Drug treatment is also HIV prevention.  People in treatment are less likely to inject drugs.  People in treatment are less likely to get involved in risky sex, another way to contract HIV.

According to the government, approximately 5 million drug users were in need of treatment in 1998, while less than half that number received it.⁽¹⁾  Methadone maintenance is the most effective treatment for heroin, the most commonly injected drug.  But this treatment is available to only about 1 in 5 heroin users.⁽²⁾  

The federal government spends 20 percent of the nation's drug-control budget to treat drug-dependent individuals^.(3)  Experts, both inside and outside government, say it would be both cost effective and humane to increase the government's expenditures on drug treatment.⁽⁴⁾  Methadone maintenance treatment for heroin addiction costs $3,900 a year, prison about $20,100 a year.⁽⁵⁾  It is an understatement to say that shifting drug war dollars from prison to treatment would be cost effective.

Even in the best of all possible worlds, with drug treatment available to all who wanted it, we would still need to be concerned about improving access to sterile needles.  Drug dependence is a chronic, relapsing disease.  Some in treatment will, in fact, relapse.⁽⁶⁾  Others, although we may think they need treatment, are not yet interested in it.  All these considerations lead to the significant conclusion that expanding drug treatment alone cannot stop the spread of HIV among people who inject drugs.  Access to sterile needles is also needed.  

Footnotes

(1) Office of National Drug Control Policy, National Drug Control Strategy: 2000 Annual Report, Washington, D.C.: U.S. Government Printing Office, 2000, page 54.

(2) New federal rules for methadone maintenance have been proposed that are intended to increase accessibility, quality, and oversight of methadone treatment. U.S. Department of Health and Human Services. Substance Abuse and Mental Health Services Administration, "Improving Quality and Oversight of Methadone Treatment," press release, July 22, 1999.

(3) Lauran Neergaard, "Study: Treatment Best for Addicts," Associated Press, March 18, 1999.

(4) Christopher S. Wren, "Top U.S. Drug Official Proposes Shift in Criminal Justice Policy," New York Times, December 9, 1999, page A23; and George D. Lundberg, "New Winds Blowing for American Drug Policies," Journal of the American Medical Association. September 17, 1999, pages 946-947.

(5) Cost of methadone maintenance from David C. Lewis and June E. Osborn, "A Waste of Lives and Money," Washington Post, July 20, 1998, page A17.  Cost of prison from Office of National Drug Control Policy, National Drug Control Strategy: 2000 Annual Report, Washington, D.C.: U.S. Government Printing Office, page 63.

(6) Office of National Drug Control Policy, National Drug Control Strategy: 2000 Annual Report, Washington, D.C., U.S. Government Printing Office, page 54.

For a list of other materials used on this website, see References.