The City's $30 Million Drug Habit

SARA ENGRAM

November 07, 1993|By SARA ENGRAM

Firm statistics about illegal drug use are hard to come by. Even so, there are some alarming signs that substance abuse in Baltimore is escalating dangerously.

Here's one red flag: In a study of 21 major cities, the Drug Abuse Warning Network reports that from 1990 to 1991, the number of hospital emergency visits in which heroin was a factor increased by 134 percent in Baltimore, while the national average rose a mere 8 percent. Nationally, the number of times patients mentioned cocaine as a factor in emergency room visits rose 28 percent, compared to 121 percent in Baltimore.

As of the third quarter of 1992, Baltimore had more cases in which heroin, cocaine and alcohol in combination with other drugs were factors in emergency-room visits than any other city in the country.

A recent report from the Abell Foundation cited those and other statistics and chided Mayor Schmoke for using so little of the city's own money for treatment of drug abuse. In fiscal year 1993, the Schmoke administration spent only about $150,000 of its own money for treatment programs -- a mere 1 percent of the public dollars spent on treatment efforts in Baltimore and 25 percent less than the previous year.

At a time when the demand for drug treatment is rising -- along with the social and financial costs of substance abuse -- the city's capacity to offer help has eroded.

Mayor Schmoke has now reversed that decline, announcing two weeks ago that an additional $250,000 in city funds will be made available to fund 100 more treatment slots next year. That should cover the expected increase in requests for treatment once the city gets permission from the General Assembly to undertake a pilot needle-exchange program.

Thus the mayor has trebled the city's commitment of its own funds to drug-treatment. But that's hardly a drop in the bucket. The hard truth is that the city will never be able to meet more than a small fraction of the demand for treatment with its own resources. Moreover, the Schmoke administration has shown surprisingly little willingness to fight the battles necessary to shift money from other needs to help politically unappealing drug addicts.

Now the mayor has before him some far-reaching suggestions from a task force on combatting drug abuse. Recommendations include supporting the proposed needle- exchange program for intravenous drug abusers as well as training health-care workers in recognizing and dealing with drug abuse. But the major emphasis is on increasing drug treatment. Without that, nothing else will make much difference.

To meet the need for adequate treatment and prevention programs in the city would take $30 million a year -- an amount far beyond the city's resources, and even beyond any reasonable expectation of largess from Annapolis.

The most realistic hope for fully meeting Baltimore's needs for drug treatment and prevention lies in Washington. City officials are preparing to propose a bold idea to the federal government, one that fits well with the Clinton administration's desire to encourage more innovative collaborations between government agencies.

Drug abuse has a direct and documented effect on law-enforcement activities. It also has a dramatic effect on families and neighborhoods. So, the Schmoke administration reasons, providing adequate treatment and prevention programs for a drug-soaked city would be a natural way to bring together the Justice and Health and Human Services departments to demonstrate how cities can address drug abuse.

As the Abell report put it, the drug problem is costing us too much not to spend more on it. The costs come not just in the fearsome toll in crime and violence -- more than 50 percent of the city's homicides are drug-related -- but also in the risk to public health. Baltimore has an estimated 35,000 intravenous drug users, along with an undetermined number of addicts who smoke or snort drugs. Between 10,000 and 13,000 of the city's intravenous drug users carry the AIDS virus. Through shared needles, sexual contact or childbirth they are spreading the virus to other people every day.

Drug treatment doesn't ''cure'' every addict for all time. But it demonstrably reduces drug abuse as well as the crime and social decay it produces. These programs repay their cost many times over.

In Mayor Schmoke, the city has one of the few elected officials in the country willing to raise hard questions about the country's ineffective war on drugs. If, at long last, he is able to put in place even a few of his ambitious plans, he still has the chance to turn thought-provoking rhetoric into the reality of a safer, healthier, more livable city.

Sara Engram is editorial-page director of The Evening Sun.

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