BALTIMORE DRUG PROGRAMS PROVE EFFECT, STUDY FINDS

Significant Drops In Crime And Abuse

An independent evaluation of Baltimore's drug programs shows significant
drops in crime and drug abuse up to a year after addicts start treatment,
findings that suggest the city is finally making headway against its
seemingly intractable heroin and cocaine problem.

The study, to be released today, is the most rigorous review ever of the
$52 million public drug-treatment system. Researchers tracked drug tests,
arrest records and other data on almost 1,000 patients in 16 city programs
for a year.

The findings mirrored what national studies have found: Drug treatment
works. But as one of the few cities to ever do such an evaluation of
itself, Baltimore now has its own data, evidence it can use to argue for
more money from the state.

"It proves that treatment is a very, very solid investment and has an
immediate effect. I can't think of anything else that makes this big of a
difference for the community," said Dr. Peter L. Beilenson, city health
commissioner. "We're quite confident now that we have built a very
effective treatment system."

The study's findings were drastic and consistent. Within a month after
entering treatment, use of alcohol, cocaine and heroin each fell by more
than 60 percent. One year later, the classic point at which to look for
relapse, the changes stayed: Heroin use dropped 69 percent, cocaine use
dropped 48 percent, and criminal activity dropped by 64 percent. Also a
year later, those in the study worked twice as many days a month and earned
$200 more a month in legal income. And they reported far less risky
behavior such as using needles to inject drugs.

"We're going to reach a critical point where you really start to have an
effect citywide," said Dr. Robert Schwartz, one of the study's authors and
an assistant professor at the University of Maryland School of Medicine.
"We just have to stay the course and stick with it and be patient."

For Baltimoreans such as Barton Bell, who used heroin for more than 10
years, the treatment is a godsend. He routinely shoplifted from stores in
Glen Burnie and Annapolis to get the $75 a day he needed for his habit. He
wound up selling drugs himself and was almost killed. Police arrested him
about 15 times.

Now, several months after going through a 28-day residential program at
Tuerk House in West Baltimore, he is appreciating simple things, such as
eating and bathing every day. And today he is applying for a warehouse job.

"I just want to have a nice, steady job, be responsible and be able to pay
bills on time," said Bell, 34, who lives in Edmondson Village. "That's all
I'm looking for, and it's coming, I know it's coming."

Baltimore Substance Abuse Systems, the quasi-governmental agency that
oversees and funds programs such as Tuerk House, paid about $2.7 million
over three years for Schwartz and researchers from the Johns Hopkins
University and Morgan State University to do the study. The researchers
looked at patients from 1998 to 1999, and they estimated that for every
1,000 additional people treated per year, the city avoids 164,000 days of
heroin use, 45,600 days of cocaine use and $3.2 million in illegal income.

The work also pointed out some areas that need attention. The methadone
clinics, for instance, generally did a better job of reducing drug use than
clinics that offer counseling.

Schwartz credited the difference to the fact that patients getting
methadone stay in treatment longer and suggested the other clinics find
ways to keep patients engaged.

Also, researchers discovered that although the methadone patients initially
reduced their alcohol use, a year after starting treatment they were
drinking slightly more than before treatment.

The report is the first of several the scientists plan to produce based on
the data they've collected. The studies will help guide the expansion of
the city's drug treatment system.

Over the past few years, new state dollars have enabled Baltimore - which
was plagued by long waiting lines for drug treatment - to boost its
treatment capacity by 15 percent.

If the city gets an additional $9 million expected in the next state
budget, health officials expect to add 12 percent capacity, for a total of
8,400 slots. Eventually, Beilenson wants to reach a point where people can
be treated immediately.

City health officials have also been working to improve the system by
adding support services such as mental health counseling and job and
housing placement. Almost all the drug treatment centers offer child care.

But Baltimore's drug problem is huge. As many as 60,000 people in the city
are addicted, most to heroin and cocaine, and roughly 80 percent of crime
is related to drugs. With only a few small studies, state legislators and
others have questioned how effective the city's drug treatment programs are.

"Before this, everyone had an opinion. Now we've got some facts," said John
Hickey, director of Tuerk House. While some of the data was reported by the
addicts, much of it was verified. During the 12-month period researchers
tracked, urine samples were tested for drugs, and police records were
screened for arrests.

In the past several months, there have been other hopeful signs in
Baltimore's drug war. In 2001, the number of drug-related emergency room
visits in the city fell by 19 percent, the largest drop among U.S. cities.
The number of overdose deaths has also been dropping, from a high of 323 in
1999 to 302 in 2000 and 241 in the preliminary 2001 report.

Taken together with a drop in crime and a weekly performance review of each
treatment program, health officials believe they are making headway, even
against a chronic condition in which people often relapse.

"Baltimore is probably one of the top two cities in the country as far as
understanding and responding to drug problems," said Karst J. Besteman,
retired deputy director of the National Institute on Drug Abuse. The other
city he noted was San Francisco.

Besteman chairs the scientific panel that advises Baltimore Substance Abuse
Systems. "They've got a very substantial heroin and cocaine problem, but
they've been persistent in their efforts to address it."