Straight stuff

STUDIES NOW SHOW THAT TREATMENT CAN PAY OFF

I HEAR IT from time to time. "Treatment costs how much?"

Employers believe it's too much. So do some politicians. At first,
most addicts and their families do, too. They're wrong.

To be sure, inpatient drug and alcohol treatment, like any other
hospital stay, costs money. But doing nothing usually costs more.

This is true for families. Addicts regularly spend thousands of
dollars a year - year after year - on alcohol or other drugs. Legal
costs for a driving while under the influence conviction can run
$10,000. I've seen patients give up six-figure incomes rather than
quit using.

It's also true in the workplace. In 1993, Brandeis University
researchers estimated that the cost of alcohol and drug use in the
workplace topped $140 billion per year - a number that has almost
certainly increased since then. The cost of poor attitudes, missed
work, medical claims and accidents is passed along to consumers every
day.

And it's also true in society. A California study in the early 1990s
- - financed by the administration of Gov. Pete Wilson, a Republican
not known for "coddling criminals" - found that every $1 invested in
treatment programs saved $7 dollars in social services.

According to Rick Williams, national programs director for the
Charles and Helen Schwab Foundation, an organization that addresses
learning disability, substance abuse, homelessness and poverty, "75
percent of drug offenders who do not receive treatment return to
custody within 36 months." That "return to custody" has a cost to the
public.

And just a few weeks ago, the Baltimore Sun reported the results of a
$2.7 million, three-year study conducted by Johns Hopkins University.
Researchers found that within a year of treatment, " 'criminal
activity' decreased by 64 percent." When criminal activity drops, so
does the cost to society.

Given all this, it's surprising we still debate expanded funding for
treatment programs. Some even argue for budget cuts. To be sure,
facilities that provide treatment programs need to control expenses.
Like all other areas of health care, treatment costs have increased.
Pressures to cut costs have mounted.

But there's something more at work in this debate: a strong thread
running through our American consciousness that addiction is a moral
issue, a failure of will power.

"Why pay for their treatment," some ask, "when they just can't get it
together?"

And even employers and government officials who generally support
treatment ask why they should offer to pay for care time and time
again, only to have addicts relapse months, weeks or even days later.

"Just fire them," some say in their frustration. "Lock 'em up,"
others say. The solution is somewhere between incarceration and
unlimited free treatment. We need easily available treatment, and we
have to hold patients accountable.

Statistics seem to indicate that a higher percentage of addicts
complete treatment when there is a significant consequence for
failing to do so, such as loss of child custody, prison time or loss
of a job. Mandatory co-payments for treatment, geared to the addict's
ability to pay, also would add an incentive. Strict legal
consequences for repeated offenses can work well, too. We need all of
these.

On its face, treatment seems expensive. But research now supports the
assertion that treatment saves far more than it costs. Chemical
dependency is a public health issue, and an economic one.

Let's stop making it a moral issue, and treat the disease. We'll all
save money in the long run.

The opinions expressed in this column are those of the writer. Jerry
Gjesvold is Serenity Lane's statewide coordinator of employer
services.