This treatment gap occurs because of low motivation to seek treatment and limited funding. Despite this, only a small percentage of those who use illicit drugs receive treatment ( 46). Treatment reduces costs to society and, in terms of societal costs averted, largely in savings from the criminal justice system, even pays for itself ( 34). Thus, treatment may be the most powerful means of fighting the ills of illicit drugs usage. High rates of incarceration based on drug-related crimes have not had a major impact on drug use ( 94, 95). Popular prevention programs such as DARE are ineffective ( 61). Furthermore, illicit drug use contributes to the disintegration of families and of inner city communities and has resulted in a huge growth in the prison population, especially of African-American males ( 83). Illicit drug use contributes to the spread of contagious diseases, including HIV/AIDS, hepatitis B and C, and tuberculosis. Drug use harms society by reducing user's physical and mental health and productivity, by reducing family and social functioning and by increasing crime. Use of illicit drugs and, in particular, dependence on drugs are important public health problems. We provide criteria on how these innovations should be evaluated in order to determine which should be adopted, funded, and transferred to existing and future treatment programs. This paper describes standard treatments and recent innovations designed to increase ( a) effectiveness of treatment, ( b) motivation to seek care, ( c) access, ( d) retention, and ( e) cost-effectiveness. These innovations include new pharmacological agents, novel counseling strategies, promising ways to motivate, and treatment in new settings. Recently, there have been important innovations that reduce barriers and increase effectiveness of treatment.
Furthermore, only a fraction of those who need treatment receive it. In addition, some individuals continue to use drugs while in treatment, and relapse is common. However, programs that treat drug dependence have high dropout rates and low completion rates.
Treatment reduces drug use and crime and increases individuals' functioning. The low effectiveness of prevention efforts leaves treatment of drug dependence as one of the most powerful means of fighting illicit drug use. ▪ AbstractIllicit drug use is an important public health problem with broad social costs.