DRUG TREATMENT NOT LIKELY TO REPLACE JAILS

A new conflict between politics and science has emerged from a recent
recommendation that the nation treat drug addicts as sick people rather
than jail them as criminals.

More emphasis on medical treatment rather than jail for addicts was
endorsed by a group of doctors, including top officials from the
administrations of Presidents Reagan, Bush and Clinton.

But there was an immediate negative reaction from Capitol Hill, where a
lock-them-up-and throw-away-the-key attitude to drug addicts dominates.
Rep. Bill McCollum, R-Fla., chairman of the subcommittee on crime, says the
country needs to spend more money, not less, on catching drug pushers.

The Clinton administration, aware that the public prefers a get-tough
approach to drug addicts, has no plans to move big amounts of money from
law enforcement to medical treatment.

Public support for drug treatment is diminishing, says Robert Blendon of
the Harvard School of Public Health. Four in five Americans believe that
the war on drugs has failed.

So the tide of public opinion and political instinct is running against any
change in emphasis from prison and aggressive law enforcement to prevention
and treatment.

The recommendation by the group called Physician Leadership on National
Drug Policy declares that "enhanced medical and public health approaches
are the most effective method of reducing harmful use of illegal drugs . .
. The current emphasis - on use of the criminal justice system and
interdiction to reduce drug use and the harmful effects of illegal drugs -
is not adequate to address these problems."

The physicians contend that medical care for addicts either on an
out-patient or residential basis is cheaper than the $25,900 it costs
annually to imprison a drug addict. It prices regular outpatient care at
$1,800 to $2,500 a year, methadone maintenance at $3,900, and residential
treatment at $4,400 to $6,800.

"We recognize that sometimes treatment does not work," says Dr. Lonnie
Bristow, an internist in San Pablo, Calif., and past president of the
American Medical Association. But studies show that drug addicts are as
likely to meet treatment requirements as people with other chronic
diseases, such as diabetes, smoking, alcoholism, stroke, and heart disease.

"Drug abuse is very treatable," says Bristow.

Jeffrey Merrill of the University of Pennsylvania says that Americans might
be more sympathetic to treatment for drug addicts if they realized that
most addicts are not minority group members in big cities. Studies show
that among young people who use cocaine, whites outnumber African-Americans
nearly 10 to one, and Hispanics more than two to one.

And young cocaine users come from what the nation regards as the best
families. Some 53 percent of cocaine users have fathers who are college
graduates. About two-thirds of monthly cocaine users are employed full-time.

"The major, false stereotype is that drug addicts are social misfits and
outcasts even though drug use is common throughout all segments of
society," says Merrill.

"Stigma is a barrier to those who would otherwise seek treatment, to
doctors who would otherwise do more in treating addiction, and to
legislators and public health officials who would otherwise do more to make
treatment available," says Merrill.

For every $1 invested in treatment, $7 is saved in medical and societal
costs, says Dr. Philip Lee, former assistant secretary for health in the
Clinton administration and faculty member at the University of California
school of medicine in San Francisco.

In sum, the physicians see treatment as an investment that will save money
and cut down on crime, two goals that are found on Capitol Hill.

But Congress doesn't want to be seen as soft on drug addicts by sending
addicts to hospitals rather than behind bars. It will continue to put
federal drug control money into law enforcement and new prisons.

Lawrence M. O'Rourke writes in the McClatchy Newspapers Washington Bureau.