US: OPED: Let's Treat Drug Abuse
As The Illness It Is

A U.S.-wide survey of police chiefs by the Police Foundation found that 85 percent want major changes in drug policy.  Sixty percent said law enforcement has not reduced the problem.  Because of mandatory sentencing laws, drug offenders represent more than 60 percent of federal prisoners. Police see firsthand that nonviolent drug users and addicts, who are the victirns of drug dealers, are the most negatively affected by "warehousing" in prison.

Historically, drug policy originated from elected of ficials and police, driven by sensational news stories of drug lords and predatory dealers.  But beyond the headhnes is the core problem of millions of ordinary people with no connection to the crime world who are caught up in abuse and addiction. As police know, if this medical problem can be reduced, the drug dealers at the top will be strangled by a shrinking market.

While serious and violent offenders must be dealt with by the law, most substance abusers and addicts threaten only themselves.  Recovery can come if effective treatment is available.  Still, 75 percent of federal and state funds for drug abuse go to law enforcement.  Physicians, like many police of ficials, believe that this 3-to1 ratio should be shifted to significantly increase treatment.

For many years before World War II, doctors were prosecuted and jailed in the United States for treanng what the newspapers then called "dope fiends." American medicine was elbowed out of drug treatment.  This exclusion crippled drug policy because the huge medical component was almost ignored.

Now a group of 37 nationally known doctors, Physician Leadership on National Drug Policy is taking an unprecedented step.  The group says that "the current emphasis---on use of the criminal justice system and interdiction to reduce illegal drug use and the harmful effects of illegal drugs---is not adequate to address these problems."

Members of Physician Leadership include Louis Sullivan, former secretary of Health and Human Services; David Kessler, former commissioner of the Food and Drug Administration; Lonnie Bristow, past president of the American Medical Association, and Antonia Novello, former U.S.  surgeon-general. Others include the editors of preeminent medical journals.

Recently the group sponsored a major study comparing the efficacy of drug-addiction treatment to the treatment of other chronic disorders.  This study of more than 600 peer-reviewed research articles showed that treatment of drug addiction is as effective, and sometimes more effective, than treatment for hypertension, asthma and diabetes.

Furthermore, the study showed that treatment was less costly than incarceration and that it lowered crime rates significantly.

The annual regular cost of out-patient treatment for a drug addict is $1,800, intensive outpatient treatment is $2,500, methadone maintenance for heroin addiction is $3,900 and residential treatment is $6,800.  A year in prison for a drug addict averages $25 ,900, triple the cost of the most expensive therapeutic option.  Compounding the problem is the fact that prisons rarely provide treatment for drug addiction.

Substance abuse must have treatment parity (insurance coverage and accessibility) with other chronic, relapsing illnesses such as hypertension and diabetes.  The societal stigma surrounding drug problems must be reduced so those needing care will seek it, those providing care will be encouraged to do so and health care programs will reimburse the costs willingly. The huge burden of laws and regulations on drug treatment must be reduced so physicians can treat abuse and addiction as aggressively as they now treat other chronic illnesses.