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Dear
AGS,
I guess you and I took a different oath when we received our
MDs. To quote Dr. Alan Leshner, Director of the National Institute
on Drug Abuse (<www.nida.nih.gov>,
Feb.16, 2001), "Imagine a debilitating disease for which
there are effective treatments. Imagine that this treatable
disease costs society $110 billion a year. Can you imagine
not using these treatments? It seems unfathomable, but that
often is the case with the treatment of drug addiction...Addicts
are often denied treatment that would not only improve their
lives, but would improve our own lives as well by cutting
crime, reducing disease, and improving the productivity of
employees and the economy."
The central
issue is not whether drug treatments are effective or not,
since, as I related in my earlier column, there is abundant
scientific data showing that they are.The big moral issue
for people like you, doctor, is whether addicts should be
treated at all. Do they deserve treatment? Didn't they do
it to themselves? Why should we coddle them? Many people,
even those who recognize addiction as a disease, still get
hung up on whether or not it is a "no-fault" illness....all
unanswerable dilemmas which science tells us should no longer
be the focus. As Dr. Leshner notes, ".. benefits to society
must be included in the decision equations. The very same
body of scientific data that demonstrates the effectiveness
of treatment in reducing an individual's drug use, also shows
the enormous benefits that drug treatment can have for the
patient's family and the community."
A variety
of studies from many prestigious institutions show that drug
treatment reduces drug use by 50% to 60% and arrests for violent
and non-violent criminal acts by over 40%. From 60% to 80%
of prison inmates, have serious substance abuse problems.
Scientific studies show that appropriately treating addicts
in prison reduces their later drug use by 50% to 70% and their
later criminality and resulting arrests by 50% to 60%. Simply
ware-housing prison addicts and discharging them untreated
is a guarantee that most will eventually be back in jail.
Successful
drug treatment takes a person who is now seen as only a drain
on society and returns the individual as a productive member.
Best estimates are that for every $1 spent on drug treatment
there is a $4 to $7 return in cost savings to society. This
means that dwelling on moralistic questions, such as who deserves
what kind of help, blocks both the individual and society
from receiving the economic and societal benefits that can
be gained by treating addicts.
It is
true that the individual initially makes the voluntary decision
to use drugs...a decision which was made by that person at
the average age of 13...just a young kid! And furthermore,
once addicted, for that person, it is no longer a simple matter
of choice. Prolonged drug use changes the brain in long lasting
and fundamental ways that result in truly compulsive, often
uncontrollable, drug craving, seeking and use, which is the
essence of addiction. It becomes a more powerful motivator
for that person than virtually any other. Once addicted, it
is almost impossible for most people to stop using drugs without
treatment.
It is
clearly in everyone's interest to rise above personal moral
outrage and get addicted people into drug treatment. If we
are ever going to significantly reduce the tremendous price
addiction exacts from every aspect of our society, alcohol
and other drug treatment for all who need it must be a core
element of our society's strategies....Oh, if I could only
live to see the day!
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