DRUG TREATMENT NEEDS TO HAVE GREATER SUPPORT

To the editor:

Kudos to The Advocate for shedding light on the ravages of substance abuse
and giving such consideration to a difficult issue ("The Forever War,"
Advocate news series, Dec. 23 to Jan. 6). Few people realize that this is
America's No. 1 health problem -- a conclusion reached by the prestigious
Robert Wood Johnson Foundation after an exhaustive study of the subject.
"Addiction is a chronic, relapsing brain disease," it states.

The human struggle portrayed by The Advocate might lead one to conclude
that this is primarily an urban male problem. Far from it. The spotlight
was on LMG Programs' Liberation House -- a residential population of men
only -- admittedly, the most challenging of the thousands of clients who
are helped every day by our many education, prevention and treatment programs.

To quote the RWJ Foundation, "no population group is immune to substance
abuse and its effects. Men and women, people of all ages, racial and ethnic
groups and levels of education drink, smoke and use illicit drugs." It
adds, "young adults are most likely to use alcohol, tobacco and illicit
drugs. Men are more likely than women to use most substances. Whites are
more likely than blacks or Hispanics to drink alcohol. People with more
education are likely to drink, but those with less education are more
likely to drink heavily."

The College on Problems of Drug Dependence -- a leading scientific
organization in the drug abuse field -- paints a graphic picture of how
substance abuse permeates our entire society:

* Cocaine has been used by over 22 million Americans, about 1 million of
whom are now regular abusers.

* Heroin is used by 2 million Americans, about 1 million of whom are now
physically dependent addicts.

* Of 59 million women of child-bearing age (14-44) nearly 5 million are
using illicit drugs such as marijuana, cocaine and heroin.

* Drug abuse is associated with myriad health problems, and drug abusers
are substantively over-represented in hospital settings.

These are staggering statistics, reinforced by the grim cost of substance
abuse to the U.S. economy. Each year it is estimated at over $414 billion,
a burden that affects all of society through productivity losses, as well
as costs related to medical care, crime, destruction of property and other
losses.

So what can we as a community do about this? The CPDD recommends:

* Drug abuse should be viewed as medical and public health problems.
Treatment can be effective and it is much less costly than the alternative
per-patient costs: Treatment, $3,000 to $8,000 per year; incarceration,
$40,000 to $70,000 per year; untreated, $50,000 to $100,000 per year in
criminal activity.

* Allocation of federal drug abuse expenditures should be redistributed
from interdiction and criminal justice activities (now 70 percent) to
public health and research activities.

We know that two out of three men leave Liberation House clean, sober and
employed, with varying degrees of hope. We also know that the realities of
re-entry into the world outside are overwhelming, even terrifying. If even
a small percentage of interdiction and criminal justice expenditures were
allocated to supplying more comprehensive supportive social services to
people in recovery, we would greatly reduce the threat of relapse.

What these men need is safe housing, good jobs, education and stable
friends and family. The road they travel is not only daunting; it's often
paved with incredible impediments. Almost 200 men graduate from Liberation
House each year, but there are only about 25 halfway house spots for them.
At the very least, more housing would go a long way to strengthen their
recovery efforts.

Let me reiterate what all the medical and scientific journals state,
including the Journal of the American Medical Association: "Treatment of
addiction is as successful as treatment of other chronic diseases such as
diabetes, hypertension and asthma. Drug treatment reduces drug use by 40
percent to 60 percent and significantly decreases criminal activity during
and after treatment. The most effective programs either provide on-site, or
are closely linked with, a wide variety of treatment elements and support
services. Moreover ... recovery can often be a long and complex process ...
the patient may need other medical services, family therapy, parenting
instruction, vocational rehabilitation and social and legal services."

In other words, this truly requires a broad, community commitment.

After reading The Advocate articles, a friend asked why I wasn't
discouraged by working in an area where only a few "make it" after a first
round of treatment. To me, recovery is a lot like learning to ride a
bicycle. Maybe two out of 60 people will hop on the first time and take off
without a problem. The rest of us will get on, fall off, get on, fall off,
and after numerous bumps and bruises, we'll get the hang of it.

The men of Lib House who "got it right" after the first try are truly
blessed. Ultimately, after a lot of tries, many more will make it. And I
want to be there to shake their hands.

Edward Spauster

Stamford

Via e-mail

The writer is president/chief executive officer of LMG Programs.