Treat Junkies, Save Money

Today's middle-class taxpayers have little sympathy for drug addicts and less use for drug treatment programs--particularly since most heavy users eventually resume the habit. Yet by the strict yardstick of cost, treatment seems to pay off big in lower consumption.

A 1993 report by the Office of National Drug Control Policy, for example, concluded that treatment programs generally produce social benefits far in excess of their costs via reduced crime and health spending, and higher productivity and employment. Now, a new study of cocaine control strategies by RAND researchers C. Peter Rydell and Susan S. Everingham finds that treatment is seven times more cost-effective than law enforcement in reducing cocaine consumption (chart).

The study estimates that current U.S. anticocaine outlays total some $12 billion for domestic law enforcement, source-country control, and interdiction at borders and about $1 billion for treatment of drug addicts. Such outlays have helped cut the number of cocaine users from 9 million in the early 1980s to 7 million today. But they have failed to cut the amount of cocaine consumed.

The reason is that the declining number of casual users has been partly offset by a rise in the ranks of heavy users (at least once a week), who now number 2 million and account for more than two-thirds of cocaine demand. Meanwhile, despite the government's antidrug crusade, the street price of cocaine has fallen sharply in real terms since 1980.

Treatment is so cost-effective because it targets cocaine consumption directly. Some 80% of heavy users stay off drugs while in treatment, and about 13% of treated addicts kick the habit--some permanently, others temporarily. By contrast, supply control methods such as law enforcement and drug seizure are relatively indirect and highly expensive.

The RAND study doesn't advocate ending efforts to control drug supply, simply changing the spending mix. By shifting $3 billion more to treatment programs, it figures the U.S. could treat all heavy cocaine users once a year--three times the number treated today. The payoff, if most could be induced to participate: a one-third reduction in cocaine consumption and significant declines in both the number of users and the social costs of addiction.

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