Pubdate: Tue, 24 Mar 1998 Source: Daily Arizona Star (AZ) Contact: Lawrence O'Rourke DRUG TREATMENT NOT LIKELY TO REPLACE JAILS A new conflict between politics and science has emerged from a recent recommendation that the nation treat drug addicts as sick people rather than jail them as criminals. More emphasis on medical treatment rather than jail for addicts was endorsed by a group of doctors, including top officials from the administrations of Presidents Reagan, Bush and Clinton. But there was an immediate negative reaction from Capitol Hill, where a lock-them-up-and throw-away-the-key attitude to drug addicts dominates. Rep. Bill McCollum, R-Fla., chairman of the subcommittee on crime, says the country needs to spend more money, not less, on catching drug pushers. The Clinton administration, aware that the public prefers a get-tough approach to drug addicts, has no plans to move big amounts of money from law enforcement to medical treatment. Public support for drug treatment is diminishing, says Robert Blendon of the Harvard School of Public Health. Four in five Americans believe that the war on drugs has failed. So the tide of public opinion and political instinct is running against any change in emphasis from prison and aggressive law enforcement to prevention and treatment. The recommendation by the group called Physician Leadership on National Drug Policy declares that "enhanced medical and public health approaches are the most effective method of reducing harmful use of illegal drugs . . . The current emphasis - on use of the criminal justice system and interdiction to reduce drug use and the harmful effects of illegal drugs - is not adequate to address these problems." The physicians contend that medical care for addicts either on an out-patient or residential basis is cheaper than the $25,900 it costs annually to imprison a drug addict. It prices regular outpatient care at $1,800 to $2,500 a year, methadone maintenance at $3,900, and residential treatment at $4,400 to $6,800. "We recognize that sometimes treatment does not work," says Dr. Lonnie Bristow, an internist in San Pablo, Calif., and past president of the American Medical Association. But studies show that drug addicts are as likely to meet treatment requirements as people with other chronic diseases, such as diabetes, smoking, alcoholism, stroke, and heart disease. "Drug abuse is very treatable," says Bristow. Jeffrey Merrill of the University of Pennsylvania says that Americans might be more sympathetic to treatment for drug addicts if they realized that most addicts are not minority group members in big cities. Studies show that among young people who use cocaine, whites outnumber African-Americans nearly 10 to one, and Hispanics more than two to one. And young cocaine users come from what the nation regards as the best families. Some 53 percent of cocaine users have fathers who are college graduates. About two-thirds of monthly cocaine users are employed full-time. "The major, false stereotype is that drug addicts are social misfits and outcasts even though drug use is common throughout all segments of society," says Merrill. "Stigma is a barrier to those who would otherwise seek treatment, to doctors who would otherwise do more in treating addiction, and to legislators and public health officials who would otherwise do more to make treatment available," says Merrill. For every $1 invested in treatment, $7 is saved in medical and societal costs, says Dr. Philip Lee, former assistant secretary for health in the Clinton administration and faculty member at the University of California school of medicine in San Francisco. In sum, the physicians see treatment as an investment that will save money and cut down on crime, two goals that are found on Capitol Hill. But Congress doesn't want to be seen as soft on drug addicts by sending addicts to hospitals rather than behind bars. It will continue to put federal drug control money into law enforcement and new prisons. Lawrence M. O'Rourke writes in the McClatchy Newspapers Washington Bureau.