Harry Jaffe

Rutberg tried to convince me that neutering was more humane than giving in to my base desire for fresh, wild meat. It’s called immunocontraception, and he explained how it’s done. First, you tranquilize a doe. Then you inject the contraceptive PZP, made from pig egg cells. Or you administer it with a blow dart. Then you tag the deer. And every year, during the fall mating season, you re-administer the contraceptive via a booster shot. Rutberg calls the program “experimental,” and admits it takes plenty of flack.

“The more we get,” he tells me, “the more we think we’re on to something.”

Now, we humans may be beyond the hunter-gatherer stage, but are we really ready to insinuate our birth control technology on wild animals? At Point Reyes National Seashore near San Francisco, it took a battalion of veterinarians and burly guys flown in by choppers to subdue the park’s exploding elk and inject them with birth control drugs, but at least that’s a controlled population where this kind of experimentation might make sense.

The deer population is anything but controlled. When “Bambi” hit movie screens in 1942 there were approximately 500,000 white-tailed deer in the United States. Now there are an estimated 27 million, more than when the Pilgrims landed in 1620. The four-legged varmints are plundering shrubbery, crowding out other wild creatures and causing traffic accidents with increasing frequency. Last year deer and cars collided nearly 500,000 times, and 100 people were killed as a result. With more malls and suburbs crowding into prime deer habitat, too-close encounters between us and them are bound to increase. So, is Norplant for deer the answer? “How else would you deal with deer populations in the middle of a town?” responds Rutberg.

“Shoot them,” says Tom Natelli, a developer who’s trying to build houses on 383 acres in Gaithersburg, Md., a bedroom community 20 miles north of Washington. It’s one of the first cities in the nation to require developers to submit a plan to handle the deer problem. Natelli wants to take care of it with sharpshooters and donate the meat to food banks.

Up the road from Natelli’s planned community sits the federal government’s National Institute of Standards and Technology, on a 575-acre campus of fenced meadow and woodlands. It has a small, controlled deer population. It is here that Rutberg and the Humane Society are carrying out their latest birth control experiments.

Leaving aside the logistics of trying to tag and dart and then re-inoculate millions of deer, let’s check dollars and cents. Developer Natelli has contracted with White Buffalo Inc., a Connecticut wildlife management agency that would cull his 200 deer for about $150 a pop. A Rutberg-style vaccination program could cost more than $500 per doe per year. It could take three to 15 years before birth control methods bring down a deer population. Hunting is quick.

So far, the tide is with the hunters. Counties overrun by deer on Long Island are allowing hunters to cull the herds this January. Maryland will permit hunts on public lands early next year. For the first time, supervisors in Fairfax, Va., a wealthy suburb near Washington, just approved a deer hunt that will extend from late January into February in county parks along the Potomac River.

During this year’s deer season, a hunter hopped the fence at Rutberg’s institute and tried to bag a deer in the experimental population. He was caught and arrested. “It reinforces all the bad things we think about hunters,” says Rutberg.

But I feel the hunter’s instinct. Every time I see the buck in Rock Creek Park, I marvel at his proud natural beauty, and as I appreciate his wildness, I feel the urge to take him. President Clinton, who lives just six miles down the road, might think ill of me. But maybe not. Three white-tailed deer jumped the White House fence last spring to munch on the manicured presidential grass.

Where’s Teddy Roosevelt when we need him?

Kay Graham would have appreciated her sudden exit, at age 84. Attending a meeting of executives in Sun Valley, Idaho, she tripped and banged her head Sunday, fell into a coma and died Tuesday, without languishing and putting anyone through a long period of keening or handwringing. It was a quick, uncomplicated parting.

Forgive me for contributing to the inevitable hagiography, but this is one person who deserves it. Katharine Graham was the accidental publisher, the unintentional feminist, the unexpected journalist. She always surprised people. She had ineffable qualities that can’t be learned or taught or bought: gumption, guts, instinct, heart, passion for truth. Raised in privilege, she was able to connect with hundreds of thousands of regular folks, not because they saw her face on TV or in the tabloids, because Kay never appeared there, but because of how she comported herself in moments of tragedy and how she shared them in a dignified way in her book, “Personal History,” which won a Pulitzer Prize in 1998.

