Pubdate: Sat, 23 Jul 2011 Source: Boston Herald (MA) Copyright: 2011 The Boston Herald, Inc Contact: http://news.bostonherald.com/ Details: http://www.mapinc.org/media/53 Author: Punyamurtula S. Kishore, MD, Founder of the American College of Addiction Medicine and the National Library of Addictions, based in Brookline. WAGE DRUG WAR IN COMMUNITY The Global Commission on Drug Policy recently declared that the global war on illicit drugs has "failed." The panel, led by former U.N. Secretary Kofi Annan, British entrepreneur Richard Branson and former heads of state representing Mexico, Colombia and Brazil, concluded that anti-drug policies have not stemmed the tide of narcotics, as global opiate use has increased 35 percent over the past decade while worldwide cocaine use has risen by 27 percent. This wholesale indictment of long-standing drug policy by respected world leaders was certainly astonishing. While the commission's call for decriminalization of drug possession will create widespread controversy, the focus should remain on the commission's call for a new model of addiction care. This appeal creates a rare opportunity for new thinking on how society might actually win the "war" on drugs. By developing and supporting local, community-based, public health models of care that stress ongoing medical, behavioral and social treatments for addicts, society will give cities and towns across the United States the tools they need to beat back the scourge of drugs. The present drug epidemic is alarming. There were 91,698 hospital admissions for substance abuse treatment in Massachusetts in 2009, with nearly half for heroin and other opiates -- a 22 percent increase over the past decade. Every day, 2.7 Massachusetts residents, on average, die as the result of opiate addiction, which is substantially higher than the flu pandemic. Nationally, the most recent Survey on Drug Use and Health shows an 8 percent increase in drug use among people age 12 or higher, with a total of 8 million people using illegal drugs. The idea of community-based treatment for epidemics is not new. When applied to drugs and addiction, the concept blends proven public health principles with psychotherapy and practical activities that increase levels of personal and social responsibility. The "community" for addicts is quite broad, encompassing family, medical professionals, the legal system, caretakers and religious entities, among others. The idea is to integrate disparate community-based elements into a single model of care. Research has shown that outcomes for addicts are directly correlated with length of treatment. Because patients are more likely to stick with treatment if a facility is local, it makes sense to encourage localized treatment and other services in outpatient settings, and the primary care setting in particular, if possible. Collaborative, community-based therapy -- including treatment in the patient's home -- not only improves outcomes and maintains sobriety, it creates the opportunity for enduring health and wellness education in the community. Perhaps the most important element of community-based addiction care is mapping of localized addict data. This "disease mapping" technique allows officials to identify possible underlying causes for local outbreaks of addiction and to direct resources in a manner that produces the most cost-effective and beneficial outcomes. In Massachusetts communities where this tool has been implemented, local officials have been able to effectively direct services where they are most needed. The medical, behavioral and social problems associated with addiction present a costly public health challenge. The best way to address these issues and "win" the war on drugs is through adoption of community-based models of care that give cities and towns the resources they need to treat these chronically ill patients. - --- MAP posted-by: Richard R Smith Jr.