AN OPTIMIST could take heart in signs that Baltimore's huge drug problem might just be on the decline. The numbers of fatal overdoses and emergency room visits are trending downward, drug treatment has expanded in the past decade, and surveys suggest there might be a generational shift away from hard drugs.
But it is impossible to seriously assess the course of the city's struggle with drugs. And because of that, the city is stuck with a number that has hung around its neck for two decades: 60,000 addicts.
That number has been invoked, over and over by countless media and government officials, as shocking shorthand for the city's many ills. It has prevailed, like a broken gauge on a gas tank, through four mayors, a large drop in the city's overall population and major changes in the narcotics trade.
In truth, the number is almost certainly wrong. It was, at best, a hit-or-miss guess to begin with.
The 60,000 estimate has been built on hazy projections and on misinterpretations of researchers' findings, a review of its sources shows. Those who produced it acknowledge its shakiness and say they're uneasy about the way the number is bandied about. Without a prohibitively costly survey, they say, there's no reliable way of keeping score in the fight against addiction.
Yet the figure has been repeated often by the national media, this newspaper, and boosters and critics of the city. The city's Baltimore Believe Web site proclaims: "The epidemic of illegal drugs has turned 60,000 city residents into addicts enslaved by chemical substances." Last month, The New York Times stated that "almost one in 10 people" in the city is addicted to drugs.
The number has at times been used to benefit Baltimore. Public officials and other advocates have wielded the figure to dramatize the city's problems in bids to obtain treatment funding or win approval for initiatives such as needle exchanges.
At the same time, use of the 60,000 figure has helped to propagate a perception of the city as an urban wasteland beyond repair, thereby demoralizing residents and potential visitors, businesses or homebuyers. "You can't help but have a gray cast over things when you're constantly getting inundated with [the number]," said Tracy Gosson, director of the Live Baltimore Home Center, an organization that promotes city living. "It's very damaging."
Questions about the estimate's validity have further implication. In the absence of more solid data, one expert says, the city will need to battle its drug problem without being able to know for sure to what degree it is succeeding.
"We know it's a huge problem. The precise number will never be known and does not need to be known," said Eric D. Wish, director of the Center for Substance Abuse Research (CESAR) at the University of Maryland, College Park, which has produced some of the estimates. "What's important is that the problem is overwhelming the resources that are available."
There is no doubt that Baltimore continues to be awash in illegal drugs and debilitated by the narcotics trade to a greater degree than almost any other large American city. There were 278 homicides last year, the vast majority of them drug-related, according to police, and 261 fatal drug overdoses. There are lengthy waiting lists for drug treatment, a sign that whatever the number of addicts, there are more than the city can help.
But researchers trying to quantify the addict population have few reliable guideposts. For instance, the numbers of people arrested for possessing drugs are heavily influenced by how aggressive policing is, and the number of those overdosing is driven partly by drug purity.
There's also the challenge of defining what is meant by an "addict." Is a former heroin user on methadone an addict? Is someone who uses cocaine every few weeks addicted?
"It's just a nightmare to try to really do those estimates," said William T. Rusinko, director of research for the state Alcohol and Drug Abuse Administration, which has made some of the projections to help guide state treatment funding. "My approach is to downplay those estimates, but then again it's always something people like to look at, that they want to know."
First citation in 1986
As near as researchers in the field can tell, the 60,000 estimate first appeared in 1986, in a study done for the state by an outside researcher. The study said there were 60,700 people in the city who were "dysfunctional" because of illicit drug use, including 29,065 whose main problem was heroin and 20,484 whose main problem was cocaine.
Within five years, the number had gained public currency: in 1991, a Sun columnist referred to the city as "home to 60,000 drug addicts," the first of many mentions of the figure in the paper.