TREATMENT THE BEST WEAPON IN DRUG WAR

Any illusions that OxyContin abuse is just one of those mountain
problems died with the 19-year-old who overdosed at a party in
affluent Oldham County last summer.

Overdoses are claiming more lives than homicides this year in
Jefferson County. But it took Rush Limbaugh to bring a celebrity
luster to the "hillbilly heroin" craze.

Limbaugh's addiction to the painkiller got us wondering: What if,
instead of being a wealthy right-wing radio talk show host, Limbaugh
had been an average Kentucky guy hooked on OxyContin?

After his supplier turned him in, Limbaugh admitted his addiction and
checked into a 30-day treatment program.

Our Kentucky addict would have had to wait two or three months.

Kentucky's residential treatment centers are overwhelmed with
patients. OxyContin fueled the explosion. But long before Oxy,
Kentucky suffered from inadequate treatment for substance abuse.

Treatment options in Kentucky come nowhere near matching the problem
or the anti-drug rhetoric of this season's political candidates.

To win the war on drugs, we must first recognize the enemy: a demand
that's driven by physical changes that take place in an addict's
brain. No amount of policing and prosecuting can defeat an addict's
craving. Only treatment offers any hope of victory.

Like Limbaugh, most addicts seek help because of a crisis. Once our
Kentucky addict is told that he'll have to wait for detox and
treatment, he won't call back until a new crisis erupts.

Like Limbaugh, our addict probably won't get clean on the first try.
Limbaugh said he had been in rehab twice before. Relapse is not a sign
of personal weakness and does not mean treatment is ineffective. A
study published in the Journal of the American Medical Association
found that addicts are no less compliant and relapse no more
frequently than diabetics, asthmatics or people with
hypertension.

Even if our Kentucky addict has private insurance, he'll have a hard
time finding a place to detox and receive in-patient treatment near
home. Public and private insurers pay so little for substance abuse
services that few hospitals can afford to offer them. Paying for
follow-up therapy is even more difficult.

Kentucky is one of 21 states where Medicaid does not pay for substance
abuse treatment. This shortsighted thriftiness has probably cost
taxpayers billions. A 10-year study shows that every $1 the state
spends on substance abuse treatment saves $4.61 in criminal-justice
costs alone.

Research also shows that the longer a patient stays in contact with a
treatment program or professional, including 12-step programs, the
greater the chances of staying clean.

One other likely difference between Limbaugh and our Oxy-head --
besides the heated pool, exercise room and gourmet grub where Limbaugh
is recovering -- is that Limbaugh has a lot to lose. Fear of job loss
motivates addicts to stay clean more than any other factor.

The disease of addiction respects no economic class, as Limbaugh's
plight demonstrates. But addiction also is a symptom of the economic
and social distress in some parts of Kentucky.

Policing won't cure that either.