Drug Addicts

Victor Capoccia says he got into the drug treatment arena "sideways." Recently named director of a drug addiction program of the Baltimore-based Open Society Institute, Capoccia was teaching planning and community organizing at Boston College's school of social work when he got involved in health planning programs for the Boston area in 1979. That work took him to the Boston Department of Health and Hospitals, working on HIV and AIDS programs, which eventually led to running a community-based drug and alcohol treatment program.

Most of the drug dealers I've met are drug addicts. They would not fit the TV version of a drug dealer: Bling-bling king, all smooth from drinking Remy and smoking weed, cruising the `hood in a shiny black Navigator, scooping up cash as he goes. The ones I've met do not own or lease motor vehicles; many of them live with their mothers. They sell drugs of the same variety they use. They do not make much money, and some of them wind up dead because they may have snorted dope they were supposed to sell or failed to pay their debts.

You might think reaching for that cup of coffee or cigarette is a simple decision. But scientists believe the way we act to satisfy cravings involves a little-understood automated response - one we have no control over - and researchers in Baltimore are using brain scans to unlock its secrets. "If there's an automated component to craving, we really want to understand how it works," says Elliot Stein, director of the neuroimaging lab at the Bayview campus of the National Institute on Drug Abuse in East Baltimore.

Mayor Sheila Dixon is using academic research to support the city's request for expanded drug treatment, including $5 million in Gov. Martin O'Malley's proposed budget to improve access to buprenorphine, a prescription drug that requires less monitoring than methadone and also weans addicts off heroin. Quoting research by the University of Maryland, Baltimore County that Medicaid patients receiving drug treatment were "four times less likely" to be hospitalized than those without treatment, Dixon is urging legislators to back the governor's budget and legislation that would increase the state's cigarette tax by $1 a pack, revenue that could provide treatment for an additional 7,000 city residents annually.

Hoping to make a revolutionary treatment more available for heroin users, Baltimore officials are taking the unusual step of subsidizing a training program that could more than double the number of physicians permitted to prescribe a new medication to cure opiate addiction. Buprenorphine, commonly referred to as "bupe," is being used in place of methadone to wean addicts off heroin because it can be taken at home, is less prone to abuse and is easier to discontinue when the patient is ready.

Icalled the other day for an expanded attack on the drug addiction that fuels the drug trade that fuels the violence that fuels the decline - or at least delays the progress - of the quality of life in Baltimore. It's a burden on the entire metropolitan area, on the whole state. Drug addiction has been placed at the root of 80 percent of crime. It's the reason our prisons are filled. It's why we have neighborhood crime patrols, why our courts are crazy-busy. In many cases, drug addiction is at the root of family dysfunction, and family dysfunction - compounded by poverty, ignorance, unemployment - is at the root of the cycle of failure of children and schools.

Alittle more attention must be paid: Keith Harrison, The Sun's Police Officer of the Year for excellence in community service, has been deeply engaged in the effort to get drug dealers and drug addicts out of that miserable game. We kind of missed the story the other day when we reported on Harrison's selection from among dozens of nominees across Maryland. He's done more than "set up an office where citizens can talk privately to officers about their lives." Like street-corner missionaries, Harrison and his colleagues from the Baltimore Police Department's Get Out of the Game unit have been encouraging hard-core drug offenders to change their lives.

Mary Ann Saar, Maryland's public safety secretary, said it again last week at a breakfast honoring both ex-offenders who find their way into the mainstream working world and the companies that have the guts to hire them: "This is not a liberal issue. This is not a conservative issue. This is not a Republican issue. It is not a Democratic issue. This is a common-sense issue that will serve all of us." The issue is corrections reform: putting corrections back into corrections after decades of mindlessly warehousing criminals - particularly, nonviolent offenders and drug addicts - at great expense.

Just so you know, before I take you into the thorny stuff: I've heard from dozens of people - city and suburban families of longtime drug addicts - who say things are better now. Their sons, husbands, brothers, daughters, wives, girlfriends, sisters are clean, staying out of trouble and away from their old junkie friends, working and taking care of their children. There are a lot of stories like that. Between 23,000 and 25,000 men and women received publicly funded treatment in this heroin-infested city in each of the last three years.