HELPING ADDICTS

The first interim report on Baltimore's efforts to reduce heroin
addiction through expanded use of a promising drug shows that the
city's strategy is working relatively well, but that results could be
even better with broader participation by doctors and hospitals. In a
city with such abundant medical talent, that should not be an
impediment to helping eliminate a major scourge.

Baltimore's buprenorphine initiative is a worthy effort, led by the
city's Health Department, to help addicts by using a synthetic opiate
that is an effective antidote to heroin. Buprenorphine is not as
habit-forming as methadone and can be managed more privately under
medical supervision, through teaching hospitals, community health
centers and group practices. The state has also been reaching out to
private physicians and training them in prescribing the drug and
managing patients who take it.

Beyond physician outreach and training, Baltimore, with a larger and
more intensely addicted population than elsewhere in the state, has
effectively beefed up its buprenorphine efforts with two important
ingredients. For starters, patients first receive the drug while
enrolled in a treatment program, where the chances of success are
enhanced by individual counseling, group therapy and other
therapeutic services. Before leaving the program, a patient is
assigned a social worker who helps secure health insurance and other
services. In addition, the social worker connects the patient to a
doctor trained to help manage the addiction with buprenorphine as
well as tend to the patient's other medical needs.

In its first nine months, the initiative enrolled 388 patients and
just about reached its goal of keeping two-thirds of them in drug
treatment for at least 90 days. Nearly 80 percent of patients were
able to qualify for health insurance, and almost all are expected to
secure coverage so that they can receive the drug from a doctor. But
only 50 Baltimore doctors have completed the training, out of 93 who
signed up. Those are disappointing numbers for a city with so many
top-flight medical facilities.

City officials can engage in more-aggressive outreach, but the
medical establishment should also make this a priority. On top of
their addiction, those who are hooked on heroin and have other
untreated medical conditions cost the medical system - and society -
millions of dollars. More medical professionals stepping up to the
plate could save money, not to mention lives.