Why Should We Treat Addicts Anyway? The Solution We Refuse to Use

By Alan I. Leshner, Ph.D., Director, National Institute of Drug Abuse, National Institutes of Health

(NAPS)-Imagine a debilitating disease for which there are effective treatments. Imagine that this treatable disease costs society $110 billion a year. Can you imagine not using these treatments? It seems unfathomable, but that often is the case with the treatment of drug addiction.

Dr. Alan I. LeshnerDr. Alan I. Leshner 
NIDA Director


Addicts are often denied treatment that would not only improve their lives, but would improve our own lives as well by cutting crime, reducing disease, and improving the productivity of employees and the economy.

People are polarized on the issue of treatment: they are either strong advocates for treating addiction or they hate the idea. People debate with passion whether treatment works or not, which approaches are best, and whether treatments like methadone simply substitute one addiction for another.

Research Shows Effectiveness of Drug Addiction Treatment

From my observation post, the core of the issue cannot simply be whether drug treatments are effective or not, since there already are abundant scientific data showing that they are. In fact, research shows that drug treatments are as, or more, effective than treatments for other chronic often relapsing disorders, such as forms of heart disease, diabetes, and some mental disorders.

The central issue for many people is whether addicts should be treated at all. I frequently hear people say: Do they really deserve to be treated? Didn't they just do it to themselves? Why should we coddle people who cause so much social disruption? Shouldn't they be punished, rather than treated? Even many people who recognize addiction as a disease, still get hung up on whether or not it is a "no-fault" illness.

Treatment Reduces Drug Use, Increases Productivity

Science has brought us to a point where we should no longer be focusing the drug treatment question simply on these kinds of unanswerable moral dilemmas. From a practical perspective, benefits to society must be included in the decision equations. The very same body of scientific data that demonstrates the effectiveness of treatments in reducing an individual's drug use, also shows the enormous benefits that drug treatment can have for the patient's family and the community at large.

A variety of studies from the National Institutes of Health, Columbia University, the University of Pennsylvania, and other prestigious institutions have all shown that drug treatment reduces drug use by 50 to 60 percent and arrests for violent and non-violent criminal acts by 40 percent or more. Drug abuse treatment reduces the risk of HIV infection, and interventions to prevent HIV are much less costly than treating the person with AIDS. Treatment tied to vocational services improves the prospects for employment, with 40-60 percent more individuals employed.

The case is just as dramatic for prison and jail inmates, 60-80 percent of whom have serious substance abuse problems. Scientific studies show that appropriately treating addicts in prison reduces their later drug use by 50-70 percent and their later criminality and resulting arrests by 50-60 percent. These data make the case against warehousing addicts in prison without attending to their addictions. If they are not treated, most will be back and may continue to pose a threat to our communities.

Successful drug treatment takes a person who is now seen as only a drain on a community's resources and returns the individual to productive membership in society. Best estimates are that for every $1 spent on drug treatment there is a $4-7 return in cost savings to society. This means that dwelling on moralistic questions, such as who deserves what kind of help, blocks both the individual and society from receiving the economic and societal benefits that can be achieved from treating addicts.

Addicts Need Treatment

It is true that the individual initially makes the voluntary decision to use drugs. But once addicted, it is no longer a simple matter of choice. Prolonged drug use changes the brain in long lasting and fundamental ways that result in truly compulsive, often uncontrollable, drug craving, seeking and use, which is the essence of addiction. It becomes a more powerful motivator for that person than virtually any other. Once addicted, it is almost impossible for most people to stop using drugs without treatment.

It is clearly in everyone's interest to rise above our moral outrage that addiction results from a voluntary behavior and get addicted people into drug treatment. If we are ever going to significantly reduce the tremendous price drug addiction exacts from every aspect of our society, drug treatment for all who need it must be a core element of our society's strategies.

Free Treatment Guide

NIDA has a special new publication that describes the most successeful treatment approaches for treating drug abuse and addiction, Principles of Drug Addiction Treatment: A Research-Based Guide.