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McCaffrey's Approach The other main criticism of current policy is that federal support of drug-prevention and treatment programs is out of balance. “Obviously, we need law enforcement because a lot of drug users are in the criminal-justice system,” says Gale Saler, deputy executive director of Second Genesis. “But the amounts we're spending on drug efforts seem way out of kilter when you consider the effectiveness of programs where most of the money is spent. It we could snap our fingers and all of a sudden stop all drugs at the border, we'd still have a drug problem in this country. We grow our own marijuana, and we produce methamphetamine and pharmaceutical drugs. People with this disease are going to use something until they get high. We need to focus on addiction.” McCaffrey defends the administration's budget priorities. “Drug-treatment dollars have gone up by 34 percent over five budget years,” he says. “That's unarguable.” In addition, McCaffrey says the administration has helped make drug treatment available by providing substance-abuse and mental-health coverage to federal workers, to take effect in October. “If you're an oncology patient and have an associated nutrition problem, the hospital will treat you as a holistic challenge,” he says. “We want the same thing for drug addiction and mental health. By the way, we'll save a lot of money if we do that. If we treat your substance-abuse problem, we won't then subsequently have to treat you for a quarter-of-a-million-dollar problem because you're HIV-infected or treat you as a traffic-accident victim.”

The use of voter initiatives as a vehicle for drug-policy reform took off in 1996, when California voters approved Proposition 215 legalizing the use of marijuana for medical purposes. The same year, Arizona voters approved a similar initiative, whose final implementation will be put to a vote this fall. In 1998, Alaska, Oregon, Washington, Colorado, Nevada and the District of Columbia followed suit. Initiatives took immediate effect in the first three states; the Colorado vote was later nullified following allegations that insufficient signatures had been collected to allow the issue to go on the ballot, while Nevada's Constitution requires a second vote for an initiative to take effect. Medical marijuana will be on ballots again this fall in Colorado and Nevada.

On the other hand, DT2 is known as a genetic disease and a positive family history for DT2 is indicative of early biochemical detection. The association between family history and obesity doubles the risk of developing DT2 in a patient. Individual susceptibility for the development of DT2 is strongly influenced by genetic factors and this fact justifies the efforts to identify and characterize susceptibility genes for this disturbance.