WASHINGTON — In the first of a series of recommendations for creating a national AIDS strategy, the chairman of the presidential AIDS commission Wednesday proposed a dramatic expansion of anti-drug abuse programs to provide treatment for addiction to all intravenous drug users who seek it.
Adm. James D. Watkins, saying that I.V. drug users pose "the greatest long-term potential for spreading the AIDS virus," called for a 10-year program, starting with an annual minimum of $2 billion in new funding, to establish a system of treatment on demand for them.
"The future course of the (AIDS) epidemic depends greatly on the effectiveness of our nation's ability to address I.V. drug abuse," he said.
Currently, because of overcrowding and inadequate funding of drug treatment programs, many intravenous drug addicts do not receive help in overcoming their habits. Sharing of contaminated needles is among the forms of transmission of the AIDS virus.
'New Money' Urged
Watkins urged that funding for the expanded effort, to be shared by federal, state and local governments, be "new money," not resources diverted from other programs.
"We've got to stop robbing Peter to pay Paul in this epidemic," he said during a breakfast meeting with reporters.
Watkins called also for:
--Increased AIDS education for health care providers, which he described as "crucial to fostering a sense of compassion and rationality among all our citizens."
--More funding for community-based health care services for AIDS patients.
--An acceleration in certain areas of basic research and drug development.
He dismissed expected criticism of the proposals, saying: "It really is not in our charter to worry about the political impact," and adding: "We waste a lot of rhetoric and time on a few issues while the forest behind us is burning."
Recommendations in the more controversial areas of AIDS education, testing, discrimination against infected individuals and health care financing are expected later this year and will be included in the commission's final report, due June 24.
These first proposals, which must be approved by the full commission, will come before commission members Monday and are expected to reach President Reagan by March 8. Watkins said "my sense is that this is a consensus-building document."
The proposals were praised Wednesday by commission members and others.
Commission member Dr. Beny J. Primm, executive director of the Addiction Research and Treatment Corp. in New York City and a specialist in drug abuse, who was chairman of the commission's hearings on drug use, called the recommendations "tremendous" and said members of the commission were solidly behind them.
Commission members consulted "experts from around the nation and other parts of the world" before formulating their recommendations, Primm said.
Commission member Kristine Gebbie, chief health officer for the state of Oregon, agreed that the proposals are "pretty solid."
Commission member Dr. William Walsh, chairman of Project Hope, said he had some questions about costs but that he would support the recommendations and agreed with Watkins that treatment of drug users was essential to curbing the epidemic.
"We're never going to get addicts to change their behavior or their sexual habits while they're still on I.V. drugs," Walsh said.
Waxman Praises Report
Rep. Henry A. Waxman (D-Los Angeles), chairman of the House Energy and Commerce subcommittee on health, called the report "a first-rate set of recommendations" that address the AIDS epidemic "responsibly and in detail."
"I hope that President Reagan will attend to these recommendations . . . and will amend his budget and come to the Congress to support them and the spending they require," Waxman said.
The Alcohol, Drug Abuse and Mental Health Administration has requested $474 million for all drug activities for fiscal 1989, including $127 million for research, $34 million for prevention programs and $313 million in grants to states, presumably for treatment clinics.
Specifically, Watkins called for an increase of 3,300 new drug abuse treatment facilities and 32,000 workers to enlarge the existing network of drug abuse clinics, with a special emphasis on the 24 cities with the highest number of intravenous drug abusers.
The National Institute on Drug Abuse has estimated that there are 1.3 million intravenous drug users and that, at any given time, only about 148,000 are in treatment.
"This has resulted in . . . long waiting lists for treatment, in some cases as long as six months," Watkins said.
"Anyone crying for help should get help on demand," he added.
In this country, AIDS has primarily afflicted homosexual and bisexual men, who make up more than 70% of the total cases. Public health officials have long felt that any substantial spread of AIDS into the heterosexual population probably would begin with members of the drug-using community and their sexual partners, who constitute most of the remaining cases.