Growing up in Washington in the 1920s, Graham was not a pretty or petite girl, which her mother, Agnes Meyer, reminded her of often. Back then that may have been tolerated; now it might be termed abusive. Her father, Eugene Meyer, came from a Jewish investment banking family and made millions organizing the Allied Chemical Co. He doted on “Kate.” Her mother was Lutheran, and she was brought up by a governess, was educated at a proper prep school and finished with classes in French and tennis and posture. She came away from her childhood feeling unloved and unappreciated, and without much ambition.

In 1933 Eugene Meyer bought the Washington Post in a bankruptcy auction for $825,000. Four years later, when Katharine Meyer was a senior at the University of Chicago, she realized her father wanted her to learn the newspaper business and perhaps join him at the Post. In a letter to her older sister, she said she might want to be a reporter, but she despised the business side. “I doubt my ability to carry a load like the Washington Post,” she wrote, “and I damn well think it would be a first-class dog’s life.”

At age 22, Kate Meyer married the dashing Philip Graham. Her father made him publisher of the Post; they had four children; they cavorted with Kennedys and Lippmans and Alsops. Kay Graham packed her husband’s bags and took care of the kids. Phil bought Newsweek, oversaw the expansion of the paper and became a usual suspect in the parties and intrigues of the capital city in the 1950s. It was a high life, but Phil also brought Kay low by having an affair with a Newsweek reporter. Then he began to suffer manic-depressive mood swings. She stayed by his side during his stays at mental hospitals, even when he rejected her. Then, one day in August 1963, at their Virginia estate outside Washington, she heard a shotgun blast, rushed to Phil’s room and found him dead on the bathroom floor.

Three days later, at 46, Katharine Graham was driven to the Washington Post to address its board of directors. She was petrified of speaking in public. She rehearsed her lines in the car with her daughter, Lally. She told the roomful of men that nothing would change, that she was now in charge and that they should get back to work. She then took a cruise before taking the reins of the paper.

When I interviewed Graham in 1997, before the publication of “Personal History,” she made it sound simple. “I began by just wading in and learning from experience,” she said. “Whatever strength I had was enhanced by dealing with Phil’s illness. Trying to take care of him undoubtedly gave me some strength.”

She needed that strength in June 1971, when the Post was confronted with whether to publish the Pentagon Papers in the face of threats from the Nixon administration. She was hosting a party at the family’s Virginia estate when Post editor Ben Bradlee and others reached her by phone. Bradlee was saying yes; the business side wanted to wait. “Go ahead,” she said. “Let’s publish.”

I asked her why.

“Viscera,” she said. “A decision like that couldn’t be very well rehearsed. It had to be instinctive.”

Then two pipsqueak reporters, Bob Woodward and Carl Bernstein, started writing stories about a break-in at the Watergate Hotel and a coverup by President Nixon. Attorney General John Mitchell said Graham would get her “titty caught in a wringer” if she kept publishing the stories. She did, and the Post reached its pinnacle, enshrined as the courageous newspaper that uncovered a scandal and brought down a president.

Woodward and Bernstein got the glory, but Graham and Bradlee were the duo who gave the reporters the freedom to write. Graham endured Mitchell’s crude threats — and real ones — to her company’s television licenses. She lived in fear during the Watergate years.

Perhaps taking down Nixon toughened her up for staring down the newspaper unions in a 1975 strike, which she broke by going down to the paper and literally carrying stacks of newspapers herself. In college, she was enamored of labor unions and wanted to report on the labor movement. As a publisher, she wanted to deal with the unions, but when they struck, she was bent on crushing them, and they never recovered.

The next 15 years were the Post’s golden era. Living off the Watergate afterglow, the paper attracted the best reporters, stacked up prizes and increased circulation. Bradlee strutted around the newsroom and pushed his reporters to break “Holy shit!” stories. The paper’s new Style section tweaked the powerful guests who were dining at Kay Graham’s table on Saturday and getting skewered by Sally Quinn on Sunday. One day Graham fielded a call from a red-faced Henry Kissinger, who screamed so loud she had to hold the phone a foot from her ear. She called Bradlee. He told her to calm down, and she did.

You get the sense that at some point in the late 1970s, after the Pentagon Papers and Watergate and the printers strike, Kay Graham threw off the yoke of her mother’s glowering judgment, put her husband’s demise behind and started to enjoy life. She traveled, threw great parties, brought the worlds of Hollywood, Washington and New York together at her R Street digs. “There are two invitations you don’t turn down,” movie lobbyist Jack Valenti once said, “the White House and Katharine Graham.”

