Access to quality drug treatment is one of the greatest obstacles to addressing the issue of drug misuse in the United States. Drug treatment is woefully under-funded, the treatment capacity is inadequate to accommodate everyone who requests it, a wide range of effective treatment modalities are unavailable, and drug treatment facilities often face NIMBY issues which can block their opening.

One of the greatest failures of current drug policy is the emphasis and support that is placed on investigation, prosecution and incarceration of drug possession offenses, rather than funding drug treatment and preventative drug education. Over the past 30 years, the government has spent 70% of drug war resources on police, prisons, and military with only 30% devoted to drug education and treatment. South Carolina is the state which spends the least on drug treatment and yet has some of the most punitive policies for drug use, particularly for women who need treatment during pregnancy. Further exacerbating the funding difficulties, health insurance companies fail to provide equal coverage for drug treatment as they do for similar recurring conditionals.

The 2000 National Household Survey on Drug Abuse found that 3.9 million people who needed treatment did not get it and treatment professionals estimate that only 1 in 10 people receive the treatment they need. Increasingly, the only way for people who do not have the financial means but need drug treatment to access it is through the criminal justice system. After being arrested for drug related crimes, some states and jurisdictions divert offenders into treatment as a cost-effective and humane alternative to incarceration, yet drug courts and other diversion programs are available only to minute percentage of eligible and needy individuals and these models problematically rely heavily on non-therapeutic drug testing and coercion. Two states, California and Arizona have implemented sweeping reforms that require nonviolent drug offenders be offered drug treatment with models that address many of the fundamental concerns of placing treatment in the criminal justice system, and have had a great deal of success so far. Read more about other ballot initiative efforts at the Campaign for New Drug Policies.

The limited option of treatment methods available is another obstacle to the provision of quality treatment. The most common form of drug treatment follows the AA model, which works well for many people but is inappropriate and inadequate for many others. Despite solid scientific evidence attesting to the effectiveness of certain drug treatment modalities, such as methadone maintenance for opioid addiction and several harm reduction models, there is strong resistance, particularly within the criminal justice system, to any model not based on abstinence. Treatment has generally been based on a model proven effective for a single ethnic group and gender and the lack of culturally sensitive treatment options and programs that provide critical ancillary services, particularly for women with children, further restrict access to successful treatment.

The NIMBY - Not In My Back Yard - phenomenon is perhaps the greatest barrier presented by the communities and the public at large. Many individuals who support drug treatment do so as long as it is not located in their community. Although health and safety considerations are understandable, they are most often based on misunderstanding and a false sense that drug treatment creates crime and instability in a community. The Drug Policy Alliance has been involved in several efforts to oppose NIMBY attitudes and policies, including the successful litigation opposing an ordinance that tried to block a methodone clinic from opening (BAART v. Antioch), and current efforts to prevent the City of Oakland from enacting policies to make it more difficult for treatment centers to open at a time when 61% of California voters support drug treatment instead of incarceration.