Bush Treatment Initiative Draws Mixed Reviews

By Phillip Smith, DRCNet. Posted February 9, 2003.

During his State of the Union address, President Bush announced a new drug treatment initiative, promising a $600 million dollar program to place an additional 300,000 people in treatment during the next three years. "As a government," said Bush, "we are fighting illegal drugs by cutting off supplies, and reducing demand through anti-drug education programs. Yet for those already addicted, the fight against drugs is a fight for their own lives."

Bush tied the treatment initiative to his push for faith-based initiatives as "acts of compassion that can transform America, one heart and one soul at a time." He further emphasized the faith-based aspect of his program when the only treatment provider he mentioned in was the Healing Place Church in Baton Rouge, LA. And he waxed religious again, telling Americans who are addicted to drugs that "the miracle of recovery is possible, and it could be you."

After the State of the Union Address, Bush's point man on drug policy, drug czar John Walters, provided a few details at a Washington press conference. The new initiative creates a voucher program that will complement existing alcohol and drug abuse treatment programs, said Walters, increasing treatment capacity and access to effective treatment programs. Under the plan, people assessed as needing drug treatment will receive vouchers to pay for drug treatment under programs monitored by the states. The states will be required to monitor the outcomes of treatment and seek cost-effective treatment modalities.

"This initiative offers a new and effective way for the federal government to help people get into recovery," said Walters. "We know that treatment works. But we also know that there are too many Americans who, for a variety of reasons, cannot access the treatment they need. By giving people a choice, and the direct means to help connect them with effective treatment, we will be able to more directly help drug users who have recognized their problem. This program will also help treatment providers and the overall drug treatment system by bringing increased accountability into the system."

Drug reformers and treatment experts greeted the announcement with a mixture of wariness, mistrust and hope. "We hope this means that people given vouchers can seek out not just unproven faith-based programs, but also treatment modalities that are well-studied and known to be effective," said Bill McColl, a policy analyst for the Drug Policy Alliance. "Study after study has shown there are effective forms of treatment, such as cognitive behavior therapy and moderation management," he told DRCNet.

Dr. Bill Miller, Distinguished Professor of Psychology and Psychiatry at the University of New Mexico and former co-director of the school's Center for Alcohol, Substance Abuse and Addiction, also urged the use of proven drug treatment models.

"I think the government ought to be putting its money into evidence-based treatments, not experimental ones," he told DRCNet. "Faith-based, what does that mean? What is the treatment that is being delivered?" he asked. "I haven't seen any evidence for the efficacy of treatment based on religious content, but that's not to say that a faith-based counseling center using couldn't use evidence-based treatments. We're not talking about faith healing here, and I hope the government will spend its money in a way that encourages people to use the scientific base that is available."

Mary Barr, director of Conextions, a New Jersey counseling center that combines public education, broad-based counseling and drug treatment, was skeptical about where the treatment dollars would end up. "Bush is going to say this is a drug treatment initiative, but he is going to put more money in law enforcement anyway," Barr told DRCNet. "He said he's going to create 300,000 new spaces; how is he going to do that when he's putting everyone in jail? Will these be spaces for court-ordered treatment?"

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