COST OF ADDICTION CARRIES HIDDEN TAX

City Doubles Spending On Treatment To Cut Price Paid By Public

If these men were not in this Hampden halfway house trying to escape the
shackles of drug addiction, they know just what they would be doing. They
did it for years.

Joe Green would be burgling homes along quiet cul-de-sacs in Baltimore
County. Todd Holland would be dipping in the till at his job as a waiter in
a downtown hotel. Kevin Herbert would be looting the Superfresh in
Cockeysville, stuffing his backpack with deodorant and batteries, then
slipping out the entrance to dodge the cashiers.

And Stanford Cooley, 33, would be taking neighbors' orders for food to
shoplift or visiting suburban department stores to ply the fine art of
reverse shopping. He'd retrieve receipts from trash cans, collect the items
on the receipts and "return" the goods for a refund. "You just have to be
careful to match up the code numbers on the price tags," he earnestly
explains.

But for now, the fierce daily struggle these men have waged to raise $50 or
$75 for heroin and cocaine is over.

Baltimore has embarked on an extraordinary experiment by more than doubling
spending on drug treatment, from about $15 million to $32 million a year.
Most of the new money was shifted from city housing, social services and
health programs; the rest was donated by the Open Society Institute of
financier George Soros and other private foundations.

"I've been in this field 20 years, and for 20 years we had to rob Peter to
pay Paul to buy toilet paper," says Ruth Daiker, director of The Counseling
Center, a treatment program that operates the Hampden halfwayhouse where
Cooley and the other addicts have found refuge. "Now all of a sudden we can
get tutoring, we can get housing, we can get medical care. I've never seen
so many people continue in treatment."

As fish cakes sizzle for lunch, the men sit around the Counseling Center's
rowhouse on Falls Road and offer firsthand testimony on what might be
called the drug tax. It is a hidden tax, collected without benefit of
bureaucrats or bills.

It is paid by the public in higher prices to cover addicts' frantic
thievery; to keep them locked in prison; to pay their medical bills when
they develop AIDS from sharing needles and take years to die. It is a
regional tax, afflicting suburbs where larceny is most lucrative as well as
the city where addiction is epidemic.

In Baltimore, where state officials estimate the number of illicit drug
users who need treatment at more than 50,000, or 1 in 10 adults, the tax is
colossal. Because stolen goods sell for a fraction of their value on the
street, an addict might steal $500 worth of goods in a day -- and break
$1,000 in car windows -- to support a $50 habit.

`Treatment On Demand'

The city's dramatic move to reduce the drug tax by moving toward "treatment
on demand" resulted from the conviction of Mayor Kurt L. Schmoke and the
city's top police, health and housing officials that narcotics are the root
of so much urban evil that it is worth cutting other programs to attack
addiction.

The treatment initiative comes 10 years after Schmoke's bombshell speech to
the U.S. Conference of Mayors advocating drug decriminalization. It
catapulted him onto network television -- and prompted predictions that he
would prove a one-term mayor.

Now in his third term, Schmoke has moderated his language, preferring the
less inflammatory "medicalization." But the country has moved slowly toward
his view that the drug war is a failure and that addiction is more
effectively and humanely treated as a disease than punished as a crime.

"There are more people from the law enforcement and military establishments
today who say publicly that we can't prosecute our way out of this
problem," Schmoke says. "Many were thinking that, even in 1988. Few would
say it out loud."

In 1988, Maryland's prison population was 12,952; by last year, it had
climbed to 21,928, largely as a result of the war on drugs. Yet there has
been no perceptible reduction in drug use and only a modest decline in
property crime.

Despite countless millions spent on drug interdiction, Baltimore teen-agers
routinely set themselves up in the cocaine business by connecting with a
wholesaler on any of a hundred New York corners. There is a such a heroin
glut that purity has climbed for years, making it popular to snort the drug
rather than inject it. In 1996, Baltimore had the highest rate of
drug-related emergency room visits of any city tracked by the federal Drug
Abuse Warning Network.

"Seven years ago, when I came here, I thought law enforcement and
incarceration were the answer to drug addiction," says LaMont W. Flanagan,
who runs the Baltimore City Detention Center as commissioner of pretrial
detention. "Now I believe that only complicates the problem. Criminality is
only the result of the addiction disease."

