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.