Drug treatment to prevent AIDS, house homeless

Editorial, San Francisco Examiner, Jan. 22, 2002

The City's failure to implement its goal of drug treatment on demand has a ripple effect, creating problems for HIV prevention and rehabilitation of the homeless.

The Examiner reported on Monday that San Francisco leads the nation in methamphetamine addiction. And meth use in the late-night party scene is particularly high, 64 percent in the preliminary findings of one Department of Public Health study.

Researchers say the use of speed helps spread HIV, the virus that causes AIDS — not always through contaminated needles. They found that behavioral changes in sex were the big culprit. The drug is an incredible aphrodisiac that encourages reckless and unprotected sex. It also allows people to have sex for up to 14 hours without a break, increasing exposure to sexually transmitted diseases.

The City’s official policy is to offer drug treatment to anyone who wants it, immediately. The reality is nowhere near that. The lack of treatment slots means people who are ready to be treated must go on a waiting list, and often never follow through. Six-month waiting lists are not unheard of.
The lack of treatment slots also frustrates reform efforts around homelessness. The get-tough policies that several supervisors have proposed — restrictions on panhandling and sleeping on the street — will be hindered if homeless drug addicts are not given the option of cleaning up their lives through treatment on demand.

Tough love only works if there is the promise of help at the other end.
Yet The City should not hang its head in shame. There is evidence that public-health programs have gone a long way toward reducing the number of deaths due to overdoses, and that’s a start.
When treatment on demand went into effect in 1997, there were 1,012 emergency-room visits for treatment of methamphetamine overdoses. In 2001 there were just 591 such visits.

Over that period of time, funding for drug-treatment programs increased from around $32 million to almost $50 million. No doubt, drug treatment costs money, but it does help.

What Proposition 36 — the 2000 referendum allowing alternative sentencing for drug crimes — taught us is that the will is out there to provide drug treatment money based on the assumption that the alternatives are more expensive.

San Francisco is facing a budget shortfall and is in a time of cutbacks. Treatment on demand is still a worthy goal, and while it is not expected to pay for itself, it certainly is cost-effective.