One In Three Arrests

Police Commissioner Thomas C. Frazier estimates that 85 percent of city
crime results from drug abuse, and he links 75 percent of shootings to the
drug trade. His department arrested 46 people a day for drugs last year,
accounting for nearly one in three arrests. But 74 percent of misdemeanor
charges are dropped by swamped prosecutors.

"We have overwhelmed the system," Frazier says. He rates availability of
drug treatment as the second most important factor, after effective police
work, in reducing the crime rate.

Disheartening statistics from the drug war have given greater credibility
to the pragmatic drug philosophy called "harm reduction," which rejects the
utopian theories of right and left alike. Draconian justice will never
scare everybody straight, this philosophy says, just as therapy and
education will never extinguish the desire to get high.

"Since Mesopotamian times, people have used mind-altering substances," says
Health Commissioner Dr. Peter L. Beilenson. "You can't eliminate that. But
you need to reduce the harm those people are causing to themselves, their
families and society."

With that goal in mind, Beilenson, who posed as an addict in 1996 to assess
the city's treatment system, oversees one of the biggest needle-exchange
programs in the country to reduce the transmission of HIV. While posing as
an addict, he found that people seeking treatment were deterred by a
befuddling tangle of rules; since then he has streamlined intake procedures
to reduce waiting times running as long as four months.

Now addicts who don't have the name of a program can call the widely
advertised number of Baltimore Substance Abuse Systems (BSAS), the
quasi-public agency overseeing publicly funded treatment.

Like hosts of some sad radio talk show, Sharon Morris and Scott Outen sit
in the second-floor office of BSAS on St. Paul Place and field calls.

There's Sandy from McCulloh Homes, a 36-year-old woman who snorts $60 in
heroin and $20 in cocaine a day. There's Joseph from East Baltimore,
severely depressed, shooting heroin for 19 of his 40 years. And so it goes,
from 8 to 4: 30 every weekday.

Matching Callers With Slots

Consulting brochures and computers, Morris and Outen match callers with
slots. Treatment may mean individual or group counseling; inpatient or
outpatient; drug-free or on methadone to quench the craving for heroin. It
often begins with hospitalization for "detox" -- medicated withdrawal; it
usually is backed by meetings of Narcotics Anonymous.

Since January, as the new money has begun to flow to programs, the average
wait for treatment has begun to edge downward. From about 17,000 people a
year in the mid-1990s, the system should be able to treat 26,000 in the
year starting July 1, offering many people longer and more intensive
treatment, says BSAS' executive director, Andrea M. Evans. The money is
flowing to established programs with state certification; about one-third
of the slots are reserved for methadone.

But demand for treatment is growing with supply, making "treatment on
demand" a receding goal. Addicts without the fortitude to endure a
monthlong wait will jump at a bed open tonight. In February, word spread of
space at Right Turn, a residential program in Owings Mills. The BSAS phones
rang off the hook, and the slots were quickly filled.

"It's just like one addict telling another about real strong dope on the
street," Outen says.

Sometimes an opening available immediately is a godsend. Morris tells of a
48-year-old woman who never dared try drugs until her children were raised.
Then she treated herself to a crack pipe and lost everything.

The woman called in February from a stranger's house, emaciated and
suicidal. Instead of suggesting that she call back in a month, Morris told
her to hop a bus immediately to Right Turn. She did so and is doing well
two months later.

"That call may have saved her life," Morris says.

Experts still debate who is more likely to succeed: a fed-up addict who
seeks treatment voluntarily, or one ordered into treatment by a judge.
Schmoke and Beilen-son favor the carrot; Frazier and Lt. Gov. Kathleen
Kennedy Townsend favor the court's stick.

But even drug experts who adamantly oppose drug decriminalization believe
that treatment pays off. Dr. Herbert D. Kleber of Columbia University's
Center on Addiction and Substance Abuse pronounces Schmoke's leanings
"misguided" but strongly endorses Baltimore's treatment expansion.

"We treat addicts not just because it's good for them, but because it's
good for us," says Kleber, a deputy drug czar under President George Bush.

