William Regelson, M.D., is a professor of medicine at the Medical College of Virginia, Virginia Commonwealth University, P.O. Box 273, Richmond, Va. 23298-0001.

Legally addictive substances should financially support the programs necessary to help solve the public health problems of both legal and illegal addiction. The federal excise taxes raised from tobacco and alcohol should be used to fund the research we need to gain a better un-derstanding of effective treatment regimens and of the effects of currently illegal drugs.

According to the latest National Household Survey on Drug Abuse, 57 million Americans used cigarettes in the last month, 105 million used alco-hol, 1 million used tranquilizers, 784,000 used sedatives, 1.7 million used stimulants, 776,000 used hallucino-gens, 484,000 used crack, 2.9 million cocaine and 11.6 million used mari-juana. Based on these numbers, the need for better information on treat-ment and addiction is apparent.

Unfortunately, we need this fund-ing at a time when the federal govern-ment is less willing to help. The $2.5 billion authorized by Congress for treat-ment and research is not enough to accomplish what is necessary to con-trol narcotic addiction or to pursue basic research that could provide an intelli-gent approach to addiction as a physi-ologic event. With automatic budget cuts mandated by the Gramm-Rudman-Hollings Act and a president adamantly not willing to face up to increased taxa-tion, we must find alternatives, and the alternative is readily available.

The use of legalized addictive sub-stances should financially support re-search and treatment involving all drug-related addictive problems. Ciga-rette taxation brings in $4.6 billion in federal taxes and an equivalent amount in state tax revenue. Based on tobacco's cost to society, it is appropriate for us to insist that tobacco substantially aid health research involving all addictive drugs as tobacco's price for continued legal acceptance. Similarly, we must seek to utilize alcohol excise taxes, which provide another $5.4 billion of federal income, for addiction research.

Obviously, police interdiction, urine testing, educational programs and punitive controls are superficial ap-proaches to deeper physiologic and social needs. Gettingrid of Noriega and his cohorts has not solved our prob-lems. However, increased support for addiction research, methadone clinics and rehabilitative environments are a pragmatic step.

The Office of National Drug Control Strategy, the Department of Health and Human Services and the pharma-ceutical industry must strongly focus on basic research regarding the neuro-physiology and biochemistry of addic-tion. Our funding needs should not dislocate support for mental health programs whose budgets are suffering from funding redirection due to the mental health needs of AIDS and drug abuse victims. Our efforts should sup-port what is necessary and be con-cerned with the fact that addiction is not always defined as criminal activity, as there are millions for whom giving up tobacco or alcohol is also extraordi-narily difficult.

While those legally addicted pay a personal price and add to medical and social costs, they are not "evil drug addicts," but are our parents, children, friends, relatives and neighbors. We should insist that excise taxes be used for all those whose addictive problems damage both the health and quality of our society.

For this reason, Congress and the president should be asked to provide excise revenue for the development of antidotes and treatment for all those with drug habits. From the $10 billion in federal tax excises, income should be made available at least equal to our effort against AIDS: $1.5 billion. What we need is a "pay-as-you-go" program where legally addicted patients sup-port research involving those using illegal drugs. This money should be used to supplement the congressional $2.5 billion supporting the current program.

Currently, the National Institutes of Health will fund less than 25 percent of research grants in 1990 as compared to 29 percent in 1989. Right now, financial support for addiction research is in the range of $500 million a year, but this is inadequate for new and experimental treatments for the physiologic and sociologic programs necessary to provide answers.

We must take the following steps:

1. We need to launch a major neurosciences research effort, funded by tobacco and alcohol excises, that deals with the basic physiology, clinical pharmacology and social psychology of addiction. This program should include tax incentives to the pharmaceutical industry to help us find pharmacologic or physiologic treatment approaches.

2. We need to expand programs that would rehabilitate narcotic ad-dicts by the creation of a new motivat-ing social environments. This should also encompass programs to help alco-hol and cigarette addicts.

3. We should explore the impact of decriminalization, at least in controlled social settings, of certain drugs. We should review what the legalization of marijuana might lead to before we enter into any efforts directed at the weaken-ing of controls for heroin, ampheta-mines and cocaine. In the latter case, we need better pharmacological ap-proaches than are currently available to help with withdrawal syndromes.

Finally, we must realize that ad-dictive behavior may involve the same basic biologic process that leads us to crave food and sex. Appropriate re-search will lead to weapons not only against drug abuse but will give in-sight into human behavior involving our basic drives that, as an example, may provide measures to control ex-cess appetite for food. If addiction re-search results in our controlling mor-bid obesity, it will make our research efforts of value to an even larger popu-lation.

It is only through a major medical research effort that involves physiologic and sociologic combined studies that we can develop a rational drug control program that will really work. Our frustration with the failure of police action should lead us to fund greater research for effective prevention and treatment programs, and tobacco and alcohol excises can pay the way.