LIFE IN THE MIDDLE

Before I began this column, I typed six key words into an online
search engine: Patrick Kennedy, Rush Limbaugh, substance abuse. I was
amazed when less than a quarter of a second later, up popped the first
dozen of some 238,000 articles!

It was gratifying to see that so many people made the same connection
I did. Two high profile guys sharing the limelight because of their
obvious substance abuse problems. What I didn't expect was that the
discussion remained largely political.

The conservative right moaned that Rush is being grilled by the
liberal media while they let Kennedy off the hook. The left points to
Rush as the wise-cracking commentator who should take his own
commentary to heart.

Meanwhile, the true importance of this story has slipped past most of
us. The real problem isn't Limbaugh, it isn't Kennedy and it isn't the
liberal media. It's substance abuse.

When two prominent political figures succumb to America's No. 1 health
problem, alcohol and substance abuse, it's a good time to re-examine
the price we all pay for "the disease that no one talks about."

If your name is Patrick Kennedy, Nicole Richie, Eminem, Rush Limbaugh,
Charlie Sheen or Bush, a substance abuse problem isn't nearly as
serious as it is for the millions of Americans who don't have the
money or name power to afford the treatment they need.

Yet one in 10 of America's young people and one in 15 American adults
have serious problems with substance abuse. Even more disturbing is
the fact that more than half of all adults have a family history of
alcoholism or problem drinking.

While the statistics on alcoholism and substance abuse are scary, our
national indifference to this problem is even scarier. If one in 10
young people and one in 15 adults were diagnosed with AIDS, we would
be fighting it with all the resources at our command.

With the nation's economy already stretched to the limit by a
burgeoning national debt, the war in Iraq and the looming retirement
of millions of baby boomers who will soon be drawing Social Security;
it would behoove Congress to consider the huge savings that could be
recouped with the reinstatement of a serious system of substance abuse
treatment facilities in every state of the union.

The usual argument that follows this suggestion is that we simply
can't afford it. Because substance abuse treatment is expensive and
many state governments have suffered large deficits and severe budget
cuts in recent years, federal and state governments have drastically
reduced their expenditures for substance abuse treatment.

As a result, in the area of adolescent alcohol abuse alone, the
National Household Survey on Drug Abuse reports that "while 915,000
youths ages 12 to 20 reported alcohol dependence in the past year,
only 16 percent of them (148,000) received treatment." That doesn't
even begin to address adult alcohol dependence or the millions more
who are addicted to drugs.

The California Drug and Alcohol Assessment found that "for every
dollar spent on addiction treatment, seven dollars is saved in reduced
health care costs." This may not seem like a big deal until you
consider what that translates to in real dollar savings.

The Institute for Health Policy at Brandeis University reports that
"Alcohol and drug abuse costs the American economy an estimated $276
billion per year in lost productivity, health care expenditures,
crime, motor vehicle crashes and other conditions. Untreated addiction
is more expensive than heart disease, diabete, and cancer combined."

Spending $39 billion on substance abuse may seem absurd until you
realize that it could translate into a savings of $237 billion which
we will spend on the aftermath of alcoholism and drug addiction if we
do not make treatment more available.

According to the White House's National Drug Control Strategy, "Every
American adult pays nearly $1,000 per year for the damages of
addiction." Over the course of an average career of 40 years, that's
$40,000 each. Personally, I'd rather pay one seventh of that amount
($143 per year or $5,714 over 40 years) on prevention and treatment.

Look at it another way. Experts tell us that if every American
contributed $28,000, we could pay off the national debt of $3
trillion. At $1,000 per year, it would take 28 years. We will spend
almost the same amount over the next few decades (enough to pay off
the national debt) dealing with the consequences of substance abuse
alone unless we address this problem head on. That's how serious it
is.

America is fighting the war on terrorism because it has the potential
to destroy us all. At the same time we have largely given up the war
on drugs, which is decimating (one in 10) our nation's youth and
sapping billions of dollars from our economy annually.

Before HMOs took over health care in the 1980s, doctors (not insurance
company employees) were in charge of deciding when a person needed
medical care and how much care that person required.

At that time, there was an extensive system of substance abuse
treatment facilities across the country where young people could get
help before their addictions got out of control and where adults who
had serious substance abuse issues could get their lives back.

That system was largely dismantled just as cocaine users discovered
crack, heroin began a huge comeback, Ecstasy introduced the culture of
Rave parties and the manufacture of methamphetamines became a cottage
industry.

Americans must insist that our No. 1 health problem be addressed and
funded. Patrick Kennedy and Rush Limbaugh aren't the only ones who
need treatment. Our children, our loved ones and our friends deserve
it every bit as much.