State budget cuts wound drug treatment efforts Many seeking help put on waiting lists

January 25, 1993|By Mike Klingaman | Mike Klingaman,Staff Writer

In sub-freezing cold, Doris, a 45-year-old heroin addict, waits in line for hours outside a drug-counseling center in Baltimore.

No luck. Not enough openings. She's told to go home and come back in a week. Doris weeps in frustration. "I've hit bottom and I'm tired. Tired of the streets. Tired of myself. And I can't get help," she says.

Like stabs from a blunt needle, state budget cuts caused by the recession have left serious wounds in Maryland's drug treatment efforts.

Since 1991, the substance-abuse budget, including federal funds, has decreased from $55.5 million to $50.8 million, closing some clinics and paring many others to the bone. And cuts in the state medical-insurance program for the poor also have hurt drug treatment.

At least 16 state-funded or hospital-based centers have closed, including:

* Three detoxification units in Baltimore, at Bon Secours Hospital, Liberty Medical Center and at Church Hospital.

* Seven long-term care clinics, totaling 292 beds, in the city and four counties: Anne Arundel, Carroll, Somerset and Worcester.

* Three halfway houses, a residential treatment center in Southern Maryland, and an adolescent group home in Montgomery County.

In addition, the state Division of Correction's drug-counseling program has been shut down.

Overall, the number of Marylanders getting help is expected to drop about 11 percent, from 55,000 in fiscal 1992 -- which ended last June 30 -- to an estimated 49,000 this fiscal year. State health officials believe that another 50,000 Marylanders would accept drug treatment if they could get it.

There now are about 140 state-funded centers and about 100 private ones.

"Don't assume the state is reluctant to step up to the plate to fund [drug-treatment] services," said Rick Sampson, director of the state's Alcohol and Drug Abuse Administration.

"Maryland has not been negligent in its responsibility," he said.

"We got in trouble because of the recession. Like many other states, we did not have the revenues to provide these services."

There are no further cuts planned through fiscal 1994, said Health Secretary Nelson J. Sabatini.

"We're not increasing the addiction budget, but we're not cutting it either," said Mr. Sabatini. "Maybe we've turned the corner."

But that doesn't help addicts like Doris, who needs help now.

About 4 a.m. Wednesday, she arrived outside the Addict Referral and Counseling Center, on West 25th Street in the city. The center opens at 8.

Doris was first in line. But drug treatment slots are scarce. The previous week she arrived at 5 a.m. and found a half-dozen addicts already there, shivering in the cold. Six people. Six slots.

Doris lost.

This time would be different, she thought. But after spending half the night on the cold marble steps, Doris was told to go home. Help was at least another long week off.

"I stay up all night to get into a program, and I'm turned down because there aren't enough slots," she said, fists clenched.

The problem hits Baltimore the hardest.

"We know we'll be treating fewer people," said Thomas Davis, head of the city's Substance Abuse Bureau. "We're drawing up plans to reduce staffs and operating expenses.

"Our whole alcohol and drug abuse program is in jeopardy. We're on the brink right now. Unfortunately, addicts don't have the advocates that other people do. They can be targeted without public outcry."

Half the city's 130 public detox beds have been lost, according to Jeff Singer, of Health Care for the Homeless. "This is devastating," said Mr. Singer. "The law says you have to be detoxed to get into long-term drug treatment, and now you can't get detoxed."

At Francis Scott Key Medical Center, the detox unit is besieged with applicants but must be restrictive and take only the sickest patients. "It's like a triage here," said Dr. Donald Jasinski, head of the hospital's Chemical Dependency Unit.

"There is no shortage of sick patients out there, only a shortage of money to treat them."

Drug counselors say that the treatment shortage will eventually put new burdens on the criminal-justice system.

"Most of our patients went back on the street," said Dr. Richard Craig, director of the X-Cell Treatment Center in Catonsville. X-Cell, a long-term inpatient program, lost all state funding, more than half its staff and 86 of its 100 clients.

On the day of reckoning, Dr. Craig recalled, "There was an almost universal cry of 'Don't turn me out.' " X-Cell had a waiting list of 400 people at the time.

Many drug abusers who don't get treatment "are ending up in the criminal-justice system, where they are going to be an even greater burden to taxpayers," said Kris Hathaway, director of the Baltimore Recovery Center.

An estimated 500 people are expected to pass through the center this year, about one-fourth the number who received treatment prior to the budget cuts. The sickest addicts, who require inpatient care, face a two-month wait for a bed.

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