Every president from JFK on except Nixon came to her home. Five months ago she introduced President Bush to Washington’s social scene with a party with regular folk like Bill Gates, Alan Greenspan, Colin Powell, Henry Kissinger, Barbara Walters, George Will, Howell Raines and other friends of hers.

On the business side, Graham grew the Washington Post Co. in the calm of the 1980s into a media conglomerate. Warren Buffett joined the board and helped the company expand into broadcasting, cable television, car phones and education and training. The rival Washington Star folded after Time Inc. ran it into the ground, which must have been satisfying on a number of levels. It left the Post with a monopoly. It killed the paper that had run a story depicting Graham as a gossipy, vindictive, cavalier socialite. (It hurt, she told friends.) She withdrew, became more private and dedicated herself to publishing.

As the Post became the newspaper with the best penetration of any major U.S. daily, Graham gradually passed the power and the publishing to her son Don. Gradually, Kay Graham’s people, who had made the Post great, left the scene. Bradlee retired. Meg Greenfield, the editorial page editor, died. And the passion that Bradlee and Kay brought to the newsroom seemed to slip away.

Don Graham is no Kay. Where she was comfortable within herself, and had a natural love of life and travel and people and playfulness, her 55-year-old son gives off a sense of extreme unease. She was born to money and privilege and wore them naturally; he was born to money and seems almost ashamed, as if he has to live like a proletarian to prove himself. If Bradlee was in Kay’s mold, his successor, Leonard Downie Jr., is a good match for Don. Downie is more of a bureaucrat, reticent to rally the troops and more interested in protecting the franchise. The paper is more of a commercial venture now, catering to suburban readers, where the advertisers want to be.

Don Graham gave up the title of publisher to concentrate on the Washington Post Co.’s other ventures, especially the Internet. The Post has plowed half a billion dollars into its Web site, far more than any other newspaper, and it has yet to recoup any of the investment. Wall Street is waiting to see a return, especially since the company’s net income sank by 40 percent last year.

With Kay Graham’s death, matters of succession obviously become more pressing. There have been rumors that the entire company might be sold, but nothing will take place without Don Graham’s blessing. Thanks to Kay Graham, control of the company’s stock is securely in the hands of the family. At this point, no other members of the family have emerged as natural leaders. Don is extremely protective of his children; the eldest is still in college. Lally Weymouth’s daughter, Katharine Scully, is an attorney who worked in the newspaper’s general counsel’s office before moving over to the Internet venture.

In a 1997 interview, I asked Kay why Don hadn’t moved into her role in the social scene.

“He’s very concentrated on business,” she said. “He’s terribly civic, speaking and attending meetings, reaching out in different ways. I enjoy people and mixing around. Don does it his way. He shouldn’t try to be me — even if I wanted him to be.”

Up in New York, the Sulzbergers have proceeded a bit differently. The only other newspaper publishing family left in control of a major paper, the Sulzbergers have given the paper to a new generation and focused on turning it into a daily national magazine. Under Arthur Ochs Sulzberger Jr., the paper has gotten better, much better, in style and tone and quality of reporting, and in its sense of its readership and how to connect with those readers. Sulzberger appointed as editor the firebrand Howell Raines, who has the temperament and passion of Ben Bradlee. Meanwhile, the Post seems to have lost its way. It’s still a great paper, still breaking news and investigating wrongdoing, but it’s missing that connection with readers, the passion that was there in the Kay and Ben days.

In 1991 Katharine Graham started working on her life story. She conducted interviews and collected material for two years. Then she sat down in the mornings and wrote out her story on yellow pads. Published in 1997, “Personal History” is a brave, sometimes brutally honest self-portrait, and at 80, the author went on a book tour. She continued to speak and travel and write over the past few years. The only thing that stopped her was a fall, three days ago. Her funeral next Monday at the National Cathedral will be attended by former presidents (perhaps even the current one), the powerful, the rich and the people who admired Kay because she never would have dreamed, after she attended her husband’s memorial service at the same cathedral in 1963, that her own death would be noticed by more than her family.

But if Williams were not the mayor, he might have been driving the truck of manure, an appetizer leading up to the massive demonstrations planned this weekend and Monday to disrupt the meetings of the World Bank and the International Monetary Fund.

