When Calvin Gregory is not in jail, he makes the streets, parks, abandoned buildings and underground garages of downtown Baltimore his home. Drug pushers and liquor stores are his neighborhood pharmacist and hospital emergency rooms his family doctor.
As do an estimated 70 percent of Baltimore's homeless, the lanky 36-year-old abuses drugs and alcohol, injecting heroin and cocaine when he can get them and drinking whiskey and cheap wine when he can't.
"It makes me feel a lot better, but really it's not good for you," Mr. Gregory says of his drug abuse. "Drugs make you steal from your family and friends, lie to people, con people. I need a break. I've been doing it too long."
But treatment is scarce for those like Mr. Gregory who have no health insurance, and it is rarely effective for people living on the streets. Even a bed is often unavailable to homeless substance abusers. Homeless shelters often eject those who are drunk or high.
Now the Mayor's Office of Homeless Services is crafting a program to provide shelter for homeless addicts and alcoholics like Mr. Gregory. It could eventually include treatment.
The city plans to contract with a nonprofit agency to open a $175,000-a-year "wet shelter" as early as this fall. Homeless substance abusers could go there at any time of the day to sleep off their drunks or drug-induced highs.
"The shelter would provide a safe haven for those who may not have chosen the road to sobriety," says Joanne Selinske, director of the Mayor's Office of Homeless Services.
"There is an absolute need for it. About 2,000 people in Baltimore City are without a home. Many have addiction problems, and there is almost no access to treatment."
A site for the "wet shelter" has not been chosen, Ms. Selinske said. That decision will likely be the key to whether the project gains needed City Council approval.
"It would be ill-received in any residential community in Baltimore, unfortunately, particularly considering the nature of the shelter," said Councilman Anthony J. Ambridge, a 2nd District Democrat.
"It's a needed facility, no question about it, but it will be very difficult to locate. It's just like any other real estate -- location, location, location."
Plan is praised
Homeless advocates and treatment professionals hail the city's plan to open a "wet shelter" -- which has been in the talking stage for about two years -- but they say it should be expanded into a "sobriety station" that would offer treatment, too.
"I would guess that [$175,000] is enough money to have a place for people who are intoxicated to go and be out of the way of merchants and tourists downtown. That's helpful and important," says Jeff Singer, director of community relations for Health Care for the Homeless Inc. "But we're going to need more money to treat homeless people's addictions."
Mr. Singer says that city government and downtown businesses should come up with more funds to attain advocates' original goal of using the shelter as a gateway to addictions treatment for homeless people who have not prospered in traditional programs.
Because state and federal budget cuts have trimmed substance-abuse treatment, experts say, homeless alcoholics and addicts often get no care at all until they have a medical problem that is severe enough to take them to hospital emergency rooms.
Calvin Gregory says he has received emergency treatment for infections, swellings and a heroin overdose. "I owe hospitals so much money it's a shame," he says.
Bottom line cited
Dr. Pamela J. Fischer, an associate professor of psychiatry at the Johns Hopkins School of Medicine who has studied Baltimore's homeless, says it "costs a lot less to take care of people in a humane way rather than throwing them onto the streets and letting them get all their services from an emergency room."
"The bottom line, ethically speaking, is that no human being should be considered disposable," she said.
"It's unfair to deny people basic shelter when they most need it. This shouldn't be looked at as supporting people in an immoral lifestyle."
Since state budget cuts wiped out nonhospital detoxification programs in 1991, the Baltimore Rescue Mission on North Central Avenue has been the largest source of nonmedical detox in the city. More than 800 people went through withdrawal at the mission last year, some of them many times.
"It's a five-day, cold-turkey dry-out. We provide Christian counseling throughout that period," says Charles Buettner, who runs the huge mission.
"What you might call success stories are minimal. We're a stopgap. We're here to keep these people from dying on the streets."
Mr. Buettner, a recovering alcoholic, regards alcoholism and drug addiction as a sin and salvation through Christ as the only answer. He is skeptical that the city's "wet shelter" will be successful.
"If the city can get the funds, I'm not against them helping people, but without requiring a certain time of sobriety, you're not helping people at all," he said.