Trying Again And Again

Few addicts achieve lifelong sobriety on their first try. Some use
treatment programs as a government-paid break from trigger-happy dealers
and hostile police.

Ask Bill Campbell, 43, who says he got a shot of morphine after he was
wounded in Vietnam in 1972 and liked it a little too much. He's been using
heroin, or in prison, or both, ever since.

His eyes grow distant as he tries to remember all his attempts to kick
heroin: City Hospitals,1981; Veterans Administration Hospital, 1982; City
Hospitals again in 1983; Sinai, 1985; Glenwood Life, 1992; Bayview, 1994;
Bayview, 1995

A year ago he overdosed in the woods off Washington Boulevard; his
girlfriend flagged down a train, and now he's been on methadone for a year,
back in Glenwood Life.

To be on methadone does not necessarily Treatment mean to be sober, he says.

Addicts "take the methadone to keep from getting sick, so they don't need
to chase that blast," Campbell says. "If they want to get high, they drink
or use cocaine." (He drinks, he says. But he says he has abandoned the
shoplifting sprees that supported his habit.)

Tracking Addiction

A review completed last year that tracked more than 10,000 drug abusers in
11 cities found that after a year on methadone, 28 percent of addicts were
using heroin again. The same study found that cocaine use was reduced 50
percent after a year of treatment.

Studies by David N. Nurco, a University of Maryland researcher who has
tracked addiction in Baltimore since the 1960s, found that addicts
committed crimes on 248 days a year when addicted, compared with 41 days a
year when in treatment.

Such results -- half of cocaine users relapsing and nearly a day of crime a
week committed by those in treatment -- do not exactly add up to
law-abiding sobriety. But by any realistic standard, harm-reduction
advocates say, the numbers represent success.

"If a baseball player hits .300, he's doing great," says Dr. Robert
Schwartz, director of the division of alcohol and drug abuse at the
University of Maryland.

Schwartz is one of six researchers from the University of Maryland, the
Johns Hopkins University and Morgan State University who are launching a
three-year study of 800 recovering addicts, 400 on methadone and 400
drug-free. The study will assess treatment success not just in terms of
drug use, but by tracking criminal activity, health, family status and
employment.

`More Time For Crime'

City officials consider employment a critical measure of success, because
addicts who complete treatment face what might be an even more daunting
challenge: getting a job without special skills, no steady work history and
with arrests instead of degrees.

"He may be a very good criminal, and he still needs to live," says Evans,
the BSAS director. "If he does not get help with training and employment,
he may just have more time for crime."

And addicts' crimes are endless, and endlessly creative. One 33-year-old
heroin user who held a job delivering seafood from a Jessup wholesaler to
supermarkets discovered he could short each delivery by three lobsters. At
day's end, he would deliver as many as 30 stolen lobsters to an
unscrupulous Joppa Road restaurateur.

"He'd take all the lobsters I could give him, at $3 apiece," says the man,
who asked not to be identified because he's due in court on a shoplifting
charge.

After months of earning as much as $500 a week from the lobster scam, he
says, he was finally caught when a suspicious grocery manager followed him
to his truck -- and discovered eight stolen lobsters that had escaped from
their box and were crawling around the truck bed.

Junkie Lore

Back at the Falls Road halfway house, Kevin Herbert and Todd Holland are
still comparing shoplifting notes. When one names a downtown drugstore,
they blurt out simultaneously that its security alarm never worked. They
laugh and shake their heads at the junkie lore they share.

Now it seems another life.

Herbert, 31, says he stole so much meat that West Baltimore neighbors would
see his 1995 Galant coming and say, "Here comes the meat man." That was
before the repo man came for the car, which was before he moved back in
with his parents and started stealing from them.

"I just got tired of living that way," Herbert says. Now, like the rest of
the men here, he's gaining confidence that his long romance with cocaine
and heroin is over for good.

Holland, 36, who says he first took drugs 25 years ago at age 11, says he
visited his grandmother recently and was proud to see his portrait returned
to the mantel with the rest of the family photos. It was a quiet sign that
he was being welcomed back after many years away.

"My niece told me, `Your grandmother's so proud of you,' " Holland says.
"It feels good."

For information on drug treatment in Baltimore, call Baltimore Substance
Abuse Systems at 410-637-1900.