342,000 LABELED HARDCORE DRUGS USERS

By Naftali Bendavid (Chicago Tribune)

Washington Bureau

WASHINGTONThe number of hardcore cocaine and heroin users in Cook County
is three times higher than previous estimates, according to an unreleased
study by President Clinton's drug czar.

The finding appears to confirm what many experts have long believed, that
traditional methods substantially undercount hardcore addicts. The
undercount, if it is found elsewhere in the country, could affect how
resources are allocated to fight drug abuse.

As many as 333,000 Cook County residents are hardcore users of crack,
powder cocaine, or heroin, according to the indepth study, which is
scheduled for release next year but was obtained by the Tribune.

In contrast, a recent, more traditional federal survey showed only 117,000
users of illegal drugs other than marijuana in Cook County, and that
included casual as well as hardcore users.

The number of hardcore drug users across the country usually is estimated
at 2 million. The new study raises the possibility that the estimate is
significantly low.

Peter Reuter, a drug expert who teaches at the University of Maryland, said
the new Cook County figures are ``troublingly high.''

``If the number of serious heroin and cocaine users is so much larger than
we thought, then the size of the markets and the revenues generated are
likely to be as well,'' he said. ``There are more people out there
committing crimes related to drug use, and not in treatment, than had
previously been expected.''

The study was conducted for the Office of National Drug Control Policy,
often called the drug czar's office, by Abt Associates Inc., a respected
research firm in Cambridge, Mass.

Mayor Richard Daley was notified of the study's results in September. The
findings bolster Daley's frequent assertion that the federal government
needs to do more to help cities fight crime, his aides said.

``They chose Chicago to demonstrate the breadth of the problem,'' said Tom
Needham, assistant to the mayor. ``This would be a great place to start
with more drug treatment and more resources for the schools.''

The findings also could influence the debate over whether to concentrate
treatment resources on hardcore addicts or more casual users.

``The findings are probably closer to the real picture than what is
normally recorded,'' said Joseph Califano, a former U.S. health secretary
who now heads the Center on Alcoholism and Substance Abuse in New York City.

``If these numbers are true, we have to look at providing a lot more
treatment to hardcore drug users than is currently available,'' Califano
said.

The Office of National Drug Control Policy, which coordinates the nation's
drugfighting efforts, declined comment on the study.

The study does not suggest that hardcore drug use has gone up, only that
it is more widespread than many thought. That in itself causes
consternation among drug experts.

The Chicago study was designed to address a longtime problem: Because the
most serious drug abusers often live on the fringes of society, the usual
ways of tracking them may be inadequate.

Studies of drug use, such as an annual survey conducted by the Health and
Human Services Department, generally rely on phone calls or household
visits. That is the least expensive approach.

It is also a flawed one, many believe. A high percentage of hardcore
addicts are largely inaccessiblesleeping on the streets, residing in
homeless shelters, living in flophouses, staying with friends.

To get a more accurate count, the drug office decided several years ago to
conduct an indepth examination of one specific metropolitan area. Cook
County was chosen because of its diverse population, including Chicago's
gritty urban neighborhoods and an array of suburbs.

>From March to November of 1995, researchers fanned out to the Cook County
Jail, homeless shelters and drugtreatment centers.

By extrapolating those findings to the entire county, the researchers
concluded that the number of hardcore cocaine and heroin users is not
117,000, but ranges from 318,000 to 333,000. Hardcore users are defined as
those who have used drugs on eight or more days during at least one of the
preceding two months.

The new estimate ``is much higher than conventional surveys would
suggest,'' the study says. ``But it is certainly not implausible.''

The new findings do not necessarily mean the number of hardcore users is
three times higher nationwide than previously thought. It is not known just
how typical Chicago is in this regard.

``The results of this feasibility study cannot be extrapolated to the
nation,'' the report cautions. ``The next steps will be to apply the
approach to an entire region of the country and then, assuming that results
are favorable, to the nation.''

Still, there is no reason to believe that other urban areas have been
undercounted any less than Cook County. Indeed, that is why it was selected.

``Probably in any area of the United States that they conducted a study of
this sort, they would find that the number is greater than anyone had
expected,'' said Daley spokeswoman Jacquelyn Heard. ``So I don't think that
Chicago or Cook County is in any way unusual in that respect.''

One of the study's most striking figures relates to the AfricanAmerican
population. The report finds that about 240,000 Cook County blacks are
hard core drug users. That is between onefifth and onesixth of the
county's 1.3 million AfricanAmericans.

In addition to refocusing attention on the drug problem, these findings
could affect the nation's drug policy debate.

Some drug experts, for example, have long favored targeting hardcore
users. Severe addicts are responsible for much of the drug trade and the
attendant crime, the thinking goes, so it makes sense to focus on them.

Others respond that hardcore users are the hardest to treat, and it is
much more efficient to target casual users. These lesser abusers tend to be
more affluent, better educated and more responsive to antidrug ads.

If the hardcore faction is much bigger than previously estimated, that may
lend force to the argument for spending more on that part of the population.

The federal government spends about $15 billion a year on antidrug
efforts. No breakdown exists regarding how much of that goes to hardcore
users and how much to casual users.

Since the report was completed in August, the drug office, headed by former
Army Gen. Barry McCaffrey, has seemed uncertain how to handle its public
release. At first the office planned to release the study several weeks
ago. A press conference was planned, then canceled.

Now the study is scheduled to be announced at a Chicago press conference
early next year.

Copyright Chicago Tribune (c) 1997