Spike in city killings linked to drug famine

Sad fact: Baltimore leads the nation in heroin addiction even as the scarcity of drugs increases their prices - and violence.

November 11, 2001

ANTI-TERRORISM efforts may have steeled U.S. borders to the drug trade, slashing the availability of narcotics on American streets.

But Baltimore still leads the nation in heroin addiction. The result: a rash of killings as the scarcity of heroin and cocaine increases prices and heightens turf battles among rival dealers.

Street slayings kept on surging last week, threatening to reverse a yearlong decline in killings. Except for a few lethal domestic quarrels, the murders were "all about drugs; not about drug money, but drugs," says Health Commissioner Peter Beilenson.

There's a sliver of good news here: The drug shortage also cut fatal overdoses by more than half in October because addicts are trying to stretch out the scanty and expensive supplies on hand.

But overall, the message here is grim. Lack of supply on the streets is making the drug trade a bloodier scourge on the city. It highlights, once again, the need for public officials in Baltimore and Annapolis to confront this city's drug problems as a health crisis, not just a criminal one.

A sudden narcotics shortage sets off killing sprees in Baltimore because there are so many addicts here, and their treatment options are pitifully limited.

It is estimated that 55,000 city residents are addicted to heroin, cocaine or alcohol. If that is true, one out of eight adults has a substance dependency that has a dramatic negative economic impact on their hometown.

Reliable information about addicts is hard to come by in Baltimore or in any other city. But a recent study by two University of Maryland researchers provides important insight into the local problem.

In February and March, Eric D. Wish and George S. Yacoubian Jr. studied a random sample of 233 men and 120 women who had been detained at Baltimore Central Booking and Intake Center for more than 48 hours. They were quizzed and their urine was screened to detect recent use of 10 different drugs. Roughly 60 percent of the sample consisted of high school graduates; 20 percent were on probation when rearrested.

The upshot: Although only a third had been charged with drug offenses, 78 percent of the men and 72 percent of women had used heroin or cocaine. Many had used multiple drugs, including alcohol, and most heroin users also showed recent use of cocaine.

This finding suggests that Baltimore City's publicly financed drug treatment efforts, although better than in most U.S. cities, are totally inadequate. Treatment slots are too few; existing programs cannot handle people suffering from multiple addictions.

If the sample accurately reflects overall drug use, male heroin addiction in Baltimore is twice as bad as in New York, Philadelphia and Washington. Among women, it is 3.5 times as bad as in Philadelphia.

Other key findings:

Traces of marijuana were detected in 71 percent of men under 21, whereas only 2 percent showed recent heroin use and 5 percent registered positive for cocaine. Marijuana continues as part of addicts' drug cocktail as men get older, but by the time they reach 26, heroin and cocaine become the narcotics of choice.

Women typically skip marijuana as a gateway drug and start using heroin and cocaine in roughly the same proportions while still in their teens. Heroin use peaks in the 26-30 age group, but cocaine continues strong. Marijuana, however, never seems to become a major ingredient of women's drug cocktail.

Some drugs that have been previously associated with antisocial behavior were not detected at all. Chief among them was PCP.

Since World War II, Baltimore has enjoyed a reputation as a "nodding" - or heroin-using - town. Nevertheless, the drug's continued prevalence here is surprising, particularly in view of drastically lower heroin usage in the District of Columbia.

Indeed, Baltimore's steadily higher heroin rate suggests to some experts that law enforcement agencies have never properly understood the drug's distribution mechanism. If dealers were part of a big and powerful central organization, wouldn't that organization also be pushing harder in Washington, which is just 40 miles away?

The snapshot of Baltimore women addicts also is startling. "Women tend to be on harder drugs. I don't know why," Dr. Wish told the board of the Baltimore Substance Abuse Systems last week. However, it is possible that because women are not arrested as frequently or easily as men, the snapshot depicts women who lead harsher lives.

Along with San Francisco, Baltimore leads the nation in combating addiction in publicly financed treatment programs. But the emphasis is on outpatient treatment and counseling, which are inadequate to deal with the complexities of multiple addictions.

Worse, neither the Central Booking and Intake Center nor the Maryland Penitentiary provides any drug treatment at all, except for a token program that uses acupuncture. Yet a high percentage of inmates and pretrial detainees have a dependency on one or more drugs.

This is scandalous. No wonder drug trafficking is such a problem in penal institutions.

Like the rest of the nation, Maryland is grappling with awesome budget problems. Nevertheless, it should set up a program that would provide effective drug treatment in jails and continue it once the inmates are freed.

Ignoring the huge addiction problem behind bars is indefensible. It's inhuman. It doesn't even make economic sense, because untreated addicts are likely to commit more crimes to satisfy their craving.

In the end, effective treatment would be cheaper to taxpayers than endless rearrests, retrials and re-jailings of addicted criminals. That's particularly true if, as the study suggests, male arrestees typically graduate to heroin and cocaine after they reach 26.

Before they reach that age, early intervention could still save them. The city and state have to try, because the alternative is unacceptable: watching the bodies pile up as Baltimore's drug trade becomes more lethal.

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