DOLLARS AND SENSE ARGUE FOR TREATING DRUG ADDICTS

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.

Science has brought us to a point where 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 that 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 percent
to 60 percent more individuals employed after treatment.

The case is just as dramatic for prison and jail inmates, 60 percent 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
percent to 70 percent and their later criminality and resulting arrests by
50 percent 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 that 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.