LET'S TREAT DRUG ABUSE AS THE ILLNESS IT IS

WASHINGTON---The war on drugs is costly, politically divisive and, after
three decades, seen by many as a failure. Congress struggles for solutions
amid steaming rhetoric. On the front line are frustrated physicians and
police searching for new answers.

A U.S.-wide survey of police chiefs by the Police Foundation found that 85
percent want major changes in drug policy. Sixty percent said law
enforcement has not reduced the problem. Because of mandatory sentencing
laws, drug offenders represent more than 60 percent of federal prisoners.
Police see firsthand that nonviolent drug users and addicts, who are the
victirns of drug dealers, are the most negatively affected by "warehousing"
in prison.

Historically, drug policy originated from elected of ficials and police,
driven by sensational news stories of drug lords and predatory dealers. But
beyond the headhnes is the core problem of millions of ordinary people with
no connection to the crime world who are caught up in abuse and addiction.
As police know, if this medical problem can be reduced, the drug dealers at
the top will be strangled by a shrinking market.

While serious and violent offenders must be dealt with by the law, most
substance abusers and addicts threaten only themselves. Recovery can come if
effective treatment is available. Still, 75 percent of federal and state
funds for drug abuse go to law enforcement. Physicians, like many police of
ficials, believe that this 3-to1 ratio should be shifted to significantly
increase treatment.

For many years before World War II, doctors were prosecuted and jailed in
the United States for treanng what the newspapers then called "dope fiends."
American medicine was elbowed out of drug treatment. This exclusion crippled
drug policy because the huge medical component was almost ignored.

Now a group of 37 nationally known doctors, Physician Leadership on National
Drug Policy is taking an unprecedented step. The group says that "the
current emphasis---on use of the criminal justice system and interdiction to
reduce illegal drug use and the harmful effects of illegal drugs---is not
adequate to address these problems."

Members of Physician Leadership include Louis Sullivan, former secretary of
Health and Human Services; David Kessler, former commissioner of the Food
and Drug Administration; Lonnie Bristow, past president of the American
Medical Association, and Antonia Novello, former U.S. surgeon-general.
Others include the editors of preeminent medical journals.

Recently the group sponsored a major study comparing the efficacy of
drug-addiction treatment to the treatment of other chronic disorders. This
study of more than 600 peer-reviewed research articles showed that treatment
of drug addiction is as effective, and sometimes more effective, than
treatment for hypertension, asthma and diabetes.

Furthermore, the study showed that treatment was less costly than
incarceration and that it lowered crime rates significantly.

The annual regular cost of out-patient treatment for a drug addict is
$1,800, intensive outpatient treatment is $2,500, methadone maintenance for
heroin addiction is $3,900 and residential treatment is $6,800. A year in
prison for a drug addict averages $25 ,900, triple the cost of the most
expensive therapeutic option. Compounding the problem is the fact that
prisons rarely provide treatment for drug addiction.

Substance abuse must have treatment parity (insurance coverage and
accessibility) with other chronic, relapsing illnesses such as hypertension
and diabetes. The societal stigma surrounding drug problems must be reduced
so those needing care will seek it, those providing care will be encouraged
to do so and health care programs will reimburse the costs willingly.

The huge burden of laws and regulations on drug treatment must be reduced so
physicians can treat abuse and addiction as aggressively as they now treat
other chronic illnesses.

Checked-by: Melodi Cornett