City successes on drug treatment are overlooked

July 05, 1999|By Peter L. Beilenson

ALTHOUGH The Sun's two-part editorial on drug treatment earlier this week was fraught with errors and serious misrepresentations, I was pleased to see two of the conclusions: Baltimore is on the right track in its efforts to get treatment to all who need it, and the organization created to oversee the publicly funded treatment system, Baltimore Substance Abuse Systems Inc. (BSAS), should remain.

No doubt, Baltimore has a serious substance abuse problem. Mayor Kurt L. Schmoke and I realize that we cannot arrest our way out of the drug problem. Although about 85 percent of all crimes committed in the city are drug-related, the vast majority are nonviolent offenses commited by individuals needing money to feed their habits. Continuing to stick these addicted individuals in prison without addressing their underlying health problems before they get into serious trouble makes no sense. Thus, we have long supported a philosophy of "medicalizing" the drug problem, which consists of three prongs: Implementing a system of treatment on request, which we define as intake into a treatment program within 24 hours of request by an addict.

Redirecting current resources from agencies whose work is seriously impacted by substance abuse to increase funding for treatment and prevention.

Initiating harm reduction programs, such as our very successful needle exchange program, to curb damage caused by individuals who can't or won't stop using at this time, to themselves, their partners, their babies and society.

Leading role downplayed

Although it was only given one sentence in the two editorials, Baltimore is leading the country in its approach to drug addiction. At a time when many other cities have cut treatment dollars, Mayor Schmoke and his administration have more than doubled treatment dollars in each of the past two years. Only San Francisco has made a similar effort. And Baltimore has achieved this increase, from $16 million to $33 million, almost solely with redirected city funds and funds from local foundations.

Because of the mayor's initiative, although we are not yet at "treatment on request," we have made tremendous strides. Two years ago, Baltimore only had 4,100 treatment slots which treated approximately 11,330 uninsured substance abusers. This year, with the infusion of redirected dollars from the city housing, social service, police and health departments, along with grants from the Open Society Institute, the Abell Foundation and the Weinberg Foundation, we have 8,100 treatment slots for between 22,000 and 24,000 uninsured individuals.

As the editorials noted, we estimate that we need an additional $30 million to $35 million to achieve our goal of true treatment on request. We will continue to work hard to increase the amount of resources available to provide treatment to all Baltimoreans in need of it.

Accentuate the negative

It is interesting to note how little attention was paid to the uniqueness of the entity we have created to manage and oversee Baltimore's treatment system. The Sun often criticizes the city for lacking creativity, yet here is an excellent example of governmental innovation that gets little credit. Instead of being stuck in bureaucracy, with slow movement of resources and personnel, the mayor and I thought that by using a quasi-public corporation to manage the treatment system, we would be able to respond much more quickly to the needs of Baltimore's addicted citizens.

In fact, that's what has happened for the past few years. Strong programs, which show good results, have been able to receive increased funding much more quickly through BSAS compared with the city system. Just as important, programs which have not performed appropriately have quickly lost funding.

The editorials have three main criticisms of BSAS and the treatment system it oversees:

The BSAS board structure.

The need for a central intake system.

The need to establish better performance standards.

I find it ironic that The Sun, which so favors inclusivity, criticizes BSAS's so-called "hand-picked" board. The members of the board were chosen to be broadly representative of the community and city and state decision-makers.

This means the board is large, with approximately 30 members. To cut the board by more than half would necessitate removing important voices from the decision-making process, making cooperation between criminal justice and health officials less likely.

On central intake

The question of a central intake for the city is controversial. Many feel that a central intake site for addicts creates a larger access problem than currently exists. Why? Because addicts will have to get to one central site or a few sites, often quite distant from their neighborhood. It makes much more sense to continue to increase treatment availability throughout the current system of 39 neighborhood-based programs.

Regarding the need for im- proved performance standards across all the programs, The Sun has a point.

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