STUDY: TREATMENT, NOT JAIL, BEST RESPONSE TO DRUG ADDICTION

WASHINGTON -- Medical treatment for drug addiction works as well as treating
diabetes or other chronic diseases, dramatically reduces crime and is a lot
cheaper than jail, says a study released yesterday by bipartisan public
health experts.

But a separate survey indicates that the public believes just the opposite
- -- that jail is best, while support for drug treatment is dropping.

That perception prompts the federal government to spend only 20 percent of
the nation's $17 billion drug-control budget to treat addicts, a proportion
the doctors' group concluded should increase.

"We've been telling people to 'just say no' when addiction is a biological
event," said Dr. June Osborn of the new Physician Leadership on National
Drug Policy, prominent physicians and public health leaders from the
Clinton, Bush and Reagan administrations that commissioned the research from
half a dozen universities.

"There must be a bridge between what the public believes and the science,"
added Dr. Lonnie Bristow of the American Medical Association, who is helping
provide the data to Republican congressional leaders who control drug
spending.

That's not to say medically treating the 14 million American alcoholics and
6.7 million drug addicts is a cure -- many do relapse. 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, vs. 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: Less than half of
diabetics comply with their therapy, less than 30 percent of asthma and
hypertension patients and less 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, vs.
21 percent of treated addicts.

Yet, there is a severe shortage of drug-treatment programs, the doctors
said. About 15 percent of people who need treatment get it. About seven
states don't offer any methadone clinics for heroin addicts, and every U.S.
methadone clinic has a waiting list.

Only between one in 20 and one in five 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 national surveys
being published today in the Journal of the American Medical Association
finds public 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 physicians group has elicited early interest in the data from Republican
health and drug-policy leaders such as Sens. Jim Jeffords of Vermont and
Orrin Hatch of Utah.

National drug policy chief Barry McCaffrey also welcomed the data, and will
discuss it next week at a conference on how to improve drug treatment inside
prisons.