Drug Panel Praises Treatment Programs

Concluding that drug rehabilitation programs are “a neglected front line in the war against drug abuse,” a panel of experts Wednesday proposed a shift in federal resources to improve and expand the nation’s drug treatment system.

In a study undertaken by the prestigious Institute of Medicine, researchers found that rehabilitation is an important and cost-effective means of fighting the war on drugs.

“The treatment methods available today can yield benefits . . . that well exceed the costs of delivering these services,” said Lawrence S. Lewin, chairman of the research panel.

The report evaluated public and private drug treatment services available across the country and concluded that, while methods and results vary, treatment programs are beneficial even if some addicts ultimately are unable to kick their habits.

“As with many therapies for chronic problems, even the best interventions work only partially--some of the time and for some of the people,” Lewin said. But while dropout rates can be high, some programs “virtually pay for themselves during the treatment period by reducing the criminal activities of the people enrolled in them,” he said.

The researchers recommended an increase in federal funding for public rehabilitation programs and changes in medical insurance policies to cut the costs of private treatment.

Responding to the report, the White House’s Office of National Drug Control Policy acknowledged Wednesday that drug treatment may have been neglected “historically.” But it noted that federal spending on drug treatment has increased dramatically in the last two years, from $880 million in 1989 when the study began, to more than $1.3 billion in 1990.

The study “is a pretty impressive piece of work that is consistent with our view of drug treatment,” said David Tell, an aide to Director William J. Bennett.

Of the four major types of rehabilitation programs, the study found that three--methadone maintenance, residential therapy and outpatient treatment--are cost-effective means to reduce drug abuse.

But the study said that the fourth type of treatment--chemical dependency programs that begin with a month-long hospitalization--are no more effective than the other methods and are significantly more expensive.

The panel noted that these programs are more attractive to many patients because the cost of hospitalization is often borne by their medical insurance. Consequently, they urged private insurance companies to restructure coverage so that patients will have an incentive to enroll in less-costly residential or outpatient treatment.

The report found that while no method was consistently better than another, patient success in all programs improved dramatically with the length of treatment.

As a result, “our data suggest that there should be a shift in emphasis toward longer-term and follow-up care,” said panel member Maxine L. Stitzer, an associate professor of behavioral biology at the Johns Hopkins University School of Medicine.

The report was conducted by the Institute of Medicine, an affiliate of the prestigious National Academy of Sciences. The academy is a congressionally chartered, private organization that advises the federal government on matters of science and technology.

Although 75 million Americans have used illegal drugs, only a small fraction--an estimated 5.5 million--”clearly” or “probably” need rehabilitation, the study said. However, admissions to drug treatment programs numbered only about 1.1 million last year.