Advocates who say addiction should be treated as a public-health issue and not a criminal problem have broad public support, according to the results of a new survey from Hazelden that also found that about one in three families include members with addiction problems.

Public support alone, however, will not be sufficient to sustain recent victories like addiction parity legislation or to meet the economic and policy challenges now facing the addiction field, said William Cope Moyers, executive director of Hazelden's Center for Public Advocacy, which conducted the survey.

The Public Attitudes Towards Addiction Survey found that more than three-quarters (79 percent) of the 1,000 adults polled called the War on Drugs a failure, and 83 percent said that first-time drug offenders should be sent to addiction-treatment programs, not prison. Moyers said the findings illustrate the disconnect between public perceptions and policymakers who "are still waging the war."

Ethan Nadelmann, director of the Drug Policy Alliance (DPA), said the Hazelden findings are in line with other research on public attitudes toward the drug war and treatment alternatives to incarceration.

Similar majorities of Americans said that addiction treatment benefits should be included in healthcare insurance plans (71 percent) and in national healthcare reform plans (77 percent). Congress last year passed legislation requiring that most health-insurance plans cover addiction and mental health services on par with other health conditions, but only if such benefits are included in their plans.

Moyers warned that the hard-earned gains of more than a decade of parity advocacy could be wiped out amid the current economic crisis and the drive for healthcare reform, despite the high levels of public support indicated by the survey findings.

He expressed particular concern that addiction treatment providers struggling with internal financial crises, such as cutbacks in public funding coupled with rising demand for services, will fail to fight the broader policy battles on issues like inclusion in healthcare reform. Hazelden plans to use the survey findings to support a new national advocacy campaign aimed at increasing public understanding of addictive diseases and increasing access to treatment.

"I think this is our moment," Moyers said. "But the fact is that while parity has been passed, the rules have not been written or implemented. If we are not careful, we are going to lose this opportunity. The passage of parity will be a hollow victory if the field doesn't stay focused and committed to doing what we know works."

Lingering Stigma

The Hazelden survey yielded mixed results when it came to public attitudes about individuals with addictions. On the one hand, 77 percent of those polled said that people who complete addiction treatment can go on to live productive lives, and 78 percent said that addiction is a chronic disease, not a moral failing.

Yet discrimination against people with addictions persists, with stigma cited as the most common negative consequence of having a family member with addiction problems.

DPA's Nadelmann said that the stubborn use of pejorative language about people with addictions noted in the survey could be traced to the continued criminalization of drug use. "Everybody generally supports the notion that treatment works, but the public still has this fundamental inconsistency in their views," he said, adding that the battle against stigma should include "both people who have problems with using drugs and people who don't have a problem."

From a policy perspective, however, Moyers said the field can't wait for the battle against stigma to be won before tackling some of the fundamental questions that will be asked of the field as healthcare reform progresses, including what constitutes treatment success and even what standard terminology should be used to define addictive diseases.

"If we don't define these things ourselves, they will be defined for us," he said.