DRUG-TIED ER VISITS DECLINE IN AREA

City improves to 5th from 3rd in U.S. survey; 'This is not a one-year fluke'

Medical emergencies tied to heroin dropped by 17 percent in the Baltimore
area last year, according to a federal survey, prompting officials to claim
progress in their efforts to get more addicts into treatment.

With cocaine emergencies holding steady, the metropolitan area dropped from
third to fifth nationally in the rate at which residents visited emergency
rooms with problems related to the abuse of illegal and prescription drugs.

Philadelphia heads the list, a distinction that belonged to Baltimore in
1999. The trends were drawn from the federal Drug Abuse Warning Network,
which annually surveys hospitals in the nation's 21 largest metropolitan
areas. The report for last year was released last week.

"This is not a one-year fluke," said Dr. Peter L. Beilenson, the city's
health commissioner. "It is a continuing trend and reflects enhanced
treatment, along with smarter policing .

He noted that the city, helped by increases in state and federal aid, has
boosted spending on drug treatment from $40 million to $60 million in the
past three years and has expanded the number of addicts in treatment from
11,000 to 25,000 since 1997.

At the same time, he said, the criminal justice system has shifted its
attention away from jailing nonviolent drug abusers and toward helping to
direct them to programs such as methadone maintenance and detoxification.

The downward trend in drug-related hospital visits began in 2000, when the
area dropped from first to third and saw a 19 percent overall decline. That
year, visits related to heroin dropped 23 percent and those related to
cocaine dropped nearly 20 percent.

The federal program, run by the U.S. Department of Health and Human
Services, draws its data from hospital records. In general, few of the
visits involve overdoses. More common are infections, injuries, and
problems of the heart, lung and kidneys.

Last year, Philadelphia reported 573 drug-related visits to emergency rooms
per 100,000 population. Next were Chicago, San Francisco, Seattle and
Baltimore, at 505 visits per 100,000.

Completing the top 10 were Boston, Detroit, Miami, Newark, N.J., and
Buffalo, N.Y. The high rates in Seattle and San Francisco resulted in part
from methamphetamines, which are less common in East Coast cities, a DAWN
official said.

According to the city health department, Baltimore has recorded the
nation's largest two-year drop in visits related to all drugs (an 18
percent decline) and those related to heroin (a 36 percent drop).

The DAWN survey does not measure how many people are abusing drugs and
offers only a snapshot of the toll drugs take on communities.

A federal report issued this year said Baltimore had proportionately more
drug-related fatalities in 2000 than did Philadelphia.

"But we have to remember that neither mortality nor emergency room visits
are truly a reflection of the prevalence of drug use in those communities,"
said Dr. Judy Ball, DAWN project director.

A better picture of how many people abuse drugs will come from a household
survey to be released next week, she said. That report will note national
and statewide trends, but will not focus on particular urban areas.

Ball also noted that some areas might rank particularly high in emergency
room visits because doctors are meticulous in their record- keeping. Areas
with serious drug problems might rank artificially low because of poor
record-keeping.

Also, a surge in drug purity can suddenly trigger more complications and
deaths.

"DAWN data cannot tell us why the heroin and cocaine rates have gone down
in Baltimore in recent years," said Ball. "We don't know whether heroin and
cocaine users have gone down, or whether purity has gone down."

Dr. Brian Browne, director of emergency medicine at University of Maryland
Medical Center, said he has noticed no decline in addicts into his
emergency room. But he said he has faith that the decline is real. "I
believe these numbers because I think there is integrity with the way the
numbers are kept," he said.