Opinion Medically Treating Drug Addiction Benefits Everyone

Imagine a debilitating disease for which there are effective treatments. Imagine that this treatable disease costs society $110 billion a year. Can you imagine not using these treatments? It seems unfathomable, but that often is the case with the treatment of drug addiction.

Addicts are often denied treatment that would not only improve their lives, but would improve our own lives as well by cutting crime, reducing disease, and improving the productivity of employees and the economy.

People are polarized on the issue of treatment: they are either strong advocates for treating addiction, or they hate the idea. People debate with passion whether treatment works or not, which approaches are best, and whether treatments like methadone simply substitute one addiction for another.

The core of the issue cannot simply be whether drug treatments are effective or not, since abundant scientific data exists showing that they are. In fact, research shows that drug treatments are at least as effective as treatments for other chronic, often relapsing disorders, such as forms of heart disease, diabetes, and some mental disorders.

The central issue for many people is whether addicts should be treated at all. I frequently hear people say, ‘Do they really deserve to be treated? Didn’t they just do it to themselves? Why should we coddle people who cause so much social disruption? Shouldn’t they be punished, rather than treated?’ Even many people who recognize addiction as a disease still get hung up on whether or not it is a “no-fault” illness.

Science has brought us to a point where we should no longer be focusing the drug treatment question simply on these kinds of unanswerable moral dilemmas. From a practical perspective, benefits to society must be included in the decision equations. The very same body of scientific data that demonstrates the effectiveness of treatments in reducing an individual’s drug use also shows the enormous benefits that drug treatment can have for the patient’s family and the community at large.

A variety of studies from the National Institutes of Health, Columbia University, the University of Pennsylvania, and other prestigious institutions have all shown that drug treatment reduces drug use by 50{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} to 60{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}, and arrests for violent and non-violent criminal acts by 40{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} or more. Drug abuse treatment reduces the risk of HIV infection, and interventions to prevent HIV are much less costly than treating the person with AIDS. Treatment tied to vocational services improves the prospects for employment, with 40{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} to 60{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} more individuals employed.

The case is just as dramatic for prison and jail inmates, 60{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} to 80{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of whom have serious substance abuse problems. Scientific studies show that appropriately treating addicts in prison reduces their later drug use by 50{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} to 70{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}, and their later criminality and resulting arrests by 50{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} to 60{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}. These data make the case against warehousing addicts in prison without attending to their addictions. If they are not treated, most will be back and may continue to pose a threat to our communities.

Successful drug treatment takes a person who is now seen only as a drain on a community’s resources and returns the individual to productive membership in society. Best estimates are that for every dollar spent on drug treatment, there is a $4 to $7 return in cost savings to society. This means that dwelling on moralistic questions, such as who deserves what kind of help, blocks both the individual and society from receiving the economic and societal benefits that can be achieved from treating addicts.

It is true that the individual initially makes the voluntary decision to use drugs. But once addicted, it is no longer a simple matter of choice. Prolonged drug use changes the brain in long-lasting and fundamental ways that result in truly compulsive, often uncontrollable drug craving, seeking, and use, which is the essence of addiction. It becomes a more powerful motivator for that person than virtually any other. Once addicted, it is almost impossible for most people to stop using drugs without treatment.

It is clearly in everyone’s interest to rise above our moral outrage that addiction results from a voluntary behavior and get addicted people into drug treatment. If we are ever going to significantly reduce the tremendous price drug addiction exacts from every aspect of our society, drug treatment for all who need it must be a core element of our society’s strategies. –

Alan I. Leshner, Ph.D. is director of the National Institute of Drug Abuse,a branch of the National Institutes of Health.