“The protests as they relate to debt are well placed,” Williams says. “Our own economic interests are at stake. These debts are punishing on developing nations. I do have some sympathy for what the protesters are saying.”

Williams is sitting on the tan leather seats of his black Lincoln Navigator, which is being driven uptown by his security detail to Catholic University for the second of two religious events of the day. Dressed in his mayoral uniform — tailored suit and bow tie — Williams is following the regular schedule he plans to maintain during the course of the coming demonstrations.

The capital city that will host the meetings of the World Bank and the International Monetary Fund and those protesting them is far different from Seattle, which was torn up by the World Trade Organization demonstrations last year. For one thing, these meetings will take place in the heart of downtown, far from the city’s main residential neighborhoods, so the country is unlikely to revisit scenes of protesters and police battling under clouds of tear gas that seep into the homes of residents. Local and federal police units have been preparing for the protests since January to avoid a repeat of Seattle.

“We’re as ready as we’re going to be,” said Police Chief Charles Ramsey outside his brand-new command center.

Williams knows all about demonstrations — from the inside. As a student in the Bay Area, he demonstrated against the Vietnam War. In 1974 he organized a 20-mile march from Santa Monica to Long Beach, Calif., on the anniversary of the bombing of Hiroshima. At Yale University he organized protests aimed at gaining access to the school’s budget information. In 1992 he marched with Jesse Jackson in his demonstrations for economic justice.

Williams has done a lot of reading about global economics, and his rhetoric could be a manifesto for the protesters. “We should have free trade,” he says, “but it should not be at the beggaring of nations. It shouldn’t be just about globalization of business. It has to be the globalization of working conditions.

“Globalization without attention to working conditions doesn’t work,” he says, “but to pretend that we’re not in a global business environment doesn’t work either.”

Williams would like to see “a global social democratic economy — one that fosters entrepreneurship yet maintains basic working and safety conditions.” The way the system works now, he says, is destructive to the world economy, “no questions about it.”

The mayor has discussed all this with World Bank president James Wolfensohn. Williams is a Wolfensohn fan and believes the banker is doing well to reform the World Bank and bring it down to the village level. They see each other socially, and have discussed the business of preparing for the impending demonstrations.

“We don’t want to be John Wayne or Bull Conner,” Williams says, “but we can’t be oblivious to civil society. My concerns are that we will overreact or the protesters will overreact and we could lose control of the situation.”

Meanwhile, as the mayor is finishing his speech at Catholic University, law enforcement officials are in the midst of a briefing at the brand-new, high-tech command center in police headquarters, rolled out to deal with this demonstration. Stationed at computer screens in the center of a huge room, local police officers share the technology with federal officers from the FBI, Marshals Service, Secret Service, Park Police, U.S. Capital Police, Bureau of Alcohol, Tobacco and Firearms and National Guard. During the 1968 riots, National Guard troops occupied the city; this time the soldiers will fill in for the local police in neighborhoods, and the local cops will deal with the protest.

Four 5-by-6 screens show computer-aided dispatch grids of the protest area. Local news is running on two huge TV screens at the end of the room — one is hooked directly into the FBI’s command center. Cameras mounted on the World Bank building can beam images of an eight-block area into the command center, and helicopters with satellite links can beam in real-time images. A command bus at ground zero has the same capabilities.

The 30 or so assembled police officers are chatting and joking in this calm before the protests, but the room goes quiet when an older woman in braided gray hair comes on the local news to say she came to Washington to make a statement so that the “world’s environment will be safe for her grandchildren.”

When the briefing is over, Chief Ramsey predicts that the mayhem of Seattle won’t happen here. “We have no intention of using any chemical weapons,” he says. “We hope to go through this entire event without having to put on our helmets and riot gear — unless things escalate.”

It’s true that the demonstrations will not take place in the midst of neighborhoods where most Washingtonians live, but there is the matter of Georgetown. The elite community that’s home to Secretary of State Madeleine Albright, Health and Human Services Secretary Donna Shalala and the Washington Post’s Katharine Graham, among other VIPs, is 10 blocks away — a perfect staging area or escape hatch for demonstrators.

“Could it spill over?” Ramsey asks. “Yeah. But we don’t envision a situation where we’ll have to take back neighborhoods.”

