DRUG ABUSE TAKES ITS TOLL ON DETROIT

Dr. Calvin Trent, who directs Detroit's Bureau of Substance Abuse, revealed
this week that drugs are a severe problem in the city. Stopping the scourge
will test Detroit's will and resources.

The bureau serves people without health insurance, the underinsured or
those who have Medicaid, the government's health insurance program for the
poor. Dr. Trent says about half of Detroiters would be eligible for his
agency's drug treatment services. Fortunately, most don't need them.

But he estimates that 120,000 Detroiters, about 14 percent of the
population, need drug treatment. About half of this number would be
classified as poor, but some may not be in a program. The remainder is
assumed to have private health coverage and to being treated elsewhere.

Detroit is unique in that it is one of the few cities in Michigan offering
"treatment on demand."

"But even if we could identify and bring everybody into treatment who needs
it," he told me, "we don't have sufficient funding to pay for their
treatment. Our funding has been flat for years."

The agency receives $28 million annually. And it's still not enough to meet
demand.

Funding problems, of course, exacerbate the social consequences of drug
abuse. Dr. Trent noted that up to 70 percent of criminal arrests in Detroit
are drug-connected. A like amount of child neglect and abuse cases are
related to substance abuse. Forty percent of AIDS cases result from
intravenous drug use. And the longer an addict goes untreated, the worse
the prognosis for recovery.

Dr. Mary F. Bridges has been in the psychiatric and substance abuse field
diagnosing and counseling patients since 1982. She has seen firsthand how
"drug addiction -- mainly heroin and crack cocaine -- is capable of
transforming a perfectly good human being into one of the most
self-destructive creatures one could imagine."

It starts with denial, making excuses and blaming something or someone else
for the drug use, Dr. Bridges says. One addict told her he used drugs
because there were too many stop lights. So insidious is the addiction that
it takes on a life of its own. "One drug-addicted person could destroy an
entire neighborhood," she says.

"The deterioration begins when someone ceases to be a functioning
individual and family member," Dr. Bridges says. She gave an addict a
hypothetical choice of having the woman of his dreams for a sexual
relationship or an "eight ball" (a large ball of cocaine priced in excess
of $300). "He didn't hesitate in choosing the eight ball," she says.
Perverted sex acts involving children, the selling of children for sex in
exchange for drugs and self-prostitution, she says, are common.

Drug abuse is also causing the AIDS virus to proliferate at an alarming
rate among addicts who share needles and have sexual contact with
nonaddicts. Detroit is reported to be second only to New York City in
intravenous drug use.

The money required to support even a $100-a-day habit is likely to come
from illegitimate sources. Addicts tend to resort to criminal and
underground activities.

Bridges stresses that social agencies must be reinvented to better identify
at-risk children.

"Even though we already have a large foster care population," she says, "we
have to become more serious about removing children from dysfunctional
homes where parents have been identified as addicts and their children are
at potential risk for all types of abuse."

To give them a fighting chance to make a life for themselves, the
psychiatrist says "these children may have to be placed in something that
resembles an orphanage."

Despite its destructive path, drug abuse is rarely on the public policy
radar screen. City officials need to focus more on the problem if Detroit
is to become a safer place to live and raise children.