DRUG TREATMENT PAYS, STUDY FINDS

But public favors costly prison time for addicts instead

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 Tuesday 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.

Big names

Included in the coalition were former Food and Drug Administration head
David Kessler; Dr. Antonia Novello, the surgeon general for the Bush
administration; Dr. Frederick Robbins, a Nobel laureate in medicine; the
deans of several prestigious medical schools; and the heads of several
professional medical associations.

Among their findings:

Sending addicts to jail costs society much more than treating them, the
coalition said. The annual cost of jailing each addict is $25,900, whereas
the annual cost of treating each addict ranges from $1,800 for outpatient
treatment to $6,800 for long-term hospitalization.

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.

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, 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 contracted 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.

Public support lacking

An analysis of national surveys 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.

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