Pubdate: Wed, 06 May 1998 Source: Houston Chronicle (TX) Contact: http://www.chron.com/ Author: Carol Wyatt MAKES MORE SENSE TO TREAT AND TRAIN DRUG OFFENDERS By CAROL WYATT GEORGE Soros has done it again. Stepped up to the plate. Walked the talk. Put his money where his mouth is. Isn't it about time we insist our government does the same? Even as it admits needle-exchange programs reduce the spread of HIV and do not cause increased drug use, the Clinton administration refuses to release federal dollars to support needle exchange programs. Not Soros. He has committed $1 million to support the programs. Again. The score? Soros: $2 million. The Clinton administration: $0. Why won't the government support a program that is proven to reduce the spread of HIV by 30 percent? Those who oppose needle exchange say providing clean needles will only encourage drug use. But study after study shows no increase in drug use. In fact, drug users who participate in needle-exchange programs are more likely to seek treatment for their addictions. They say they oppose needle exchange to protect our kids, yet more than half of all new HIV infections in children are directly related to unclean needles. Some protection. A clean syringe costs pennies. The lifetime cost of treating a person with HIV/AIDS is more than $100,000. In dollars and cents, it doesn't make sense. Needle exchange isn't the only area of the nation's drug policy that is inconsistent. The sad truth is that what the government does and does not fund in its war on drugs brings more harm than good. It puts Americans at greater risk each day and costs us each far more dollars in government spending than policies that follow a harm-reduction model, policies endorsed by the American Medical Association, the American Public Health Association, the National Academy of Sciences, the Centers for Disease Control and Prevention and the American Academy of Pediatrics. It is estimated that there are 3 million hard-core addicts in the United States. Treatment is available for less than half that number. To treat every substance abuser would cost $21 billion. That's not cheap. Yet imagine the cost of not treating them. In 1996 the direct and indirect costs related to alcohol -- a legal drug -- were $86 billion. There are workplace costs in absenteeism, lost productivity and disability days. There are health-care costs -- drugs and alcohol are involved in approximately 65 percent of all emergency hospital visits. And then there are the costs of arrest, prosecution and incarceration. In 1996, we spent $38 billion to incarcerate all federal, state and local prisoners; $30 billion was for 1.2 million individuals convicted of crimes involved with drugs and alcohol. That's 80 percent of all prisoners. It doesn't make sense. We now spend up to $37,000 per year to keep an adult in prison. Without changing our policies, at this rate it is estimated that by the year 2000, only 20 months from now, we will spend $100 million per day to incarcerate individuals with serious drug and alcohol problems -- $100 million each day. It doesn't make sense. Currently, the war on drugs costs $16 billion, with approximately two-thirds spent on law enforcement and interdiction. The net effect? We stop 10 percent of all illegal drugs from entering the country. Under certain economic assumptions, the cost to reduce the street supply of drugs by 50 percent approaches the gross national product, at approximately $5 trillion. It doesn't make sense. Not all drug users are in prison. Some 55 percent of illicit drug users are employed full time and 13 percent are employed part time. Add to that the employees who abuse legal drugs such as alcohol and tobacco and the problem increases. There are solutions. They aren't simple. We have learned that there are many causes of addiction and, logically, there are many different treatments. Not all treatments work 100 percent of the time. But they do work, and they cost less in the short run and a whole lot less in the long run. What can we do? We as employees and employers can insist on coverage for treatment of substance abuse equal to that of any chronic illness. That means treatment and maintenance. The increase to insurance premiums for treatment coverage would be less that $12 per year per insured. We can identify our high-risk children and provide opportunities for personal growth and reward each step of that growth no matter how small. We can provide educational programs that help them improve their interpersonal skills such as communicating with their peers, their teachers and their parents. We can provide drug-free social activities and drug-free peers. We can give the police and the courts options to divert nonviolent addicted offenders into treatment programs. Compare the $37,000 annual cost to incarcerate one prisoner with $14,600 for residential treatment or $2,300 for outpatient treatment. We can speak out to end mandatory sentencing of nonviolent offenders with no chance of parole, and we can provide treatment in prison to those who need it. Prisoners who are substance abusers are more likely to commit new offenses when released. An estimated 81 percent of inmates with at least five prior convictions are drug abusers compared to 41 percent of first-time offenders. The cost to provide treatment, vocational and educational training, and after-care for one prisoner would add only $6,500 to the annual cost of incarceration. But the payback is big. That $6,500 investment will have an estimated economic benefit of $68,000 measured in reduced crime-related costs, health-care savings and potential earnings in the first year after release. One estimate places the cost for treatment and training of the 1.2 million inmates at $7.8 billion. The economic benefit in the first year following release if treatment is successful for just 10 percent of those is estimated to be $8.6 billion and another $8 billion each year thereafter. That's a lot fewer dollars and a whole lot more sense. Wyatt works as a legal assistant and is a student at the University of Houston Graduate School of Social Work.