S.F. LEADERS, EXPERTS GRAPPLE WITH CITY'S RAMPANT DRUG PROBLEM

Hospitalizations at crisis proportions

Edward Epstein, Chronicle Staff Writer

SAN FRANCISCO

The problem of heroin and methamphetamine use in San Francisco is daunting
and growing, and the Board of Supervisors is launching an effort to try to
get a handle on it.

The city has the highest rate among the nation's large cities for
methrelated emergency room visits, and is third in heroinlinked visits.
Overdose deaths are soaring.

Even though the city has a policy of eventually providing drug treatment on
demand for all indigent San Franciscans, fulfillment of that goal remains
years off.

So Supervisor Gavin Newsom summoned experts from the medical, drug
treatment and law enforcement communities this week to the first of a
series of hearings to learn firsthand about the roadblocks that exist in
reaching the mosttroubled drug abusers.

Particularly scary was a report from Department of Public Health specialist
Alice Cleghorn about homeless young people caught up in drug use along
Haight Street.

Ninety eight percent of the 1,121 youths interviewed said they had used
illegal drugs, with 35 percent admitting they had injected drugs and 21
percent saying they had done so in the last month.

The survey found that outreach efforts could be very effective among these
young people and that many have tried to enter treatment programs.

But for those under age 18 it can be practically impossible to find shelter
space or to get treatment. In part, that's because underage runaways have
to prove that their parents don't have medical insurance before they can
get treated at most clinics.

They also have a hard time getting work because it's difficult for them to
establish a legal identity.

John Newmeyer, an epidemiologist at the HaightAshbury Free Clinic,
proposed a novel way to help clean up neighborhoods with serious
drugdealing and drugusing problems, reduce crime and increase property
values.

Using parts of the Mission District as an example, he suggested that
philanthropists interested in the drug issue be offered a multiyear deal.
They could pay for extensive drug treatment programs in the neighborhood.
That would change the neighborhood's image, property values and property
tax revenues would rise, and the philanthropists could be paid back out of
those increased revenues.

In fact, Newmeyer and others said, the best way to get taxpayers to warm to
the idea of treatment on demand is to appeal to them on an economic basis.

``Treatment on demand will raise the tax base,'' he said. Addicts can
reenter the work force, crime will fall and property values in affected
areas will rise.

Newsom said he was alarmed by the falling price of heroin, which has
tumbled from $2,000 an ounce 15 years ago to $400 an ounce today, according
to police.

But Newmeyer, who has tracked drug use since 1971, said there was an upside
to this. ``It requires less money from the criminal subculture to pay for
it,'' he said.

Jim Dickey told the committee that he was a heroin addict and dealer for 19
years, from 1970 to 1989, before he finally got treatment.

He said treatment on demand in vital. ``Heroin addicts don't want to cure
themselves, most of the time.

``Maybe 15 times in a 10year period an addict will be ready to make a
change in his life. But if he's turned away because there is no place for
him, that window of opportunity is gone.

``They need to know that when they're ready to make that change, that they
can make it,'' Dickey said.

The city has appropriated $8 million more for treatment this fiscal year,
but it's estimated that $20 million would be needed to accommodate
everybody. City Hall hopes to reach that sum over the next few years.

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