What’s a nice boy from MIT know about narcotics?
During his doctoral student days at the Massachusetts
Institute of Technology, Jonathan Caulkins’s professors
told him that mathematical modeling methods used in
operations research could solve any problem. So he
whittled humanity’s 10 biggest challenges down to the
one that was both quantifiable and not yet addressed by
engineers: drug addiction. He then spent a summer
rolling with the police in Hartford, Conn., so he could
meet the city’s drug dealers in person and grill them
about their business.
Some two decades later, Caulkins, 41, now a professor
of operations research and public policy at Carnegie
Mellon University, in Pittsburgh, is among a handful of
engineers, statisticians, and computer scientists using
math modeling to predict, treat, and contain drug
addiction. Armed with degrees in computer science,
public policy, and electrical and systems engineering
from MIT and Washington University, in St. Louis,
Caulkins has carved an award-winning career out of
analyzing the best combinations of policies needed to
tackle different types and stages of drug epidemics.
“It’s common to use engineering to address public
policy in industries with strong technological
components, like telecommunications and transportation,”
he says. “But drug-, crime-, and delinquency-prevention
issues have traditionally been addressed through classic
social science methods, which tend to focus on comparing
static situations and pay less attention to changes over
time. Engineering incorporates more dynamic systems
analysis that’s less familiar to social scientists.”
Caulkins’s unorthodox approach has yielded some
provocative findings, the main one being that long
prison sentences don’t curtail drug use and often create
more serious problems, such as HIV infection,
unemployment, and families breaking up. As a result, he
often finds himself walking a fine line between factions.
“In trying to be objective, sometimes I find
something different than the conventional wisdom—which
rocks boats because it forces people to rethink things,”
he says. “Innovative programs are costly in the
political sense. It’s easier to say, ‘Let’s get tough
and lock them up.’ Drug addiction and markets are more
complicated—they intersect with health care, foreign
policy, education, and environmental issues—which takes
more than a sound bite to explain to voters.”
Caulkins’s research is bound to have increasingly
timely implications as the United States gears up for
next year’s presidential election. His modeling has
shown that drug use responds to such market factors as
price and that a drug’s evolution from introduction to
maturity mirrors the pattern of a medical epidemic. His
findings, he says, reflect the need for a fluid
counterbalance, rather than simply increasing
incarceration, which has had limited success.
For example, the beginning of the cocaine surge in
the 1980s prompted a spike in drug-related homicides.
But as a mature epidemic, cocaine is now primarily used
by an older, more drug-dependent, less violent
population. Each stage requires different containment
methods. Supply-control interventions, like a police
crackdown on drug dealers, might be more effective
during a drug’s early explosive use; more treatment and
less reliance on incarceration might be called for
later, when the drug is used mainly by addicts.
Caulkins’s research ascertains the most effective mix of
interventions during the course of an epidemic.
Modeling relies on computer programs to track changes
in a system over time based on the introduction of
different variables. Since 1990, Caulkins has been
evaluating how singular factors—such as border control,
school-based prevention, inpatient/outpatient treatment,
price, and incarceration—affect drug use among
recreational, criminal, HIV-infected, and addicted
users. He then layers the findings to track increasingly
complex situations. (Other modeling studies are looking
at treatment allocations, how to predict which
populations are most likely to become addicts, and how
social policies are combating addiction-spawned diseases
such as HIV and hepatitis C.)
Even so, modeling epidemics has its limitations: it
works on a macro level, while individual behavior is
much harder to predict. “It’s akin to needing quantum
mechanics to understand a single atom, and Newtonian
physics to understand aggregation, because the law of
larger numbers takes effect,” Caulkins says.
Still, he says, “modeling works when you try to
figure out the right policy for a country and have
drug-control choices that are enormously diverse.”
Colleagues regard Caulkins’s biggest contribution as
his challenging—and then proving wrong—many assumptions.
For example, he discovered that higher drug prices do
not necessarily increase crime, as previously thought.
“What distinguishes Caulkins from most modelers is
that he takes the time to understand the topic before
throwing equations at it,” says Mark Kleiman, a
professor of public policy at the University of
California at Los Angeles, who was one of Caulkins’s
thesis advisors and has been “a fan” ever since. “He
doesn’t assume, as lots of modelers do, that merely
having abstract modeling capacity is as substantive as
actually understanding the real-world problem.”
Slowly, Caulkins’s ideas have been gaining a foothold
outside the United States, particularly in Australia,
and in some regional U.S. arenas. “State and local
governments are more concerned about cost-effectiveness,
because they have to balance budgets; the federal
government does not,” he notes.
But changing minds takes time. “Every time we release
a study, there’s always some aspect that ruffles
feathers,” he says, laughing. "We’ve successfully
offended every faction, from law enforcement to the
treatment community.
“I like it when there’s a little controversy, because
it means we’re challenging the status quo.”