Mayor Williams doesn’t plan to be anywhere near the demonstrations, unless things get out of control. He’ll go on national TV, perhaps “Face the Nation” on Sunday and “Good Morning America” on Monday. Other than that, he expects a normal few days.

But, he says, “you can never be totally relaxed about it.”

“Office-based methadone treatment would represent an enormous step forward in treating heroin addiction,” says Alan Leshner, director of the National Institute on Drug Abuse (NIDA), in response to a new report in the Journal of Urban Health: Bulletin of the New York Academy of Medicine. “This study shows that practitioners understand that their addicted patients are suffering from a treatable disease, and they are willing to provide that treatment.”

Sharon Hall, a researcher at the University of California at San Francisco whose study on methadone treatment appears in the Journal of the American Medical Association, concurs: “My feeling is anything that moves drug addiction treatment from clinics to physician’s offices and pharmacies is a major step. It takes it from a moral issue to a medical issue.”

The past five years have seen a 25 percent increase in heroin use. There are now an estimated 800,000 heroin addicts in the United States, and only 180,000 of them are being treated with methadone. Drug treatment specialists have been trying for many years to loosen strict federal and state regulations that require methadone to be administered at public clinics. They argue that many more people would undergo treatment for their addictions if it wasn’t provided only at clinics. The stigma of going to such clinics often keeps addicts away, as does the requirement to come to the clinic every day to get a methadone dose. “There’s a group of addicts who refuse to go to clinics,” says Frank Vocci, director of treatment research and development at the NIDA.

Even the National Academy of Sciences and the National Institutes of Health have recommended integrating methadone treatment into general medical practice as a way to increase the number of individuals receiving treatment.

One of the reasons there is strong support for moving heroin treatment out of clinics and into mainstream medicine is the increased use of potent, cheap heroin by middle-class suburbanites and teenagers in small towns across the country — from high-class suburbs outside Chicago to bucolic towns in Vermont. They start by snorting and smoking heroin and wind up with habits they cannot break, drug enforcement officials say.

“Many of the users are lulled into a false sense of security, believing that because they inhale heroin, they are less likely to become addicted to it,” said Drug Enforcement Administration agent William Nelson in testimony before a congressional committee last year. “As a result, we’re seeing a rise in first-time heroin users.”

The phenomenon of middle-class heroin use is so new that officials are just starting to compile statistics. By one measure, emergency room visits for heroin rose from 33,000 in 1990 to 70,000 in 1997. And the number of teens seeking emergency treatment for heroin showed a “dramatic increase,” Nelson testified. In the Philadelphia region and other metropolitan and suburban areas, heroin is on its way to eclipsing crack cocaine as the drug of choice.

“More 20-something professionals are showing up as heroin addicts,” says Jeremiah Daley, head of the Philadelphia Police Department’s narcotics unit. “They aren’t all doctors and lawyers, but enough people working important jobs are using dope. We locked up a school-bus driver the other day. It’s frightening. Young, white suburban housewives are becoming as common as middle-aged African-Americans.”

Potent new varieties of heroin that can be snorted rather than injected may be on their way to becoming the “mother’s little helper” of the new millennium. In response, the push for new and better treatments is becoming a priority. President Clinton has asked Congress to increase the treatment and prevention research budget by $37.2 million, and scientists are testing some promising new drugs.

Methadone, used for more than 50 years as the principal pharmacological treatment to combat heroin addiction, remains the drug of choice. Methadone is an agonist opioid that affects the nervous system much the same way heroin does. It relieves craving and reduces symptoms of withdrawal, but without giving the user a high.

New studies show that higher doses of methadone are more effective in keeping addicts from relapsing. In ongoing tests at Johns Hopkins University Medical Center in Baltimore, doctors are upping the daily dose from 25 milligrams to 100 milligrams, with promising results. During treatment, only about 30 percent still use opiates, and when treatment stops, as many as 80 percent relapse. Methadone’s only side effects are constipation (as with heroin) and sweating. “Methadone treatment can be highly effective when properly delivered,” says Eric Strain, the lead researcher in the Johns Hopkins study. “Properly delivered means prescribed along with counseling and other psychological therapies.”

