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Does Treatment Work?

Data released in December from the National Institute on Drug Abuse shows that drug abuse treatment can have a significant effect on reducing drug use. NIDA tracked 10,000 drug abusers in 100 treatment programs around the U.S. from 1991 to 1993 and found that methadone treatment cut heroin use by 70 percent. Only 28 percent of patients in outpatient methadone treatment programs reported weekly or more frequent heroin use, down from 89.4 percent prior to admission. The study also found that long-term abstinence-based treatment resulted in 50 percent reductions in weekly or more frequent cocaine use after one year of follow-up. Reductions were greatest for those patients in treatment for at least three months.

A federal study found a marked decline in criminal activity for individuals given drug treatment.

Chart: Changes in Criminal Activity 12 Months Before and After Treatment

The Economics of Recovery

The findings corroborate economic studies showing the importance of treatment. Studies have found that every dollar spent on substance abuse treatment produces at least seven dollars worth of savings in terms of health-care costs, increased productivity, and reductions in accidents. The 1996 President's Commission on Model State Drug Laws found that about 65 percent of all emergency hospital visits in the U.S. are alcohol- and drug-related. After treatment, absenteeism, disability days, and disciplinary actions in the workplace drop by half. A RAND Corporation study found that providing treatment to all addicts in the U.S., at a price tag of $21 billion, would save more than $150 billion in social costs over the next 15 years -- a sevenfold return on investment.

Dr. Herbert Kleber, executive vice president and medical director of Columbia University’s National Center on Addiction and Drug Abuse (CASA), says there remain several reasons why U.S. drug policy continues to focus more on interdiction and criminalization than on treatment, despite these advantages. The most notable reason, he says, is that politicians -- in both parties -- want to be viewed as tough on crime, not be perceived as sympathetic to addicts. "No one ever lost an election for refusing to vote for more money for drug treatment. There is no political penalty to be paid" by voting against treatment, he adds. Kleber also says that despite the mountains of data showing the effectiveness and cost-effectiveness of treatment, "There is often a feeling that these people aren't worth spending tax dollars on."

--Janet Firshein

Chart Source: The National Treatment Improvement Evaluation Study. U.S. Substance Abuse and Mental Health Services Administration. 1997.

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