SPIKE IN CITY KILLINGS LINKED TO DRUG FAMINE

Sad Fact: Baltimore Leads The Nation In Heroin Addiction Even As The
Scarcity Of Drugs Increases Their Prices - And Violence.

ANTI-TERRORISM efforts may have steeled U.S. borders to the drug
trade, slashing the availability of narcotics on American streets.

But Baltimore still leads the nation in heroin addiction. The result:
a rash of killings as the scarcity of heroin and cocaine increases
prices and heightens turf battles among rival dealers.

Street slayings kept on surging last week, threatening to reverse a
yearlong decline in killings. Except for a few lethal domestic
quarrels, the murders were "all about drugs; not about drug money, but
drugs," says Health Commissioner Peter Beilenson.

There's a sliver of good news here: The drug shortage also cut fatal
overdoses by more than half in October because addicts are trying to
stretch out the scanty and expensive supplies on hand.

But overall, the message here is grim. Lack of supply on the streets
is making the drug trade a bloodier scourge on the city. It
highlights, once again, the need for public officials in Baltimore and
Annapolis to confront this city's drug problems as a health crisis,
not just a criminal one.

A sudden narcotics shortage sets off killing sprees in Baltimore
because there are so many addicts here, and their treatment options
are pitifully limited.

It is estimated that 55,000 city residents are addicted to heroin,
cocaine or alcohol. If that is true, one out of eight adults has a
substance dependency that has a dramatic negative economic impact on
their hometown.

Reliable information about addicts is hard to come by in Baltimore or
in any other city. But a recent study by two University of Maryland
researchers provides important insight into the local problem.

In February and March, Eric D. Wish and George S. Yacoubian Jr.
studied a random sample of 233 men and 120 women who had been detained
at Baltimore Central Booking and Intake Center for more than 48 hours.
They were quizzed and their urine was screened to detect recent use of
10 different drugs. Roughly 60 percent of the sample consisted of high
school graduates; 20 percent were on probation when rearrested.

The upshot: Although only a third had been charged with drug offenses,
78 percent of the men and 72 percent of women had used heroin or
cocaine. Many had used multiple drugs, including alcohol, and most
heroin users also showed recent use of cocaine.

This finding suggests that Baltimore City's publicly financed drug
treatment efforts, although better than in most U.S. cities, are
totally inadequate. Treatment slots are too few; existing programs
cannot handle people suffering from multiple addictions.

If the sample accurately reflects overall drug use, male heroin
addiction in Baltimore is twice as bad as in New York, Philadelphia
and Washington. Among women, it is 3.5 times as bad as in
Philadelphia.

Other key findings:

Traces of marijuana were detected in 71 percent of men under 21,
whereas only 2 percent showed recent heroin use and 5 percent
registered positive for cocaine. Marijuana continues as part of
addicts' drug cocktail as men get older, but by the time they reach
26, heroin and cocaine become the narcotics of choice.

Women typically skip marijuana as a gateway drug and start using
heroin and cocaine in roughly the same proportions while still in
their teens. Heroin use peaks in the 26-30 age group, but cocaine
continues strong. Marijuana, however, never seems to become a major
ingredient of women's drug cocktail.

Some drugs that have been previously associated with antisocial
behavior were not detected at all. Chief among them was PCP.

Since World War II, Baltimore has enjoyed a reputation as a "nodding"
- - or heroin-using - town. Nevertheless, the drug's continued
prevalence here is surprising, particularly in view of drastically
lower heroin usage in the District of Columbia.

Indeed, Baltimore's steadily higher heroin rate suggests to some
experts that law enforcement agencies have never properly understood
the drug's distribution mechanism. If dealers were part of a big and
powerful central organization, wouldn't that organization also be
pushing harder in Washington, which is just 40 miles away?

The snapshot of Baltimore women addicts also is startling. "Women tend
to be on harder drugs. I don't know why," Dr. Wish told the board of
the Baltimore Substance Abuse Systems last week. However, it is
possible that because women are not arrested as frequently or easily
as men, the snapshot depicts women who lead harsher lives.

Along with San Francisco, Baltimore leads the nation in combating
addiction in publicly financed treatment programs. But the emphasis is
on outpatient treatment and counseling, which are inadequate to deal
with the complexities of multiple addictions.

Worse, neither the Central Booking and Intake Center nor the Maryland
Penitentiary provides any drug treatment at all, except for a token
program that uses acupuncture. Yet a high percentage of inmates and
pretrial detainees have a dependency on one or more drugs.

This is scandalous. No wonder drug trafficking is such a problem in
penal institutions.

Like the rest of the nation, Maryland is grappling with awesome budget
problems. Nevertheless, it should set up a program that would provide
effective drug treatment in jails and continue it once the inmates are
freed.

Ignoring the huge addiction problem behind bars is indefensible. It's
inhuman. It doesn't even make economic sense, because untreated
addicts are likely to commit more crimes to satisfy their craving.

In the end, effective treatment would be cheaper to taxpayers than
endless rearrests, retrials and re-jailings of addicted criminals.
That's particularly true if, as the study suggests, male arrestees
typically graduate to heroin and cocaine after they reach 26.

Before they reach that age, early intervention could still save them.
The city and state have to try, because the alternative is
unacceptable: watching the bodies pile up as Baltimore's drug trade
becomes more lethal.