Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.

Reuters NewMedia, Inc.; Wednesday September 9, 1998
Maggie Fox, Health and Science Correspondent

The report, timed to coincide with the final budget battles in Congress, is the first long-term look at whether treatment for substance abuse works.

It does, at least for adults. There is a big exception. Drug treatment programs do not seem to help adolescents -- who increased alcohol use by 14 percent and crack use by more than 200 percent after treatment.

But Camille Barry, acting director of the Center for Substance Abuse Treatment, told a news conference that the long-term effects of treatment are better than expected.

"We found that five years after treatment there is a 21 percent reduction in illicit drug use and a 14 percent drop in alcohol use, in spite of the fact that 44 percent of those in the sample had been in treatment less than one month," she said.

The study, based on interviews with 1,799 people five years after they underwent drug treatment programs, found a 45 percent drop in cocaine use, a 28 percent drop in marijuana use and a 14 percent decrease in heroin use.

"What we found was that five years following treatment there were 156,000 fewer users of any illicit drug, and those that did continue to use alcohol or illicit drugs used them less frequently than before," Barry added.

"Alcohol and drug treatment programs produce results. They have long lasting, enduring benefits for people in need of help," said Nelba Chavez, administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA), which conducted the study, told the news conference.

The report found criminal behavior by drug users and alcoholics dropped by between 23 and 38 percent after treatment. It showed many had better physical and mental health, more reliable housing and managed to keep custody of their children, or win it back.

Gen. Barry McCaffrey, who heads the Office of National Drug Control Policy, said the study showed treatment prevented "a gigantic amount of damage to American society".

"It certainly works better than locking them up," he added -- pointing out that it costs more than $100,000 a year, on average, to keep someone in jail. McCaffrey noted the weaknesses in the program. "We're not very smart about dealing with children," he said. "We have got to do better on dealing with adolescent drug addiction behavior because they are costing us a fortune."

He said he was meeting with Health and Human Services Secretary Donna Shalala to figure out ways to get more money for drug treatment programs. He said both House and Senate committees working on the budget had turned down provisions for $200 million for drug treatment programs.

"If we don't put that $200 million investment into it I guarantee you there is going to be increased suffering and you and I are going to pay for it," he said.

McCaffrey said about 4 million Americans are "screwed up beyond belief" by drug and alcohol addiction. "We manage them through emergency rooms and the prison system. If they get HIV (the virus that causes AIDS) we'll probably pay a quarter of a million dollars to manage them through a painful death," he added. Treatment facilities included methadone clinics, which give out a legal substitute for heroin, hospital inpatient clinics and outpatient clinics.

Long-term residential treatment programs worked the best, the study found, except for crack and heroin users.
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