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Drug Treatment Less Expensive and More Effective Than Incarcerations, But Not for Adolescents, Says CSAT Report


September-October 1998

Treatment for drug abusers works, is cheaper and more effective than incarceration, and should receive more funding, according to a study released September 9 by the Center for Substance Abuse Treatment (CSAT) (Substance Abuse and Mental Health Services Administration, "Services Research Outcomes Study," Department of Health and Human Services, 1998; "Report Says Drug Rehab Works, Urges More Funding," Boston Globe, September 10, 1998, p. A26).

Camille Barry, acting head of CSAT, said, "We found that five years after treatment there is a 21% reduction in illicit drug use and a 14% drop in alcohol use, in spite of the fact that 44% of those in the sample had been in treatment less than one month." General Barry McCaffrey, the nation's "drug czar," said the study showed treatment prevented "a gigantic amount of damage to American society. . .It certainly works better than locking them up."

The study tracked the drug use and criminal behavior of 1,799 clients discharged from 99 drug treatment facilities in 1990. It concluded that the percentage of people using heroin after treatment declined by 14%, cocaine by 45%, crack by 17%, and marijuana by 28%. Additionally, the majority of those who continued to use drugs used less after treatment. The study found that thefts and burglaries committed by treated individuals declined by as much as 38%, prostitution by 23%, and car thefts by 56%. McCaffrey said, "The cycle of crime, arrest, prosecution, is tremendously expensive, compared with the expense of treatment programs, and most people I talk to in the criminal justice system know this" (Lee Bowman, "Value of Drug Treatment Shows On the Streets," Boston Herald, September 10, 1998, p. 34).

Adolescents were the only exception to the study's findings. Post-treatment drug use did not significantly decline, in fact, the number who smoked crack cocaine and abused alcohol increased. A factor in this finding may be that adolescents have been conclusively identified as the highest risk-taking age group (Christopher S. Wren, "Study Finds Treatment Aids Addicts," The New York Times, September 12, 1998). [Other factors may be that the sample size was too small; that many adolescent drug treatment programs are poorly conceived and managed; or that many adolescents sent to drug treatment don't belong there and are exposed to peer pressure to use drugs and to new networks distributing drugs. -- EES]

Lifestyle characteristics of clients also changed after treatment. The treated group showed a 9% increase in custody of children, a 30% decline in loss of child custody, a 34% decline in being homeless at least 2 nights, a 40% reduction in spending time on the street, a 21% decline in being attacked with a weapon or seriously hit or beaten, a 38% reduction in injecting drugs, a 13% drop in having hallucinations or delusions, and a 43% decline in attempted suicide.

The report's release coincided with debate in Congress over how to spend tax dollars to combat drug abuse. McCaffrey was hoping that lawmakers will allocate more money for treatment programs. Kristin Hansen of the conservative Family Research Council said, "Treatment is an important part of the comprehensive approach." Her group took a poll earlier this year and found that 7-out-of-10 voters desire that drug addicts be treated for their addiction before they are released from prison (Robert Davis, "Treatment `absolutely changes' Addiction," USA Today, September 10, 1998).

A related study by CSAT and the Center for Substance Abuse Research (CESAR)/University of Maryland showed that completing drug abuse treatment results in higher employment levels. Clients who completed the full continuum of treatment (varying combinations of intensive inpatient, long-term residential, recovery house, and outpatient care) were substantively employed within 18 months at a rate 250% higher than those who did not receive treatment. The researchers concluded that "by helping clients to overcome their dependence on alcohol and other drugs, treatment provides a critical function that moves clients on a trajectory toward increased economic independence" ("Completing Treatment Results in Higher Employment Levels Among Indigent Washington State Clients," CSAT by Fax, August 5, 1998, Vol. 3, Issue 15).

Center for Substance Abuse Treatment - Rockwall II Building, 5600 Fishers Lane, Rockville, MD 20857, Tel: (301) 443-5052.