BOOST TREATMENT STRATEGY IN WAR ON DRUGS

Imagine a debilitating disease for which there are effective treatments.
Imagine that this treatable disease costs society $110 billion a year. Can
you imagine not using the treatments? It seems unfathomable, but that often
is the case with the treatment of drug addiction.

Addicts are frequently denied treatment that would not only improve their
lives, but also would improve our own lives by cutting crime, reducing
disease and improving the productivity of employees and the economy.

People are polarized on the issue of treatment: They are either strong
advocates for treating addiction or they hate the idea.

People debate with passion whether treatment works or not, which approaches
are best and whether treatments such as methadone simply substitute one
addiction for another.

From my observation post, the core of the issue cannot be simply whether
drug treatments are effective or not, since there already is abundant
scientific data showing that they are.

In fact, research shows that drug treatments are as, or more, effective than
treatments for other chronic disorders, such as forms of heart disease,
diabetes and some mental illness.

The central issue for many people is whether addicts should be treated at all.

I frequently hear people ask:

* Do they really deserve to be treated?

* Didn't they just do it to themselves?

* Why should we coddle people who cause so much societal disruption?

* Shouldn't they be punished, rather than treated?

Even many people who recognize addiction as a disease still get hung up on
whether it is a "no-fault" illness.

WE should no longer focus the drug treatment question simply on these kinds
of unanswerable moral dilemmas. From a practical perspective, benefits to
society must be included in the decision equations. The very same body of
scientific data that demonstrates the effectiveness of treatments in
reducing an individual's drug use also shows the enormous benefits drug
treatment can have for the patient's family and the community.

A variety of studies from the National Institutes of Health, Columbia
University, the University of Pennsylvania and other institutions all have
shown that drug treatment reduces use by 50 percent to 60 percent and
arrests for violent and nonviolent criminal acts by 40 percent or more.

Drug abuse treatment reduces the risk of HIV infection, and interventions to
prevent HIV are much less costly than treating AIDS.

Treatment tied to vocational services improves the prospects for employment,
with 40 to 60 percent more individuals employed after treatment.

The case is just as dramatic for prison and jail inmates, 60 to 80 percent
of whom have serious substance abuse problems.

Science shows that appropriately treating addicts in prison reduces their
later drug use by 50 to 70 percent and their later criminality and resulting
arrests by 50 to 60 percent.

These data make the case against warehousing addicts in prison without
attending to their addictions.

Successful drug treatment takes a person who is now seen as only a drain on
a community's resources and returns the individual to productive membership
in society.

Best estimates are that for every $1 spent on drug treatment, there is a $4
to $7 return in cost savings to society. This means that dwelling on
moralistic questions, such as who deserves what kind of help, blocks both
the individual and society from receiving the economic and societal benefits
that can be achieved from treating addicts.

It is true that the individual initially made the voluntary decision to use
drugs.

But once addicted, it is no longer a simple matter of choice.

Prolonged drug use changes the brain in long-lasting and fundamental ways
that result in truly compulsive, often uncontrollable, drug craving, seeking
and use, which is the essence of addiction.

Once addicted, it is almost impossible for most people to stop using drugs
without treatment.

It is clearly in everyone's interest to rise above our moral outrage that
addiction results from a voluntary behavior.

If we are ever going to significantly reduce the tremendous price drug
addiction exacts from every aspect of our society, drug treatment for all
who need it must be a core element of our society's strategies.

Alan I. Leshner, is director of the National Institute on Drug Abuse at the
National Institutes of Health.