Source:  The Philedelphia Inquirer
Pubdate:  Mon, 29 Dec 1997
Author: Jeff Gammage

BALTIMORE FORGES A DIFFERENT COURSE ON DRUG ABUSE

A financier has pledged $25 million to find new ways to treat the city's
devastating addiction problems.

BALTIMORE  Soon, drug addicts in this harborside city may not be sent to
jail when they're arrested.

Instead, some might go for acupuncture, tiny needles lancing their ears to
ease their cravings.

Or to faith counseling, with belief in an allhealing higher power offered
as a means to escape addiction.

Or to a special court that lets them avoid prison by submitting to
highsupervision, highintensity probation.

These programs, some already begun, are part of an unusual social
experiment being undertaken in Baltimore, one aimed not at winning the war
on drugs but at forging a livable peace.

Billionaire financier and philanthropist George Soros has pledged $25
million over the next five years to try to control and treat drug addiction
here, seeing in the city's uncommon political and cultural landscape a
chance to redefine the way America thinks about drug abuse.

As social laboratories go, Baltimore has a lot in its favor. It has a mayor
who wants the country to consider liberalizing its drug policies. It has a
population where an estimated one of every nine adults is using illicit
drugs, often heroin.

"It's a huge problem here," Health Commissioner Peter Beilenson said. "But
we're willing to face it, and try to do something about it."

The money will go not only to treat addiction but to relieve the
constellation of ills that go with it  joblessness, illiteracy,
homelessness. Soros, an outspoken advocate of drug decriminalization, has
imposed only one condition: that the money be spent with creativity and
imagination.

That has bolstered the city's enthusiasm for attacking the drug problem,
from which so many other urban ailments seem to spring.

About 85 percent of felonies here are classified by police as drugrelated.
The same goes for homicides. Nearly 80 percent of the city's AIDS cases are
caused by shared contaminated needles.

The goal is to "medicalize" drug abuse by handling nonviolent users less as
criminals and more as people who need help. The city is working toward a
policy of "treatment on demand," allowing people who want to quit drugs to
get immediate aid, rather than spend up to three months on a waiting list
  plenty of time to give up and return to crime.

Soros has pledged an additional $2 million in matching funds toward that
goal, an approach applauded by analysts who study drug use.

"Treatment is more costeffective than just locking everyone up," said
Diane Schoeff, administrator of the Drug Policy Research Center at the Rand
Corporation, a Californiabased think tank. "It's been proven in study
after study."

Baltimore officials say they have two choices: Continue shoving users into
overcrowded jails that provide little treatment but that cost taxpayers
about $20,000 per inmate; or try to divert nonviolent offenders into
treatment programs at onesixth the cost  an option made more viable by
Soros' gift.

For Baltimore, it's no choice at all.

The Health Department says the innercity streets are home to about 59,000
illicitdrug users, a staggering number in a city half the size of
Philadelphia. The average junkie spends $50 to $100 a day on his habit,
fostering a $1 billion to $2 billionayear drug market and a concurrent
universe of crime, violence and disease.

"The heavy users cost society so much," said associate professor John
Caulkins, who researches drugs and crime at Carnegie Mellon University in
Pittsburgh. "Robbery, burglaries, prostitution, shoplifting."

The experiment here is believed to be unique in a major American city,
being tried in a community thirsting for solutions to street violence, high
student dropout rates and teenage pregnancy.

Like Soros, Mayor Kurt Schmoke sees drug abuse more as a publichealth
concern than a lawenforcement dilemma. Eight years ago, Schmoke was among
the first bigcity mayors to declare the war on drugs a lost cause. Since
then he has moved to start a needleexchange program, foster experimental
treatments such as acupuncture, and increase funding for rehabilitation.

Last year, the city spent $15 million on drug treatment, most of it state
and federal money. This year, it will spend nearly $28 million, much of it
skimmed from departments such as housing and health. Officials say that
should cut the wait for treatment from months to weeks.

But critics see the effort as a step toward decriminalizing drugs, and both
Soros and Schmoke have been condemned by lawenforcement authorities.
Baltimore's police commissioner, Thomas Frazier, firmly opposes
legalization and promises continuing drug arrests, while innovations
proceed in dealing with those arrested.

"A lot of this is going to sound like sacrilege to most Americans," said
Steven Donziger, a New York lawyer who studied U.S. drug policy while
serving the National Criminal Justice Commission. "It's much easier to sell
a platform where you're locking people up than trying a variety of
approaches to deal with the problem. . . . If it works, a powerful case
will be made for its duplication in other areas."

Soros' Open Society Institute started its first satellite office here this
year, and administrators are preparing to accept proposals for battling
drugs and other social ills.

"What we have to offer is an interest in unorthodox approaches," said Diana
Morris, director of the local institute office. "I really want our programs
to reinforce one another."

Baltimore runs one program that has met with some success  its
threeyearold drug court, which aims to wean nonviolent addicts from drugs
while keeping them out of jail, thus saving prison beds and tax money.

In drug court, relapse is accepted as normal  some studies show 90
percent of all recovering addicts temporarily return to drugs  and judges
are willing to grant second and third chances. At the same time, those
trying to quit must submit to intense supervision, including
everyotherday meetings with probation agents and twiceweekly urine
tests.

"We call it 'coerced abstinence,' and that's what it is," said Raymond
Sheaffer, the parole and probation field supervisor here.

Since 1994, the drug court has produced 174 "graduates" who have completed
the 18month program while providing clean urine for the last six months.

"I got my selfesteem back," said Anthony Hubbard, 38, a West Baltimore man
who graduated from drug court last week after spending the previous seven
years addicted to heroin. "It feels good to be clean."

Larry Mack, who like Hubbard accepted a diploma and a handshake from the
judge, said he's drugfree and working two jobs because the court helped
him kick a 29year habit. "It gives people a chance to look at themselves,"
he said.

It also gives them someone to look over their shoulders.

"If addicts come into treatment on a voluntary basis, they don't stick
around," said Jill Jonnes, the Baltimore author of HepCats, Narcs and Pipe
Dreams, a history of drug use in the United States.

Most drug courts claim success rates of 50 percent to 80 percent; Baltimore
ranks toward the low end, she said. But it still probably offers the best
hope of changing lives.

"Soros, they say they want to do something new, original and dynamic,"
Jonnes said. "What's new and dramatic is drug courts. If they're prepared
to work within that model, they could be very successful."

Precisely how Soros' initiative will proceed is undecided. But city
officials already know how they want to be judged.

"Give us three years," Health Commissioner Beilenson said. "Then look at
retention rates, recovery rates, crime rates  which is basically drugs. .
. Medicalizing and getting people off of drugs is by far the most sensible
thing."