BOSTON'S HEROIN CRISIS

THE MENINO administration knows that the abuse of heroin and other opiates
in Boston is easily outstripping local enforcement efforts and the
availability of state and federally funded treatment programs.

The gap has prompted the city's Public Health Commission to turn to the
city's operating budget to stop the freefall.

Last week Mayor Menino and John Auerbach, director of the Boston Public
Health Commission, chose South Boston as the site to announce the
commitment of $180,000 for drug treatment and prevention programs.

The location was no accident. The neighborhood of 29,000 ranks at or near
the top of several disturbing indicators, including discharges from
hospitals for substance abuse problems and the percentage of patients in
publicly funded treatment centers who reported heroin as their primary drug.

Cuts in state funding have forced city officials to hunt for quicker,
cheaper alternatives to detoxification beds. They have settled on
acupuncture detoxification, an effective outpatient option for some
addicts, and Buprenorphine, a relatively new medication used to lessen
withdrawal symptoms related to heroin, morphine, and OxyContin. The Public
Health Commission will use $30,000 to double the number of patients seen in
the city's South End acupuncture clinic from the current 180. About $60,000
will be used for physician training courses and new distribution sites to
widen the availability of Buprenorphine. The remainder of the new funds,
says Auerbach, will be used for public education. City officials are making
good efforts in a tight fiscal situation.

But no one should think quick fixes will solve the problem.

Routine medical detoxification for heroin addiction requires five to seven
days, according to Dr. John Rodolico, a psychologist and substance abuse
expert at McLean Hospital in Belmont. And shortcuts, he warns, can easily
mask underlying psychiatric problems. The city, however, is left with
little choice.

The nonprofit Mental Health and Substance Abuse Corporations of
Massachusetts notes the loss of $12 million for publicly supported
substance abuse treatment since 2001. And the Romney administration
proposes an additional $2 million cut for 2005, leading to fears of further
loss of scarce state-funded detox beds, which fell from nearly 1,000 two
years ago to about half that number today. At just $180,000, the Menino
administration's initiative is largely symbolic. But city officials are
right to call attention to the growing crisis.

Heroin is the number one cause of drug abuse deaths in Greater Boston,
according to the Public Health Commission. Any effort to bring addicts in
contact with medical systems, no matter how limited, is better than the
morbid self-medication that takes place on the city's streets.