Wednesday, November 11, 2009

Expanding Drug Treatment: Is US Ready to Step Up?

In a perfect world we would help addicts by sending them into treatment rather than incarcerating them. It is so sad when a person becomes institutionalized ruining their life; more often than not institutionalized addicts do not receive the treatment they need. Only to walk through life labeled a convict and owning their parole #, becoming what society labels them. This is a festering problem that definitely needs change.

Read this article I found:

Expanding Drug Treatment: Is US Ready to Step Up?

Published: November 9, 2009
Filed at 9:03 a.m. ET

NEW YORK (AP) -- 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.''
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
''For the first time, it can truly be said that we know what to do -- we know the things that work,'' he said. ''But do we have the economic and political willingness to put them into place? If we do, we'll see results.''

McLellan, insisting he's not ''a wild-eyed liberal,'' said expanding treatment wouldn't negate the war on drugs.

''Law enforcement is necessary, but it's not sufficient,'' he said. ''You need effective preventive services, addiction and mental health services integrated with the rest of medicine. You shouldn't have to go to some squalid little place across the railroad tracks.''
By federal count, there are more than 13,640 treatment programs nationwide, ranging from world-class to dubious and mostly operating apart from the mainstream health-care industry.
Dr. H. Westley Clark, director of the federal Center for Substance Abuse Treatment, said his agency wants states to develop better measurements of programs' performance.
''The data shows treatment saves money -- $1 spent to $4 or $7 saved,'' Clark said. ''If you're an altruist, making treatment available is a good thing. If you're a narcissist, it's a good thing -- you'd pay less in taxes.''

Treatment advocates are closely watching Congress, hoping the pending health care overhaul will expand insurance coverage for substance abuse programs. Recent federal data indicates that 37 percent of those seeking treatment don't get it because they can't pay for it -- and many land in prison.

The work force in drug treatment is, for the most part, modestly paid, with counselors often earning less than the $40,000 per year that it costs to keep an inmate in prison in many states.

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