A relatively new version of methadone called LAAM (for l-alpha-acetyl-methadol) is growing in popularity among recovering addicts. A new pill made by combining buprenorphine and naloxone is also promising; in clinical trials, it was found to “reduce or eliminate” the craving for heroin in more than half the heroin addicts. As narcotics, buprenorphine and naloxone would have to be strictly regulated, but the Food and Drug Administration has said the treatment is “approvable,” which is one step from full approval. “This is a big deal,” says the NIDA’s Vocci.

The trials took place in six states: California, Florida, Illinois, New York, Texas and Washington. What’s unusual about the trials is that they were conducted outside traditional drug treatment clinics. Doctors administered the new drugs in group practices, private offices, community mental health facilities and veterans clinics. “The idea is to drive it toward traditional medical practice as much as possible,” Vocci says.

Under current regulations governing methadone delivery, addicts in treatment have to go to a clinic every day so a nurse can watch as they down their dose of methadone. The next stage of treatment allows them to take a dose or two home. Strain says a small proportion of addicts in treatment is ready for pills from the pharmacy.

“These people could well be walking by you in the supermarket,” he says, “only they might be dressed better than you.”

Since methadone is itself an addictive drug, it is strictly regulated, and it is illegal for doctors to prescribe it. The regulations, developed in the early 1970s when methadone treatment increased tenfold, are gradually being liberalized, with treatment in doctor’s offices being the ultimate goal. “We’re working our way towards that,” Vocci says.

Once the federal regulations are changed, researchers say, pharmacies will be willing to dispense methadone, LAAM and other treatments.

Researchers are less enthusiastic about ultra-rapid opiate detoxification (UROD). Under this radical treatment, heroin addicts are anesthetized during the “cold turkey” phase of recovery while doctors administer a series of intravenous drugs to remove the opiates in the nervous system causing addiction. The treatment has proved costly, controversial and perhaps even deadly for a few patients, and studies of the method are under way. The demand for such instant detoxification comes from the new addicts: middle-class suburban youth.

“What I’m seeing now is kids and parents who are desperate,” said Dr. Lance Gooberman in a recent New York Times article. Gooberman, who had been performing UROD in New Jersey, was barred from providing the treatment by state medical examiners, who said the procedure “constitutes a danger to the public’s health, safety and welfare.”

Parents are indeed desperate. Take Burlington, Vt., a small college town on Lake Champlain known as “Boulder East” because of its rock music scene, cycling trails and nearby mountains for skiing. The city always had a few junkies, but now teenagers are buying dope in City Hall Park, across from the mayor’s office, and showing up in emergency rooms. “Evidence of a small but growing heroin problem cannot be ignored,” the Burlington Free Press acknowledged in an editorial last October.

Or Westminster, Md., a small town amid rolling farmland near the Pennsylvania line, which was just hit with a few heroin overdoses among teenagers. Baltimore has always had its share of junkies; now heroin arrests are off the charts in the nearby suburbs of Carroll County. Teenagers in the suburbs around Richmond, Va., have also been getting hooked on smack, according to the DEA. Likewise, heroin that used to be the drug of choice primarily among Seattle’s musicians has been showing up from King County, Wash., to Eugene, Ore.

Clinton’s new federal budget would raise funding for drug enforcement to $18.9 billion, an 8 percent increase over last year’s allocation of $17.8 billion. Despite the hefty increases, the war on drugs is losing the battle against heroin.

“We’re not going to win it with law enforcement,” says Kermit Miller, a narcotics officer on a federal task force in Arizona. “We’re just a stopgap. We’re holding the line.”

Ten years ago the average purity of heroin on the street was perhaps 10 percent. Now heroin from South America has a purity as high as 70 percent. Stronger heroin means that middle-class users can snort or smoke it, avoiding the complications and health risks of shooting up.

Heroin supply routes used to follow the old French Connection path from Burma and Thailand through Europe to the United States. But since federal agents and Thai army units wiped out heroin warlord Khun Sa in 1994, Colombian drug cartels have been growing poppies in South America, processing the heroin and shipping it through Mexico or Puerto Rico to U.S. markets.

The dealers have adapted to their well-heeled suburban customers. One 14-year-old pusher in Wilmington, Del., sold smack under the brand name “Landrover.” By 1999 dire numbers started showing up in federal statistics: Heroin use was up in St. Louis, Seattle, Texas, Washington, D.C., Baltimore and Denver, where the Community Epidemiology Work Group report mentions “record mortality” among “new young users.” Indeed, “increases in heroin use in younger populations were reported in seven cities,” said the group, part of the NIDA.

