HEROIN MAINTENANCE DENOUNCED BY OFFICIALS

Schmoke Pulls Back From Health Chief's Support For Study

A proposal for a research trial in which doctors would provide heroin to
some Baltimore addicts came under fierce attack yesterday from elected
officials as a symbolic step in the wrong direction.

"It doesn't make any sense," said Gov. Parris N. Glendening. "It sends
totally the wrong signal."

"Do we go from `Baltimore, the city that reads,' to `Baltimore, the city
that nods'?" asked City Council President Lawrence A. Bell III, using the
slang term for the sleepy euphoria of the heroin user.

Mayor Kurt L. Schmoke reined in his health commissioner, who had expressed
strong support for a trial of heroin maintenance, saying he wanted "to make
it real clear that this administration has no intention of initiating a
heroin maintenance program."

Dr. Peter L. Beilenson, the health commissioner, had not proposed
distributing heroin from city Health Department clinics or with city money,
but he had urged John Hopkins University drug abuse experts to pursue an
academic study. Schmoke said he does not want Beilenson to be "spokesman"
for the idea.

"Any further discussion about heroin maintenance and how it relates to the
city of Baltimore will come out of the university community and not the
local government," Schmoke said.

The mayor received national attention about 10 years ago for advocating
"decriminalization" of drug use, and he told The Sun in April he would
consider having Baltimore participate in a multicity heroin maintenance
experiment. But in that interview he also expressed concern that such a
program could prove so controversial as to be counterproductive, and
yesterday he appeared to reach that conclusion.

"We've gotten such good support from the public [for a health care approach
to drug abuse] that I don't want to lose that support because they feel
we've gone in a direction they are not comfortable with," he said.

But Dr. Alfred Sommer, dean of the Johns Hopkins School of Public Health,
said the criticism should not be permitted to stifle scientific inquiry.

"It's discouraging to hear people say they're absolutely against this
before they know anything about it," said Sommer. "That's not the way to
advance public policy or to find ways to protect public health."

Improved Health

Sommer cited data from a Swiss study that tracked more than 1,000 addicts
over three years. "What we've learned so far is that such programs can
dramatically improve the health of those addicted to heroin," as well as
reducing crime, increasing employment and moving some people into treatment
or off drugs altogether, he said.

Sommer said he wants Hopkins to help organize a conference to bring local
and state public health officials together with drug treatment specialists
and community leaders to discuss heroin maintenance.

"Does it make sense in Baltimore? I have no idea," Sommer said. "It's going
to take a lot of debate and discussion."

Drug abuse experts, including some from Baltimore, gathered in New York
over the weekend to hear about the Swiss experience with heroin maintenance
and plans for similar experiments in Spain and the Netherlands. Several
Hopkins drug abuse experts and Beilenson recently discussed joining with
other cities to try offering heroin to a limited number of the hardest-core
drug addicts who have not responded to treatment.

Advocates of the concept say the war on drugs has failed and new approaches
should be tried. Several hundred public figures, including Schmoke and
Beilenson, signed a letter in the New York Times Monday declaring that "the
global war on drugs is now causing more harm than drug abuse itself."

Reduced Crime

Drug policy reform advocates say heroin addicts now steal to support their
habits and spread AIDS by sharing needles. Administering injections of
heroin in clinics to people already addicted would at least reduce theft
and curb HIV transmission; it might lure otherwise unreachable drug abusers
into counseling that eventually could get them off drugs, the advocates say.

Baltimore City Councilman Norman A. Handy Sr., a minister from the
southwest 6th District, was one of the few public officials to express such
a view yesterday.

"If we don't do [heroin maintenance], some other city will do it," Handy
said. "And even if we don't do it, it should be discussed. Obviously, this
war on drugs is a failure, and we need to fire all the generals."

But many addiction experts say funding for traditional drug treatment falls
far short of the demand, and heroin maintenance is a dubious distraction
from proven remedies for drug abuse.

"Even as a research proposal, I think it's a bad idea," said Dr. Georges C.
Benjamin, the deputy state health secretary who oversees drug and alcohol
treatment. "I think to translate the Swiss data to this very different
culture is a very big jump."

While the number of heroin addicts in Baltimore -- more than 34,000,
according to state estimates -- dwarfs the number in suburban counties, the
discussion of heroin maintenance comes at a time when the drug has made
inroads into suburban and even rural high schools. Even pastoral Carroll
County has had a number of highly publicized overdose deaths.

Wrong Message

At such a time, some officials fear any program that makes heroin
available, however well-intentioned, could send a disastrous message to
curious teen-agers.

"It's much better to tell young people that heroin is bad," said Lt. Gov.
Kathleen Kennedy Townsend, who announced this week a plan to test juvenile
arrestees for drug use. "This undermines that whole effort."

The Rev. Melvin Baxter Tuggle II, president of Clergy United for the
Renewal of East Baltimore, blasted the heroin maintenance idea, saying,
"You don't fix the problem by giving the addicts drugs. It's genocide." He
said he also opposes giving addicts methadone, a substitute addictive
medication widely used to treat heroin addicts.

A chastened Beilenson yesterday said his daughter had heard a radio disc
jockey open a news report on the commissioner's support for heroin
maintenance by declaring: "Come get your heroin." He said he regretted that
some people incorrectly believed he was advocating a city-run program, but
he still supports academic research on heroin maintenance.

"We shouldn't close our eyes to any new initiative," Beilenson said. Citing
a study that found more than half of Baltimore African-American males
between the ages of 18 and 34 were involved in the criminal justice system,
he added: "The war on drugs has criminalized a whole segment of the
population. That's the great tragedy."