LESSONS RIGHT & LEFT

BEHIND the political chatter over Rush Limbaugh's all-too-human admission
of drug addiction is a more important question: Why would someone of his
stature risk everything for a drug?

Scientific research has begun to give us the answer, showing that repeated
exposure to drugs and/or alcohol changes brain functions in fundamental,
long-lasting ways - and revealing genetic and environmental vulnerabilities
to addiction as well. Ongoing research will provide more insights in the
future.

As commissioner of the New York State Office of Alcoholism and Substance
Abuse Services (OASAS), I learned not to be surprised when famous, highly
successful, people found themselves in the grip of some chemical addiction.

Indeed, for well over 125 years medical authorities (if not always the
public at large) have recognized chemical dependence as a social,
public-health and criminal-justice threat - and labored to mitigate the
damage, or stop it altogether.

The first public concern about drug addiction came right after the Civil
War: Many veterans had become dependent on the blessedly potent new opiate
painkillers they were given. Ever since, we have vacillated between seeing
addiction as a moral lapse and seeing it as a sickness.

Even now, liberals will use Limbaugh's admission to argue for expanded drug
treatment. Conservatives will contend that anyone who uses illegal
substances must pay the consequences. But these views are not mutually
exclusive.

Drug addiction is a brain disease with serious social implications; its
treatment does deserve expanded financial commitment at the local, state
and federal levels. But those who suffer from it do need to accept
responsibility for their actions.

Limbaugh, who has accepted responsibility, could play a critical role in
helping large numbers of hitherto uninformed people understand drug
dependency and how to get on the road to recovery.

As Limbaugh himself has already learned through two failed efforts,
detoxification in and of itself is not a cure for addiction. It's an
important initial phase of treatment, to control potential serious
withdrawal symptoms. But without further treatment, more drug abuse is
almost certain.

But there are many highly successful and proven courses of treatment
available, both with or without medication, in-patient, out-patient,
individual and group counseling, and therapeutic communities.

In all of them, participants must face both their failings and their
responsibilities, no matter how great their past achievements have been.
They must repair damaged relationships and get on with their lives in a
positive and productive manner - a new beginning which can take
considerable time and may, as is often the case, include relapse.

But it can work. It does work. And it will work for Rush Limbaugh.

My agency, OASAS, built an extensive data system and followed the status of
patients who had been in treatment for six months. The outcomes were
extraordinary. In one review of more than 18,000 patients, 68 percent to 83
percent (depending on their type of treatment) of those involved
discontinued use.

Other studies prove beyond doubt that treatment is effective and lasting.
One, of clients a year after leaving treatment, found that abstinence and
other positive behavioral changes had been dramatic.

As OASAS commissioner, I visited dozens of drug-treatment programs. Over
and over, like a refrain, I heard this simple but powerful sentence from
those receiving care: "Now I have my life back."

Coddled? Punished? No, just getting their lives back.

We can all hope that when Limbaugh returns to his show, he too will have
his life back - and that, using the candor and verbal skill on which he
justifiably prides himself, he'll share with others the genuine success
that drug treatment can achieve.

In the meantime, let us not, shall we say . . . rush to judgment.

Jean Somers Miller, an attorney, was commissioner of the New York State
Office of Alcoholism and Substance Abuse Services 1995-2002. She now does
consulting work at the federal and state level.