REALITY DOESN'T MATCH PRESIDENTIAL RHETORIC FOR U.S. DRUG ADDICTS

Rehabilitation scarce despite reports showing its effectiveness

WITH 150 world leaders plotting to fight the scourge of drugs at the United
Nations recently, even a cynic might hope for some substantial result.

President Clinton was hopeful, telling the gathering, ``With determined and
relentless effort, we can turn the tide.'' And U.N. Secretary General Kofi
Annan assured delegates that historians will see this as a turning point in
the history of drug control.

The ``new vision,'' said Annan, is driven by 52 million users of illegal
drugs.

Darlene James is one of those 52 million. She lives in a cave alongside a
freeway in San Francisco. A few weeks back, while U.N. leaders were
planning their meeting, James was deciding she would not let her boyfriend
inject ``speed'' into a vein in her neck.

``Methamphetamine's making me crazy,'' she said. ``I need to stop.'' But
that same week James was rejected for treatment for the fourth time -- this
time because she did not have the appropriate paperwork.

James first walked into a drug-rehab center more than six months ago and
asked for help. But, although San Francisco has a policy of ``treatment on
demand'' -- within 48 hours of an addict's decision to quit -- she has yet
to be accepted into a program.

James' story is not unusual. Most addicts seeking rehab wait weeks or
months. Michael Pagsolingan overdosed on heroin after waiting eight weeks
to get into a program. Cost of emergency treatment for an overdose --
$1,450. Cost of one day in treatment -- $55.

At the United Nations, President Clinton proclaimed that the United States
would spend $17 billion to combat the drug scourge. Yet only 35 percent of
those funds will be directed at treatment of addicts -- ``demand
reduction.'' The rest will go to controlling the flow of drugs.

These priorities seem wrongheaded, given the findings of a study sponsored
by the U.S. Office of National Drug Control Policy. The study shows that $1
spent on treatment decreases drug use as much as $7 spent on domestic law
enforcement, $11 on confiscating drugs at the border, and $23 to stop drugs
at their country of origin.

Funding in San Francisco's Treatment on Demand program is at 40 percent of
needs. In Baltimore, there are 5,700 treatment slots for 60,000 addicts. In
New York City, 60 percent of paroled drug abusers who don't get into
treatment are back in jail within months, but new treatment programs are
still awaiting funding.

In the country as a whole, an estimated 4 to 6 million addicts who need
treatment are not receiving any.

``We are determined to build a drug-free America,'' President Clinton told
the U.N. special assembly, ``and to join with others to combat drugs around
the world.'' He spoke of a ``virtual university'' where anyone with access
to a computer and modem could share knowledge and experience about
substance abuse.

Darlene James, in her cave by the freeway, with no modem or computer,
remains trapped in a chemical and bureaucratic nightmare. After being
turned down four times, she beds down in her wet sleeping bag, and says she
is trying to keep from asking her boyfriend to inject her.

``These programs keep running me in littler and littler circles,'' she said.

James did not think the conference marked the beginning of a new war
against drugs.

Lonny Shavelson is a physician and writer based in Berkeley and author of
``A Chosen Death.'' He wrote this for the Pacific News Service.

Checked-by: Mike Gogulski