HEALTH EXPERTS: TREAT, DON'T JAIL, DRUG ABUSERS

WASHINGTON (AP) -- Drug and alcohol abuse are medical problems that respond
to medical treatment just as well as diabetes and other chronic diseases do
- -- and treatment is cheaper and more effective than jail, says new
research.

Yet the nation spends only 20 percent of its $17 billion drug-control
budget to treat addicts, and the public believes that jailing addicts is
best, a bipartisan group of public health experts said Tuesday.

"We've been telling people to 'just say no' when addiction is a biological
event," said Dr. June Osborn, who chairs the new Physician Leadership on
National Drug Policy. "There must be a bridge between what the public
believes and the science," added Dr. Lonnie Bristow of the American Medical
Association.

The group of prominent physicians and public health leaders from the
Clinton, Bush and Reagan administrations commissioned the research. They
are using it to urge doctors to play a greater role in diagnosing and
treating addiction - - and are providing it to politicians who control
drug-treatment money.

Many of the 14 million American alcoholics and 6.7 million drug addicts
relapse after drug treatment, but the scientists concluded that:

Jailing a drug addict costs $25,900 per year. A year of traditional
outpatient drug treatment costs $1,800, intensive outpatient care costs
$2,500, methadone treatment for heroin users costs $3,900 and residential
drug-treatment programs range from $4,400 to $6,800 a year.

Drug treatment can cut crime by 80 percent, said Brown University addiction
director Norman Hoffman. Brown researcher Craig Love studied female
substance abusers who were in jail, and found that 25 percent who underwent
treatment were later re-arrested, versus 62 percent released without
substance abuse treatment. A California study of 1,600 drug abusers found
their involvement in drug sales, drug-related prostitution and theft
decreased threefold after treatment.

Every dollar invested in drug treatment can save $7 in societal and medical
costs, said former Assistant Health Secretary Philip Lee.

Long-term drug treatment is as effective as long-term treatment for chronic
diseases, said Dr. Thomas McLellan of the University of Pennsylvania.
One-year relapse rates for the diseases and for addicts all are about 50
percent, he said. Compliance with therapy is similar, too: Fewer than half
of diabetics comply with their therapy, as do fewer than 30 percent of
asthma and hypertension patients and fewer than 40 percent of alcohol or
drug abusers.

Drug treatment also helps society's health, McLellan said. Heroin users,
for example, are at huge risk of catching and spreading the AIDS virus or
hepatitis. A seven-year study of heroin addicts found 51 percent who never
entered drug treatment caught HIV during that period, versus. 21 percent of
treated addicts.

Severe shortage of treatment programs

Yet, there is a severe shortage of drug-treatment programs, the doctors
said About 15 percent of people who need treatment get it. Seven states
don't offer any methadone clinics for heroin addicts, and every U.S.
methadone clinic has a waiting list. Only 5 percent to 20 percent of
pregnant drug abusers can get drug treatment because of too few programs,
inability to pay or too few inpatient programs that will accept the woman's
other children, said Pennsylvania's Dr. Jeffrey Merrill.

The findings conflict with public opinion. An analysis of surveys being
published Wednesday in the Journal of the American Medical Association
finds support for increased spending on drug treatment has dropped from 65
percent in 1990 to 53 percent in 1996.

In contrast, 84 percent of Americans say the solution is tougher criminal
penalties. Next on the list are anti-drug education, more police and
mandatory drug testing.

The survey also found Americans believe drug abusers are predominantly
poor, uneducated and minorities. In fact, the majority are like Dr. Richard
Corlin's son, once a cocaine addict: white, from well-educated families and
initially employed.

Dispelling those myths is vital to public commitment for drug treatment,
said Corlin, a Los Angeles medical professor. "People think it is someone
else's problem. It is not."