Guess what? So-called traditional addiction treatment doesn't work. By their own shady estimates, programs such as A.A. that use the 12-step method have only a 5 to 7 percent recovery rate. That's effective treatment? Why has this inadequate form of therapy dominated the addiction treatment field when there are alternatives with much better recovery rates such as Rational Recovery (www.rational.org) or SMART recovery?

-- Stephen D'Amico

Your reviewer makes two critical mistakes in her article on Shavelson's book "Hooked." Her most important mistake could, if allowed to pass without comment, undermine drug treatment. Harm reduction is not a form of drug abuse treatment. The aim of drug abuse treatment is to help the abuser stop using drugs. The aim of harm reduction is to manage the consequences of drug abuse. For example, the aim of needle exchange (perhaps the most common harm reduction strategy) is not to stop the users from injecting drugs, it is to stop the spread of AIDS and other diseases. The efficacy of harm reduction is a matter for debate among reasonable people, but the definition is not.

The second error made is that your reviewer chides Barry McCaffrey for the relatively small amount of federal funding for drug courts. This is a misguided criticism. Drug courts are not federal institutions; they are state and local institutions. The drug cases that appear in federal courts are typically large criminal enterprises; the small-time addict winds up in state and local courts. The federal effort on drug courts is an educational one. McCaffrey was an outspoken advocate of drug courts during his tenure as drug czar, and his advocacy was reflected in the expansion of drug courts across the nation during his tenure -- if memory serves, a tenfold expansion. Drug courts are not and should not be a federally funded effort. But McCaffrey was the lead champion of them and saw his advocacy pay off.

-- D.B. Des Roches
Former Special Assistant for Strategy
Office of National Drug Control Policy

I don't know whether to laugh or cry when I read a piece like Laura Miller's "The Nightmare of Recovery," which is imbued with the notion that we're just not doing enough to help our addicts. You bet the war on drugs is a corporate joke that approaches the addiction problem ass-backwards. But while we debate drug courts and other supposed panaceas for addiction, let's not lose sight of the fact that addicts are ultimately responsible for their own condition. Their respective social and medical histories can be brutally unfortunate. But unlike, say, the cancer patient, who does not choose the affliction, the addict has made a conscious choice to pick up. That choice can be influenced or clouded by a host of emotional and physical problems (including those induced by the addiction itself), but the fact remains it is a choice. At a certain point it becomes ridiculous to think we as a society can construct a system that will be there each and every step of the way to save people from themselves. I heartily endorse full and appropriate resources for detox, counseling and other primary therapy. But this is alloyed by the cold reality that, ultimately, addicts are the only ones who can permanently stop their own destructive behavior.

-- J. Smith

I find it unsurprising that coerced treatment works. I am a recovering alcoholic. In a sense, I was coerced into recovery. My health was failing. My life was starting to unravel. I didn't come to the conclusion that alcohol was immoral. I came to the conclusion that it wasn't fun anymore. We call that a bottom. The truism I have witnessed is that those who make it have had low bottoms (note that the reverse is not true). It seems obvious to me that the threat of jail could contribute to one's bottom.

But what right have we to invent negative side effects in order to coerce others into treatment? Yes, if someone commits a violent crime to fuel a drug habit, we have every right to compel treatment (assuming an addict deserves what amounts to leniency). But what if the only crime is possession of the drug itself? We have no right to compel treatment in that case.

-- David Griffin

This article means a lot to me because I went through a horrendous nightmare about 10 years ago with my addict boyfriend, who finally killed himself rather than go back to jail. I had sent him to an excellent hospital and he had gone to lots of A.A. and N.A. meetings. When he relapsed I could not afford to send him out of state for 28 days again, so he was extremely lucky, we thought, finally to get a spot in a local rehab program and residence facility.

What I learned is that most of these programs, all of them around here at least, are today's nursing homes -- moneymaking schemes for doctors. They are poorly staffed with borderline "professionals," and the physical facilities are dismal. They are cruel jokes on people who see them as a hope for life. He and I talked many times about how wonderful it would be if money were put into rehabilitation rather than punishment, and I still agree with the theory. What absolutely terrifies me is that the rehab programs are all about the operators and very little about the addicts.

-- Rebecca Wall

I agree that treatment is a better solution to the drug problem than the "war on drugs." But I don't think it's the main solution either. Only legalization will have the kind of major impact on our society that is needed to end the problem. Legalization will remove the profit motive from illegal distribution. That will make all the difference.

We should still have drug treatment available for those who want it for simple humanitarian reasons. For those whose drug problems lead to antisocial behavior that impacts others, the drug courts could be a good compromise between punishment and voluntary treatment (which is the ideal).

-- Fran

Maya Angelou reads from "The Heart of a Woman"