age” just might mix drinking and sex. The result: the five percent of 15-17 year-olds who actually engaged in high-risk behavior were ignored in favor of the 89 percent of 15-24 year-olds who thought someone in their age group “might” do so. Guess which number made the evening news?
This is the way that real science works, and it’s the best tool we have to make sure that half-baked and ill-informed conclusions stay out of the mainstream of scientific thought. CASA has consistently chosen to avoid this process like the plague, leading some in the public health field to suggest that its findings would never survive such concentrated scientific inquiry. Dr. Herbert Kleber, CASA’s medical director, has written that the length of CASA’s monographs “does not readily lend itself to the format of an academic peer-reviewed journal.” Accordingly, Kleber says, CASA has “chosen to issue these documents ourselves.”
CASA would obviously garner tremendous prestige if even a short paper were accepted for publication by the likes of Nature, JAMA, or the New England Journal of Medicine. All it would take is an acknowledgement that CASA’s work should be subject to the same scrutiny as everyone else’s at Columbia University. The fact that they’ve chosen not to try speaks volumes.