Federal researchers are hoping that the increased demand for heroin among younger, more affluent users will focus more attention on treatment and their goal of making medications available where people go to buy aspirin and shampoo.

There has been some resistance. New York Mayor Rudy Giuliani caused a ruckus two years ago when he announced that the city would no longer provide methadone at its clinics, but he backed off a few months later and added $5 million to the city’s methadone budget. While Narcotics Anonymous and other groups are opposed to any use of addictive drugs, opposition to mainstreaming methadone maintenance therapy has yet to materialize.

“There’s very little opposition to the idea that certified, trained physicians be involved in administering methadone to stabilized patients,” says Mark Parrino, president of the American Methadone Treatment Association. “The problem becomes, Should all doctors be able to prescribe methadone to opiate-dependent patients?” Two doctors are prescribing methadone in model programs in New York, Parrino says.

“It’s time to move treatment from clinics to physician’s offices and pharmacies,” says researcher Hall. “This is the underlying issue in drug addiction.”

On the House side, Secretary of State Madeleine Albright found herself in a similar fight in front of the Appropriations Committee, with many Republican members criticizing her for starting a war without adequate preparation. The Clinton administration will have to ask the committee for a $4 billion supplemental appropriations bill to pay for the war’s enormous expense, and the politics are already intense. Republicans can probably be counted on to support an increase in the military budget, but they may attach strings that won’t be to the administration’s liking. House Majority Leader Richard Armey sent an e-mail to Republicans early Thursday asking for support to tack on more funds to increase Pentagon funding across the board, but it’s likely Armey and his allies will also seek dollars for things Clinton opposes.

But if the war may ultimately hurt Democrats, right now it’s giving the Republicans the biggest political problems. The GOP is sharply divided between old-line internationalists like former Sen. Bob Dole and isolationists like Pat Buchanan, who has a number of GOP allies in Congress. California Rep. Tom Campbell, a moderate Silicon Valley Republican, has introduced two bills intended to force the House to declare war on Yugoslavia or halt the bombing campaign by May 1. He introduced the legislation under the War Powers Act to compel Congress and the Clinton administration to obey the constitutional requirement that “Congress and only Congress [can] declare war.”

“We are presently at war,” Campbell declared. “It is an unconstitutional war, and the sooner we bring the matter to a vote in the House of Representatives, the sooner the Constitution is complied with.”

In this topsy-turvy political climate, liberal California Democrats who represent the anti-war wing of the party immediately criticized Campbell for not backing the military action. Still, the solid support for Clinton among Democrats started to develop some cracks.

On April 14, Vermont Sen. Patrick Leahy, normally a staunch defender of the president, took to the Senate floor to issue a strong broadside. “Despite claims by NATO and Pentagon officials that they predicted everything, the United States and the rest of NATO were clearly unprepared for the debacle that unfolded,” he said. “I suspect historians may look unkindly on the administration officials who did not have the contingency plan if Milosevic refused to back down after a few days or weeks of NATO bombing.”

Leahy went on to praise Arizona Sen. John McCain for advocating the use of ground forces. Clouds over the rugged mountains of Kosovo have brought sunny days to McCain’s campaign to take the White House in 2000. The longer the war drags on, the more media, money and volunteers will flow into McCain’s camp.

“The phones are ringing off the hook,” says McCain’s campaign press secretary, Howard Opinsky. “Our poll numbers are up six points.” Campaign contributions are sure to follow.

In the crass calculus of presidential politics, the pained faces and bombed bridges that flash across American TV screens have given McCain the opportunity to display himself as a true American hero, the Vietnam War vet who spent years as a POW in the Hanoi Hilton. By comparison, Texas Gov. George W. Bush’s reticence to comment on the American and NATO air war in Yugoslavia has dropped him from golden boy to missing in action. And the Republican Party that used to line up in lockstep on military and foreign policy matters is divided and demoralized, according to a variety of GOP activists.

The war in Kosovo is the first defining moment in a campaign that is a year away from hitting high gear. In a crowded field of potential GOP nominees, McCain has quickly defined himself as a distinguished former Naval officer who knows something about foreign affairs and isn’t afraid of taking bold positions. As soon as Serbian troops captured three American servicemen, McCain was all over the news: “Nightline,” “Larry King Live,” the three morning shows. He looked like Ike Eisenhower in waiting.

