Baltimore drug programs prove effect, study finds

Significant drops in crime and abuse

January 31, 2002|By Diana K. Sugg | Diana K. Sugg,SUN STAFF

An independent evaluation of Baltimore's drug programs shows significant drops in crime and drug abuse up to a year after addicts start treatment, findings that suggest the city is finally making headway against its seemingly intractable heroin and cocaine problem.

The study, to be released today, is the most rigorous review ever of the $52 million public drug-treatment system. Researchers tracked drug tests, arrest records and other data on almost 1,000 patients in 16 city programs for a year.

The findings mirrored what national studies have found: Drug treatment works. But as one of the few cities to ever do such an evaluation of itself, Baltimore now has its own data, evidence it can use to argue for more money from the state.

"It proves that treatment is a very, very solid investment and has an immediate effect. I can't think of anything else that makes this big of a difference for the community," said Dr. Peter L. Beilenson, city health commissioner. "We're quite confident now that we have built a very effective treatment system."

The study's findings were drastic and consistent. Within a month after entering treatment, use of alcohol, cocaine and heroin each fell by more than 60 percent. One year later, the classic point at which to look for relapse, the changes stayed: Heroin use dropped 69 percent, cocaine use dropped 48 percent, and criminal activity dropped by 64 percent. Also a year later, those in the study worked twice as many days a month and earned $200 more a month in legal income. And they reported far less risky behavior such as using needles to inject drugs.

"We're going to reach a critical point where you really start to have an effect citywide," said Dr. Robert Schwartz, one of the study's authors and an assistant professor at the University of Maryland School of Medicine. "We just have to stay the course and stick with it and be patient."

For Baltimoreans such as Barton Bell, who used heroin for more than 10 years, the treatment is a godsend. He routinely shoplifted from stores in Glen Burnie and Annapolis to get the $75 a day he needed for his habit. He wound up selling drugs himself and was almost killed. Police arrested him about 15 times.

Now, several months after going through a 28-day residential program at Tuerk House in West Baltimore, he is appreciating simple things, such as eating and bathing every day. And today he is applying for a warehouse job.

"I just want to have a nice, steady job, be responsible and be able to pay bills on time," said Bell, 34, who lives in Edmondson Village. "That's all I'm looking for, and it's coming, I know it's coming."

Baltimore Substance Abuse Systems, the quasi-governmental agency that oversees and funds programs such as Tuerk House, paid about $2.7 million over three years for Schwartz and researchers from the Johns Hopkins University and Morgan State University to do the study. The researchers looked at patients from 1998 to 1999, and they estimated that for every 1,000 additional people treated per year, the city avoids 164,000 days of heroin use, 45,600 days of cocaine use and $3.2 million in illegal income.

The work also pointed out some areas that need attention. The methadone clinics, for instance, generally did a better job of reducing drug use than clinics that offer counseling.

Schwartz credited the difference to the fact that patients getting methadone stay in treatment longer and suggested the other clinics find ways to keep patients engaged.

Also, researchers discovered that although the methadone patients initially reduced their alcohol use, a year after starting treatment they were drinking slightly more than before treatment.

The report is the first of several the scientists plan to produce based on the data they've collected. The studies will help guide the expansion of the city's drug treatment system.

Over the past few years, new state dollars have enabled Baltimore - which was plagued by long waiting lines for drug treatment - to boost its treatment capacity by 15 percent.

If the city gets an additional $9 million expected in the next state budget, health officials expect to add 12 percent capacity, for a total of 8,400 slots. Eventually, Beilenson wants to reach a point where people can be treated immediately.

City health officials have also been working to improve the system by adding support services such as mental health counseling and job and housing placement. Almost all the drug treatment centers offer child care.

But Baltimore's drug problem is huge. As many as 60,000 people in the city are addicted, most to heroin and cocaine, and roughly 80 percent of crime is related to drugs. With only a few small studies, state legislators and others have questioned how effective the city's drug treatment programs are.

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