HOSPITALS CAN HELP SOLVE DRUG PROBLEM

It's time to get serious and step up to the plate with the required
money and commitment to reduce the crisis that addiction in Maryland
causes.

The 100,000 addicts in Baltimore City and surrounding counties cost us in
many ways.

Addicts are responsible for 80 percent of our region's crime. Their
injuries -- inflicted on themselves and their victims -- drive up health
care costs, jam the courts and criminal justice system and disrupt the
lives of their families and our communities. Estimates of the cost of their
criminal behavior alone exceed $2.3 billion a year.

Yet it has been proved that addiction treatment programs are effective in
promptly reducing these fiscal and social costs. What will it take to get
the job done? Can local hospitals help?

First, we must acknowledge that addiction treatment is often not a cure,
just as treatments for cancer or asthma may not result in a cure. A 28-year
habit will not be solved in a 28-day drug program. For treatment to work,
we need a community commitment to tackle this problem head-on, with
compassion but without illusions that it will be easy or quick. And as we
pursue treatment, we should intensify our efforts at interdiction and
prevention education.

Second, we need a substantial and sustained funding mechanism. Addiction
treatment costs money, and counselors are woefully underpaid. Because each
dollar spent on addiction treatment saves $7 in taxpayers' costs, this
expenditure is a sound investment and deserves protection from political
whims and economic fluctuations.

If one-third of the total number of addicts in the Baltimore areaenter
programs, about $200 million a year will be needed. And we cananticipate
spending this annually for at least a decade. Severalfunding plans have
been proposed. One suggestion is an across-the-board fee on all insurance
carriers;another is an independent funding mechanism similar to that
usedfor Maryland Shock TraumaCenter. But whatever method is used, it must
be sufficient and ongoing.

Third, such a vast expenditure demands tight fiscal accountability.
Different types of programs work for different addicts. Some respond to
methadone, others need a faith-based approach; some need in-patient care,
some out-patient; some need job skills and others child care. Whatever
programs we fund must be held accountable and must have results. Studies
have shown that the key element for success is treatment on demand. The
addict must be able to immediately enter a program when the opportunity --
whether voluntary or coerced -- presents itself.

Lastly, we need to use one resource that has been overlooked in our
treatment approach: our community hospitals. These hospitals already take
care of every problem an addict might have except the addiction itself.

Community hospitals could provide treatment on demand. They are open 24
hours a day, are secure, safe -- often with a police presence -- and are
near public transportation. They have the range of personnel -- from
physicians and nurses to social workers -- to deal with the myriad physical
and mental challenges addicts present.

Fiscal systems of accountability are already in place at hospitals, as are
regulatory systems and quality-of-care review. Most hospitals have space
available, and putting addiction programs there would avoid the
"not-in-my-backyard" problems often faced by new drug treatment centers.

So why don't hospitals already treat addiction?

Very simply, because they are not reimbursed to do so, regardless of
whether the patient is insured. Therefore, let's add these hospitals to the
addiction care system and have them work in concert with the other programs
and community efforts that are available.

We've been paying the price of drug addiction for a long time: in wasted
lives, shattered families, the spread of AIDS and other diseases and the
constant impact of crime and violence on our streets.

It's time to get serious and step up to the plate with the required money
and commitment to reduce the crisis that addiction in Maryland causes.
Let's spell out the costs and demand results. We know how to get the job
done. The only question is whether we have the will to do so.