NCJ Number
52794
Journal
POLICE LAW QUARTERLY Volume: 7 Issue: 1 Dated: (OCTOBER 1977) Pages: 34-45
Date Published
1977
Length
12 pages
Annotation
THE SUITABILITY OF USING HEALTH MAINTENANCE ORGANIZATIONS AS THE VEHICLES FOR A LEGAL HEROIN MAINTENANCE PROGRAM IS DISCUSSED.
Abstract
TO REDUCE THE CRIMINAL ACTIVITY OF HEROIN-DEPENDENT PERSONS IT IS PROPOSED THAT HEALTH MAINTENANCE ORGANIZATIONS (HM0'S) BE UTILIZED TO PROVIDE ADDICTS WITH A SERIES OF HEALTH SERVICES INCLUDING THE REGULATED PROVISION OF HEROIN. IT IS ESTIMATED THAT 50 PERCENT OF THE CRIMES IN URBAN AREAS ARE COMMITTED BY ADDICTS WHO STEAL AN AVERAGE OF $1,000 PER WEEK EACH IN THE SUPPORT OF THEIR HABITS. THE PRESENT MODEL OF HEROIN CONTROL HAS BEEN BASED ON TWO DISPROVED PREMISES: THE POSSIBILITY OF CONTROLLING THE IMPORTATION OF HEROIN, AND THE LIKELIHOOD THAT ADDICTS WHO CANNOT OBTAIN HEROIN WILL SEEK MEDICAL HELP. IT IS THEREFORE PROPOSED THAT THE BLACK MARKET NO LONGER BE CHALLENGED BY THE POLICE, BUT THAT IT BE UNDERSOLD BY MEDICAL ORGANIZATIONS. THE HMO'S CAN MEET THE MEDICAL NEEDS OF THE ADDICTS, INCLUDING THE CONTROLLED ADMINISTRATION OF HEROIN, AND THUS CAN ELIMINATE THE ADDICTS' INCENTIVE TO CRIMINAL BEHAVIOR. THE OBJECTIVE OF A HEROIN-MAINTENANCE MODEL IS THE CREATION OF SELF-SUFFICIENT CLIENTS. PRIOR PROGRAMS HAVE FAILED TO ACHIEVE THIS GOAL, BUT IT IS FELT THAT THE HM0'S COULD INSULATE THE ADDICTS FROM THE POLITICAL SCRUTINY WHICH HAS REDUCED THE EFFECTIVENESS OF GOVERNMENT PROGRAMS. BECAUSE MOST HMO'S ARE PRIVATE PREPAID PROGRAMS THEY WOULD NOT HAVE THE TOTALITARIAN CHARACTERISTICS WHICH HAVE BEEN PRESENT IN GOVERNMENT PROGRAMS. THE CRITERIA FOR THE HEROIN MAINTENANCE MODEL INCLUDE THE FLEXIBILITY TO APPLY THE BEST TREATMENT FOR EACH SPECIFIC PATIENT, REVIEW OF THE WORK OF EACH PHYSICIAN, AND CONTROLS OVER FURTHER DRUG ABUSE. THE HMO STRUCTURE IS PREFERRED BECAUSE IT ALLOWS FOR 24-HOUR SERVICES, ADDITIONAL MEDICAL AND MENTAL SERVICES, AND DRUG REHABILITATION PROGRAMS; IT ALSO IS FAVORED BECAUSE IT IS NOT BASED ON THE PREVAILING FEE-FOR-SERVICE MODEL. AN URBAN-BASED STRUCTURE SUCH AS THAT OF THE HMO APPEARS TO BE WELL SUITED FOR SERVING THE LARGELY URBAN POPULATION OF ADDICTS. FURTHER DISCUSSION INCLUDES THE DISINCENTIVES TO SUPPLY ILLICT DRUGS, AND THE FINANCIAL DISADVANTAGES OF USING HM0'S. (TWK)