Center for Alcohol and Addiction Studies

Major New Study Finds Drug Treatment as Good as Treatments for Diabetes, Asthma, etc., and Better and Cheaper Than Prison

March 17, 1998

WASHINGTON, D.C.--- A major review of more than 600 peer reviewed research articles, plus original data analyses, show conclusively that drug addiction treatment is very effective and that it works as well as other established medical treatments for illnesses such as diabetes, asthma and hypertension.

The study also compared the outcome of treatment of a drug addict with imprisonment and found that treatment is an effective anti-crime measure and less costly than prison.

These improved outcomes include greatly reduced medical costs to society, returning many more drug addicts to normal, healthy lifestyles and gainful employment, major crime reductions and savings that would otherwise be spent on new prisons and law enforcement.

The study released today was sponsored by Physician Leadership on National Drug Policy (PLNDP), a group of 37 distinguished physicians that includes high ranking officials from the Administrations of Presidents Reagan, Bush and Clinton. They include David Kessler, M.D., immediate past Commissioner of the Food and Drug Administration (FDA), Louis Sullivan, M.D., Secretary of Health and Human Services (HHS) under President Bush, and Edward Brandt, M.D. and Philip Lee, M.D., who were Assistant Secretaries of HHS under Presidents Reagan and Clinton, respectively.

Other members of the PLNDP include Lonnie Bristow, M.D., Past President of the American Medical Association (AMA), Richard Corlin, M.D., Speaker of the House of Delegates of the AMA, June Osborn, M.D., former chair of the Congressionally appointed National Commission on AIDS, former U.S. Surgeon General Antonia Novello, M.D., Frederick Robbins, M.D., a Nobel Laureate, as well as the editors of the JAMA, The New England Journal of Medicine and Science.

"The good news is that today's scientific findings will help us select and fund the best methods to reduce drug addiction. This will result in greatly reduced medical costs and many more people back to gainful employment. The reduction in crime also means less spent on jails and police work," said David Lewis, M.D., Project Director for PLNDP.

"The bad news is that most Americans don't yet understand how well drug treatment works. We all want a healthier society and safer streets, and now we have the scientific research showing us how to get there," Dr. Lewis added. He is also Director of the Center for Alcohol and Addiction Studies at Brown University.

Another new study to be released in the March 18 edition of the Journal of the American Medical Association (JAMA), and distributed at today's press conference with the permission of JAMA, found diminishing public support for drug treatment, and increased support for "more severe penalties for the possession and sale of drugs."

The survey of more than 100 public opinion polls taken between 1951 and 1997 found that the majority of respondents also favored more anti drug education in schools and more funding for police. The JAMAstudy by Robert Blendon, Sc.D., of the Harvard School of Public Health, says that 78% of Americans "see the War on Drugs as having failed thus far..."

According to Dr. Blendon's study, "public support for increased spending for drug treatment has declined from a high of 65% in 1990 to 53% in 1996."

June Osborn, M.D., the Chair of PLNDP who is also President of the Josiah Macy, Jr. Foundation in New York City, said, "Dr. Blendon's study is of real value because it tells us what we have to do. Doctors, members of Congress, law enforcement officials and public health experts must reach out to the public with the message of drug treatment's power to reduce substance abuse, reduce medical costs, and reduce crime more than any other single approach.

That means creating more treatment programs where they are needed, and more funds for the good ones to expand," she added.

Relative to the PLNDP study, Lonnie Bristow, M.D., the Vice Chair of PLNDP and Past President of the AMA, said, "doctors have not been sufficiently involved in diagnosing and treating substance abuse, with a major reason being the stigma attached to substance abuse.

"The research we are releasing today shows, conclusively, that drug addiction is very treatable and that it reaches across all strata of society with affluent, educated Caucasians being the most likely drug users, and the most likely to be addicted," Dr. Bristow said.

"Stigmatizing drug abusers is counter productive both for those who need treatment, and for society. Stigma discourages drug abusers from seeking help, discourages doctors from providing it, and discourages health policy people from finding the best ways to deliver treatment," Dr. Bristow added.

The report released today on drug addiction and treatment is an integrated effort by leading researchers to provide a scientific foundation on which to build the best drug policies. The report includes the following five components:

Myths and Facts about Drug Use and Addiction
The major, false stereotype is that all drug addicts are social misfits and outcasts even though drug use is common through all segments of society. In reality the "typical" American family is greatly impacted by addiction, and those family members can have their lives turned around by entering treatment. Unfortunately, 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.
Principal Researcher, Jeffrey Merrill, University of Pennsylvania.

Prevalence and Costs of Addiction Relative to Other Chronic Diseases
The economic impact of addictions, including lost productivity, medical and other costs is greater than any other chronic medical conditions. However drug treatment greatly reduces all these costs. Improvements in employment status and in work productivity, in addition to medical savings, far outweigh the costs of drug treatment. Drug Addiction is a chronic health problem like heart disease, diabetes, smoking, alcoholism, and stroke. As with these other health problems, behaviors such as diet, exercise and taking medications appropriately, affect the natural progression and treatment outcomes of drug addiction.
Principal Researcher, Henrick Harwood, The Lewin Group

Is Drug Dependence a Treatable Medical Illness?
Drug dependence meets the criteria for a treatable, chronic medical condition and is as consistently diagnoseable as other illnesses. As important, addiction treatment has outcomes comparable to their chronic conditions.
The heritability, or estimate of genetic contribution for addictions is comparable to that of hypertension, diabetes, and asthma.
Comparisons of medication and behaviorial compliance reveals that addicted patients have compliance rates comparable to patients receiving treatment for diabetes, asthma and hypertension. In fact the likelihood of requiring additional treatment within a 12 month period is generally higher for diabetes, hypertension and asthma than for drug addiction.
Principal Researchers:
Thomas McLellan, Ph.D., University of Pennsylvania
Charles O'Brien, M.D., Ph.D., University of Pennsylvania
Norman Hoffmann, Ph.D., Brown University
Herbert Kleber, M.D., Colombia University

Cost-Effectiveness of Drug Treatment
Among a list of more than 500 health and life saving measures, addiction treatment consistently ranks among the top 10%. Compared to other chronic conditions, additional professional services to enhance maintenance of recovery are among the most cost-effective forms of treatment
In addition to considerable savings in short and long term medical treatments, major savings to the individual and society also come from significant drops in interpersonal conflicts, various types of accidents, crime and assaults.
Principal Researcher, Donald Shepard, Ph.D., Brandeis University

Returns on Drug Addiction Treatment Investments
Alcohol and drug addiction make a major contribution to the incidence and severity of a wide range of medical conditions, such as certain forms of cancer, pancreatitis, endocarditis, injury and AIDS.
Although addicted persons are among the highest users of medical care, only 5% to 10% of these costs are due to addiction treatment. The rest is attributed to medical problems that are most often the result of, or triggered by the addiction. However addiction treatment produces marked reductions in medical care utilization and costs.
While reduced health care costs are impressive, even larger savings can be made in other areas. The most dramatic return is the effectiveness of drug addiction treatment in reducing the occurrence and costs relating to crime.
Principal Researcher, James W. Langenbucher, Ph.D., Rutgers University.

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