Million initiative will expand hours and services at three city recovery programs, creating havens for drug addicts waiting for treatment

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Helping Those On Threshold


For hundreds of drug addicts in Baltimore, the experience is the same: After years of procrastinating, they finally make the move to get into treatment, only to be told there's no room and to be put on a waiting list. For too many, the rebuff becomes an excuse to keep using, and the window of opportunity is lost.

An unconventional $1 million initiative, overseen by the city but funded by private foundations, is now seeking to close that gap -- not by expanding the availability of treatment, but by creating a place for addicts to go while they're waiting for a slot.

Under the three-year initiative, dubbed Threshold to Recovery and scheduled to formally begin today with a ceremony attended by the mayor, three existing programs for recovering addicts will expand their hours and services to become official havens for drug users who haven't yet gotten into treatment. Addicts will be able to visit the programs -- two on the west side, one on the east -- to attend 12-step meetings, receive acupuncture or take tai chi, or simply have a cup of coffee in supportive surroundings out of the reach of their dealer or fellow users.

The hope, say the initiatives' proponents, is that welcoming addicts into the programs will serve to draw them into the treatment system before there is a methadone, inpatient or outpatient counseling slot available.

"They've made a first step to come and seek help, and just because we don't have a slot, we don't want to send them out into the community without a resource," said Adam Brickner, the president of Baltimore Substance Abuse Systems, the quasi-governmental agency that oversees treatment in the city. "This way we can engage them in the concept of changing their behavior."

The initiative raises an obvious question: Why not simply devote the additional funding to creating new treatment slots? The city estimates that Baltimore's 75 or so publicly funded treatment programs treat about 20,000 people per year with a budget of $52 million, but many programs, particularly those offering methadone and inpatient beds, have months-long waiting lists.

The initiative's funders and other proponents say they decided it was more cost-effective to use the $1 million to offer services short of full treatment to hundreds of addicts, rather than using them to create a smaller number of regular slots. They estimate that the initiative will draw about 1,500 users per year to the three sites.

What's more, they hope the initiative will serve some addicts who simply aren't prepared to go into treatment, whether or not a slot is open to them, either because they're not ready to quit drugs yet or because they're wary of the treatment system. Often, addicts go into treatment before they've made a commitment to getting clean, and when they then relapse, they wind up feeling like even more of a failure -- while having taken up a scarce treatment slot.

"This is a bridge for people terrified to go near the system so they can slowly build up their trust before they go in," said Bob Duggan, the president of the Tai Sophia Institute in Laurel, which oversees one of the three participating agencies, Penn North. "If they go in on a whim, they get more failure. You can't do it on a whim, you have to build up to it."

Karen Kreisberg, director of the Zanvyl and Isabelle Krieger Foundation, said the initiative's appeal to funders was that it could reach an entirely new group of addicts in the city. Krieger is one of several local foundations that are together matching a $500,000 gift from the Robert Wood Johnson Foundation to pay for the initiative.

"The funders realize we're not touching enough folks in the city," Kreisberg said. "This so critical for those folks who don't want to give their Social Security number, who want to remain anonymous." Penn North, in the 2400 block of Pennsylvania Ave., focuses on offering acupuncture, tai chi and meditation, which help addicts by getting them to "take responsibility for their whole health and well-being," said the program's on-site director, Al Duha. The extra funding will allow it to expand its hours into the early evening and hire an additional worker to offer guidance to addicts, Duggan said.

A second program, Dee's Place, specializes in late-night 12-step meetings, holding them continuously from 9 p.m. to 9 a.m. in the 2200 block of Jefferson St. Its director, Dee Sparks, said the added funding could help expand the meetings to around the clock.

Services at the third agency, Recovery in Community, in the 100 block of N. Monroe St., include 12-step meetings, acupuncture, and HIV counseling. It will also extend its hours into the early evening.

Those overseeing the initiative acknowledge there could be occasional complications with addicts coming in off the street mixing with those already using the programs, who tend to be recovering addicts engaged in treatment. The general policy will be to welcome addicts as long they're not using drugs on the premises or being disruptive.

The key, the initiative's proponents say, is that addicts feel they can come to the three sites without having to sign up, wait in line or meet any other guidelines.

"You can just walk in, you don't need to meet any criteria," said Rebecca Ruggles, the director of special projects for the Mid-Atlantic Association of Community Health Centers and a consultant on the initiative. "If you need to talk to someone, great. If you need to sit in a quiet room and listen to music and calm yourself, great. It's a welcoming environment that has a big, wide-open door."

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