Center for Alcohol and Addiction Studies

The Atlanta Constitution
Monday, November 16, 1998

Treat Drug Addiction as an Illness

by Louis W. Sullivan and David Lewis

Our war on drugs costs billions of dollars and thousands of lives. Frustration foments political divisiveness as Congress struggles for solutions amid steaming rhetoric. Physicians, police and legislators search for new answers to save lives and improve society.

The Police Foundation conducted a nationwide survey of police chiefs and found that 85 percent want major changes in drug policy. Sixty percent said law enforcement has not reduced the problem. Because of mandatory sentencing laws, drug offenders now represent more than 60 percent of federal prisoners. Police see firsthand that nonviolent drug users and addicts, the targets of drug dealers, are the most negatively affected by prison "warehousing."

U.S. drug policy has historically been influenced by elected officials and police, driven by sensational news stories of drug lords and predatory dealers. But beyond the headlines is the core problem of millions of ordinary people, with no connection to the crime world, who are caught up in abuse and addiction. As police know, if this medical problem can be reduced, the drug dealers at the top would be strangled by the shrinking market.

Cost of Drug Addiction graph

Although serious and violent offenders must be dealt with by the law, the vast majority of substance abusers and addicts threaten only themselves. Recovery is more likely if effective treatment is available. Still, 75 percent of our federal and state funds for drug abuse go to law enforcement. Physicians, as well as many police officials, believe that a far greater percentage should go to treatment.

In response to this need, a group of 37 nationally known doctors, Physician Leadership on National Drug Policy, is taking an unprecedented step. PLNDP's new consensus statement says: "The current emphasis- on use of the criminal justice system and interdiction to reduce illegal drug use and the harmful effects of illegal drugs-is not adequate to address these problems."

To assure a true national consensus, PLNDP members were selected to include those with diverse medical accomplishments, plus high ranking officials from the administrations of Presidents Reagan, Bush and Clinton. Members include Lonnie Bristow, past president of the American Medical Association; former U.S. Surgeon General Antonia Novello; and David Kessler, former commissioner of the Food and Drug Administration and current dean of Yale Medical School. Others include the editors of the preeminent medical journals Science, The New England Journal of Medicine and The Journal of the American Medical Association.

Recently, the PLNDP sponsored a study comparing the efficacy of treatment for drug addiction to the treatment of other chronic disorders. It concluded that drug addiction treatment is at least as effective as treatment for hypertension, asthma and diabetes.

Though the PLNDP has more research under way, this group of physicians has several recommendations to immediately improve the nation's drug policy:

Substance abuse must have treatment parity (insurance coverage and accessibility) with other chronic illnesses such as hypertension and diabetes.

The societal stigma surrounding drug problems must be reduced so those needing care will seek it, those providing care will be encouraged to do so and health care programs will reimburse the costs.

The huge burden of laws and regulations on drug treatment must be reduced so physicians can treat abuse and addiction as aggressively as they now treat other chronic illnesses.

More research needs to be funded to improve prevention and treatment programs.

The bottom line is, treating drug addicts, rather than locking them up, is better for both the patients and society. It also frees up the police to focus on the real criminals: the dealers at the top.

Dr. Louis W. Sullivan, a member of the Physician Leadership on National Drug Policy, is president of Morehouse School of Medicine. Dr. David C. Lewis is project director of PLNDP and director of the Center for Alcohol and Addiction Studies at Brown University.

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