IN-KIND AID COULD CUT DRUG DEATHS, STUDY SAYS

The number of deaths in the United States rises at the start of every month
and drops at the end, and addicts spending their first-of-the-month
government checks on drugs and drink probably account for most of the
difference, researchers say.

University of California-San Diego sociologist David Phillips and
colleagues reached that conclusion after analyzing nearly 32 million
electronic death certificates over 15 years. The study was published in
today's New England Journal of Medicine.

The researchers suggested that addicts get aid that can be used only for
food, clothes and shelter.

"You wouldn't do that for the country as a whole. But you could try it out
for a pilot project and see if it would make any difference," Phillips said.

Phillips found that, during an average year, there were 4,320 more deaths
in the first week of every month than in the last week of the preceding month.

That's about a 1 percent difference. But the gap widened when the
researchers looked at killings, suicides or accidents in which drugs or
drink played a part.

For every 100 such deaths at the end of a month, there were 106 or 107 at
the start. And the difference doubled, to about 14, when the death
certificates listed both drugs and alcohol as a cause.

There were 106.5 homicides at the start of the month for every 100 at the end.

The researchers also did a breakdown by race and found that during the
first week of the month vs. the last week, there were nearly 29 extra
homicides, suicides and accidents involving substance abuse among
minorities, compared with 10 extra such deaths among whites.

Welfare, Social Security and veterans benefit checks are sent out at the
start of the month.

The study "really highlights the extraordinary toll of substance abuse,"
said Lisa Najavits, a professor of psychology at Harvard Medical School.

Phillips got the idea for his study from a 1995 report on 105 schizophrenic
cocaine addicts treated at a Los Angeles veterans hospital. They were most
likely to test positive for cocaine, to have their worst psychiatric
symptoms and to need psychiatric hospitalization during the first week of
each month, and least likely during the last week.

Wondering if the findings apply to the general population, Phillips and his
colleagues looked at deaths from 1973 through 1988. (The electronic death
data provided by the National Center for Health Statistics after 1988
include only the month of death, not the date.)

Phillips said some people may object that giving addicts "in-kind" aid
rather than money is treating them like children.

"But for people who do have drug and alcohol habits, that person is not
making the decision himself how to use the money. His habit is making that
decision for him," he said. "Why should one feed his habit by giving him
extra money for it?"