Drug treatment: Will U.S. step up?

Published: Sunday, Nov. 8, 2009 9:43 p.m. MST
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NEW YORK — Based on the rhetoric, America's war on drugs seems poised to shift into a more enlightened phase where treatment of addicts gains favor over imprisonment of low-level offenders. Questions abound, however, about the nation's readiness to turn the talk into reality.

The economic case for expanding treatment, especially amid a recession, seems clear. Study after study concludes that treating addicts, even in lengthy residential programs, costs markedly less than incarcerating them, so budget-strapped states could save millions.

The unmet need for more treatment also is vast. According to federal data, 7.6 million Americans needed treatment for illicit drug use in 2008, and only 1.2 million — or 16 percent — received it.

But the prospect of savings on prison and court costs hasn't produced a surge of new fiscal support for treatment. California's latest crisis budget, for example, strips all but a small fraction of state funding away from a successful diversion and treatment program that voters approved in 2000.

"It's easy to talk a good game about more treatment and helping people," said Scott Burns, executive director of the National District Attorneys Association. "But it smashes head on into reality when they don't put their money where their mouth is."

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Money aside, the treatment field faces multiple challenges. At many programs, counselors — often former addicts themselves — are low-paid and turnover is high. Many states have yet to impose effective systems for evaluating programs, a crucial issue in a field where success is relative and relapses inevitable.

"Fifty percent of clients who enter treatment complete it successfully — that means we're losing half," said Raquel Jeffers, director of New Jersey's Division of Addiction Services. "We can do better."

The appointment of treatment expert Tom McLellan as deputy director of the White House Office of National Drug Control Policy in April was seen as part of a shift of priorities for the drug czar's office.

McLellan said he sees greater openness to expanding treatment but also deep misunderstanding or ignorance about scientific advances in the field and the need to integrate it into the health care system.

Most Americans, he suggested, have an image of drug treatment formed from the movies — "cartoon treatment" involving emotional group encounters — and are unaware of a new wave of medications and other therapies that haven't gained wide use despite proven effectiveness

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Bebeto Matthews, Associated Press

A substance-abuse counseling session is held at a nonprofit support center in New York. Demand in U.S. for treatment exceeds funding.

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