TREATMENT WITH TEETH

The battle against drug abuse, rightly, is shifting. But if California is
to make the new approach work, it must reach consensus on the most
promising models.

In the acclaimed movie "Traffic," Michael Douglas plays a U.S. anti-drug
czar whose 16-year-old daughter spirals into ever more debilitating drug
addiction. In this fable of the futility of the drug war, drug treatment
takes its lumps as well but mostly comes off as the hero.

The movie is but one sign of how, after spending several decades and
billions of dollars on helicopters, border patrols and other military
methods to curb the supply of illegal narcotics, the United States has
begun to embrace treatment programs to curb demand instead. Last November,
for instance, Californians decisively passed Proposition 36, the measure
that will put most nonviolent drug-possession offenders into treatment
rather than prison. Proposition 36, however, carries no inherent guarantees
of success. It will assuredly change sentencing laws, starting July 1. But
it won't have a chance to actually curb illegal drug use unless probation
officers, drug treatment counselors and other professionals now designing
county-based treatment programs manage to reconcile a number of
disagreements, which they openly expressed at a conference on implementing
the measure in Sacramento last month.

One key disagreement concerns whether some of the $120 million in
Proposition 36 funding should be used to help county probation officers
monitor users in treatment. While the measure technically prohibits its
funds from being used for random drug testing, it does explicitly allow the
money to "reimburse . . . probation department costs" and it does nothing
to bar counties from, for example, requiring offenders to pay for testing.
Some state legislators have considered seeking revision of the prohibition
on funds for testing.

Drug treatment providers say they are fully capable of monitoring relapse
rates on their own, but they have an inherent conflict of interest: Each
relapse or treatment failure they detect will lower their program's success
rate and its chance of getting future Proposition 36 business. Probation
officers are more neutral observers and better able than drug counselors to
report relapses to prosecutors and judges, who can use the threat of
criminal sanctions to motivate clients to continue treatment.

The Chief Probation Officers of California recently suggested that
probation officers working on Proposition 36 have no more than 50 clients
each--just under the cap in a drug treatment program that Arizona voters
passed four years ago. This would consume more than half of the $120
million in annual funding that the measure provides and deprive drug
treatment programs of their rightful lion's share. The most pragmatic
solution for cash-strapped counties like Los Angeles, which received $15.7
million of the state's initial $60-million allocation, is to differentiate
hard-core addicts, who need intensive drug treatment, from people caught
experimenting with drugs.

One model to follow is San Diego County, which is already planning a super
drug court that would offer "a continuum of treatment," beginning with
minimal supervision and ratcheting up oversight with subsequent offenses.

Neither drug treatment nor drug testing is a magic bullet, and Proposition
36 will inevitably have some failures. However, its chance of success will
be greatly enhanced if counties set up systems now for spending their money
wisely.