DRUG TREATMENT TO PREVENT AIDS, HOUSE HOMELESS

THE City's failure to implement its goal of drug treatment on demand has a
ripple effect, creating problems for HIV prevention and rehabilitation of
the homeless.

The Examiner reported on Monday that San Francisco leads the nation in
methamphetamine addiction. And meth use in the late-night gay party scene is
particularly high, 64 percent in the preliminary findings of one Department
of Public Health study.

Researchers say the use of speed helps spread HIV, the virus that causes
AIDS -- not always through contaminated needles. They found that behavioral
changes in sex were the big culprit. The drug is an incredible aphrodisiac
that encourages reckless and unprotected sex. It also allows people to have
sex for up to 14 hours without a break, increasing exposure to sexually
transmitted diseases.

The City's official policy is to offer drug treatment to anyone who wants
it, immediately. The reality is nowhere near that. The lack of treatment
slots means people who are ready to be treated must go on a waiting list,
and often never follow through. Six-month waiting lists are not unheard of.

The lack of treatment slots also frustrates reform efforts around
homelessness. The get-tough policies that several supervisors have proposed
- -- restrictions on panhandling and sleeping on the street -- will be
hindered if homeless drug addicts are not given the option of cleaning up
their lives through treatment on demand.

Tough love only works if there is the promise of help at the other end.

YET The City should not hang its head in shame. There is evidence that
public-health programs have gone a long way toward reducing the number of
deaths due to overdoses, and that's a start.

When treatment on demand went into effect in 1997, there were 1,012
emergency-room visits for treatment of methamphetamine overdoses. In 2001
there were just 591 such visits.

Over that period of time, funding for drug-treatment programs increased from
around $32 million to almost $50 million. No doubt, drug treatment costs
money, but it does help.

What Proposition 36 -- the 2000 referendum allowing alternative sentencing
for drug crimes -- taught us is that the will is out there to provide drug
treatment money based on the assumption that the alternatives are more
expensive.

San Francisco is facing a budget shortfall and is in a time of cutbacks.
Treatment on demand is still a worthy goal, and while it is not expected to
pay for itself, it certainly is cost-effective.