The just-concluded UN conference on drug control was filled with resounding pledges of cooperation and determination offered with the best of intentions. Drug users seeking treatment however are more likely to hear words of rejection from underfunded programs. PNS commentator Lonny Shavelson is a physician and writer based in Berkeley, California and author of "A Chosen Death."

SAN FRANCISCO -- With 150 world leaders plotting to fight the scourge of drugs at the United Nations last week, even a cynic might hope for some substantial result.

President Clinton is hopeful, telling the gathering, "With determined and relentless effort, we can turn the tide." And UN Secretary General Kofi Annan assured delegates that historians will see this as a turning point in the history of drug control.

The "new vision," says Annan, is driven by 52 million users of illegal drugs.

Darlene James is one of those 52 million. She lives in a cave alongside a freeway in San Francisco. A few weeks back, while UN leaders were planning their meeting, James was deciding she would not let her boyfriend inject "speed" into a vein in her neck. 

"Methamphetamine's making me crazy," she says. "I need to stop." But that same week James was rejected for treatment for the fourth time -- this time because she did not have the appropriate paperwork.

James first walked into a drug-rehab center more than six months ago and asked for help. But, although San Francisco has a policy of "treatment on demand" -- within 48 hours of an addict's decision to quit -- she has yet to be accepted into a program.

James's story is not unusual. Most addicts seeking rehab wait weeks or months. Michael Pagsolingan overdosed on heroin after waiting eight weeks to get into a program. Cost of emergency treatment for an overdose -- $1,450. Cost of one day in treatment -- $55.

At the United Nations, President Clinton proclaimed that the United States would spend $17 billion to combat the drug scourge. Yet only 35 percent of those funds will be directed at treatment of addicts -- "demand reduction." The rest will go to controlling the flow of drugs.

These priorities seem wrongheaded, given the findings of a study sponsored by the U.S. Office of National Drug Control Policy. The study shows that one dollar spent on treatment decreases drug use as much as $7 spent on domestic law enforcement, $11 on confiscating drugs at the border, and $23 to stop drugs at their country of origin.

Funding in San Francisco's Treatment on Demand program is at 40 percent of needs. In Baltimore, there are 5,700 treatment slots for 60,000 addicts. In New York City, 60 percent of paroled drug abusers who don't get into treatment are back in jail within months, but new treatment programs are still awaiting funding.

In the country as a whole, an estimated 4 to 6 million addicts who need treatment are not receiving any.

"We are determined to build a drug-free America," President Clinton told the UN special assembly, "and to join with others to combat drugs around the world." He spoke of a "virtual university" where anyone with access to a computer and modem could share knowledge and experience about substance abuse.

Darlene James, in her cave by the freeway, with no modem or computer, remains trapped in a chemical and bureaucratic nightmare. After being turned down four times, she beds down in her wet sleeping bag, and says she is trying to keep from asking her boyfriend to inject her.

"These programs keep running me in littler and littler circles," she says.

James did not think  this week marked the beginning of a new war against drugs.