WHEN AN ADDICT FINISHES DETOX

To the Editor:

It's important that we not blame homeless substance abusers seeking
detoxification for the high cost of these services in hospitals.

I have seen many of these "frequent fliers" come into our out-patient
programs burdened with multiple psychiatric diagnoses, chronic health
conditions like H.I.V./AIDS and hepatitis C, criminal backgrounds and
long histories of drug-treatment failures.

I believe that our treatment programs for this population are too
rigorous, all too often reinforcing a sense of failure and despair.
Many participants are simply not ready to be abstinent. We need to
develop interim models that can meet them on their level and help
them to learn about their conditions and develop the necessary coping skills.

Programs like these could allow the homeless drug user to "graduate,"
as a way of building self-esteem and a sense of accomplishment that
could ultimately lead to abstention from drugs or alcohol.

Howard Josepher

New York, April 18, 2007

The writer is executive director of Exponents, a nonprofit group
helping people with drug problems and H.I.V./AIDS.