"dr. ldmf [ph.d, j.d.]" <[EMAIL PROTECTED]> writes:
Hi Suer - this is certainly a difficult issue. Concurrently 'sick and
criminal' (an individual factor, a social factor -- though that's too
simplistic a distinction) which should be treated? I understand prisons
have psychiatric wards and psychiatric hospitals have criminal wards; I
would think that working in these fields would be extremely
challenging. What would you prefer as the disposition? And I wonder
what the comparative costs are? Maybe Doc and others will come in on
this one (as to medical sociologuy, etc.) Glad you posted this. :) LDMF.
-------------------Sue Hartigan wrote:-----------------------------
> Lawrence M. O'Rourke
> THE SACRAMENTO BEE
>
> Anew conflict between politics and science has emerged from a recent
> recommendation that the nation treat drug addicts as sick people rather
> than
> jail them as criminals.
>
> More emphasis on medical treatment rather than jail for addicts was
> endorsed by a group of doctors, including top officials from the
> administrations of Presidents Reagan, Bush and Clinton.
>
> But there was an immediate negative reaction from Capitol Hill, where a
> lock-them-up-and throw-away-the-key attitude to drug addicts dominates.
> Rep. Bill McCollum, R-Fla., chairman of the subcommittee on crime, says
> the country needs to spend more money, not less, on catching drug
> pushers.
>
> The Clinton administration, aware that the public prefers a get-tough
> approach to drug addicts, has no plans to move big amounts of money from
> law enforcement to medical treatment.
>
> Public support for drug treatment is diminishing, says Robert Blendon of
> the
> Harvard School of Public Health. Four in five Americans believe that the
> war
> on drugs has failed.
>
> So the tide of public opinion and political instinct is running against
> any
> change in emphasis from prison and aggressive law enforcement to
> prevention and treatment.
>
> The recommendation by the group called Physician Leadership on National
> Drug Policy declares that "enhanced medical and public health approaches
> are the most effective method of reducing harmful use of illegal drugs.
> . . .
> The current emphasis -- on use of the criminal justice system and
> interdiction
> to reduce drug use and the harmful effects of illegal drugs -- is not
> adequate
> to address these problems."
>
> The physicians contend that medical care for addicts either on an
> out-patient
> or residential basis is cheaper than the $25,900 it costs annually to
> imprison
> a drug addict. It prices regular outpatient care at $1,800 to $2,500 a
> year,
> methadone maintenance at $3,900, and residential treatment at $4,400 to
> $6,800.
>
> "We recognize that sometimes treatment does not work," says Dr. Lonnie
> Bristow, an internist in San Pablo and past president of the American
> Medical Association. But studies show that drug addicts are as likely to
> meet
> treatment requirements as people with other chronic diseases, such as
> diabetes, smoking, alcoholism, stroke, and heart disease.
>
> "Drug abuse is very treatable," says Bristow.
>
> Jeffrey Merrill of the University of Pennsylvania says that Americans
> might be
> more sympathetic to treatment for drug addicts if they realized that
> most
> addicts are not minority group members in big cities. Studies show that
> among young people who use cocaine, whites outnumber African-Americans
> nearly 10 to one, and Hispanics more than two to one.
>
> And young cocaine users come from what the nation regards as the best
> families. Some 53 percent of cocaine users have fathers who are college
> graduates. About two-thirds of monthly cocaine users are employed
> full-time.
>
> "The major, false stereotype is that drug addicts are social misfits and
> outcasts even though drug use is common throughout all segments of
> society," says Merrill. He wishes Americans would see drug addiction as
> a
> chronic disease rather than a crime.
>
> "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," says Merrill.
>
> For every $1 invested in treatment, $7 is saved in medical and societal
> costs,
> says Dr. Philip Lee, former assistant secretary for health in the
> Clinton
> administration and faculty member at the University of California School
> of
> Medicine in San Francisco.
>
> Addicts in treatment are much less likely than other addicts to catch
> and
> spread AIDS and hepatitis, says Dr. Thomas McLellan of the University of
> Pennsylvania. About 90 percent of the cost of treating addicts goes for
> medical problems that are triggered by addiction, such as AIDS,
> accidents,
> pancreatis and certain forms of cancer.
>
> In sum, the physicians see treatment as an investment that will save
> money
> and cut down on crime, two goals that are found on Capitol Hill.
>
> But Congress doesn't want to be seen as soft on drug addicts by sending
> addicts to hospitals rather than behind bars. It will continue to put
> federal
> drug control money into law enforcement and new prisons.
> --
> Two rules in life:
>
> 1. Don't tell people everything you know.
> 2.
>
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