“Avoiding casualties, theirs and ours, is not our primary objective,” he told the Center for Strategic and International Studies on Tuesday. “Winning is, the sooner the better. To that end, we should commence today to mobilize infantry and armored divisions for a possible ground war in Kosovo.”

“It’s a total plus for McCain,” says veteran GOP pollster Frank Luntz. “All the other Republicans are scared to talk.”

The greatest fear is coming from Bush’s campaign headquarters in Austin, Texas. The son of the former president has said very little about Kosovo, and what he has said makes him look less than presidential. Bush apparently referred to Kosovar refugees as Kosovarians. “What’s that,” asks a gleeful Democratic operative, “a new group from a distant galaxy in the next ‘Star Wars’ movie?”

In his most candid remarks to date, Bush told New York Times columnist William Safire: “I believe we ought to be slow to engage our military, slow to commit our troops,” but he begged off on more details, saying he didn’t have full intelligence on the matter.

It’s not that Bush lacks good advisors. Two luminaries in the foreign policy firmament, Paul Wolfowitz and Richard Haas, have put themselves at Bush’s disposal. But he’s either not happy with their advice or he’s chosen to take the politically expedient course of keeping his mouth shut.

Or perhaps he’s trying to avoid the fate of former Michigan Gov. George Romney, whose presidential bid collapsed when he said he’d changed his views on the Vietnam War because he’d had “the greatest brainwashing that anybody can get.”

Bush’s inability to take a clear position has opened him up to jabs from other Republicans and Democrats. On the one hand he’s said that the United States has a stake in Kosovo; on the other he’s tapped New Hampshire Sen. Judd Gregg as his standard bearer for that state’s key early primary, and Gregg is firmly against U.S. involvement.

“He’s getting buffeted by his right and by his right,” says one prominent Democratic official.

The governor’s vacillation is a metaphor for the divisions within the GOP. With the Democrats in command of bedrock GOP issues like the economy and crime, Republicans are desperate for an issue, but they are in disarray on defense, too.

“For 30 years, Republicans have maintained a unified foreign policy as military hawks against communism,” says Luntz. “This time, for some strange reason, Bill Clinton has unified the Democratic Party, and the Republicans are divided.” Indeed, isolationists may constitute a strong bloc of GOP primary voters, so that McCain’s strong support for the war could ultimately backfire come election time.

The day McCain advocated sending troops to Kosovo, Pat Buchanan, running once again for the GOP nomination, said the Kosovo campaign was “the greatest debacle I’ve ever seen almost in my lifetime.” Both Steve Forbes and Dan Quayle, two more in the pack of GOP hopefuls, have come out against U.S. involvement.

David Keene, longtime head of the American Conservative Union, is calling for a withdrawal from Kosovo. “Who appointed us God?” he asks.

Looking like Republicans, the Democrats are unified behind Clinton and the bombing campaign. Even liberals like Minnesota Sen. Paul Wellstone is in step. But there are pitfalls, especially for Vice President Al Gore. The Democratic front-runner has been a proponent of American involvement, but a prolonged war that starts costing American lives could put Gore in the position of campaigning while soldiers in body bags are flown home.

“Gore’s got to be very nervous,” says Keene. “He doesn’t know what’s going to happen.”

But even GOP candidates who favor action in Kosovo have found ways to criticize Clinton, and by extension Gore. Both McCain and Republican presidential contender Elizabeth Dole assailed his “credibility.” Taking a page from McCain’s speeches, Dole used a speech Wednesday before the Naval Academy to call on Clinton to “build up and deploy the forces necessary to win the war” in Kosovo. But she also hit Clinton’s credibility and vacillation on foreign policy. “When we accept half promises,” she said, “we send the wrong messages about our values and our will.”

McCain has already admitted the potential risks of his strong position. “I know that should Americans die in a land war with Serbia, I will bear considerable share of the responsibility for their loss,” he says. “I and any member who shares my views must be as accountable to their families as the president must be.”

The bottom line is that McCain gets to look presidential as long as Americans are at war, and that’s a big advantage for a candidate who was not at the front of the large Republican pack.

“Americans are seeing someone who they could easily see sitting in the Oval Office,” says McCain spokesman Opinsky.

Meanwhile, Bush is still sitting in Austin, padding his campaign war chest.