Mayor's drug stance is gaining tolerance But legalization anathema to many


After five years of lonely campaigning for the decriminalizatio of drugs, Baltimore Mayor Kurt L. Schmoke believes people have at least begun to listen.

At community meetings, audiences sound more receptive. And in Washington, Attorney General Janet Reno says that expensive efforts to stop drugs from entering the country have failed to lessen substance abuse and crime. The government, she believes, should be putting its money into more treatment programs for addicts instead of just jail terms.

She doesn't talk about decriminalization, but Mr. Schmoke nonetheless is heartened. "I can sense movement in the country more toward treatment and prevention," he says.

In 1988, when Mr. Schmoke first began talking publicly about "decriminalization" and "legalization," the response was quick and hostile.

His opponents said he was advocating a free-for-all, where cocaine or heroin might be as available as cigarettes and alcohol are today. He said the profit motive had to be taken out of the system, so that dealers no longer would be able to make big money selling illegal substances. He said he wanted treatment so that addicts no longer were forced to steal to buy illegal drugs.

But he never defined exactly how his plan would work: What drugs? Who could use them? Who could sell them? And would no one ever go to jail? A national panel, the mayor said, should settle such issues.

Now, he's refined his position. Today, he talks about "medicalization" to emphasize his belief that drug abuse can be more successfully treated as a health problem than as a crime. Drugs would remain illegal, but people arrested for possessing them would be directed to treatment programs that might even offer addicts maintenance levels of such hard drugs as heroin and cocaine.

Do others believe the public is warming to the idea?

"We have no way of assessing that," says an aide to Democratic New York Rep. Charles B. Rangel. A vehement opponent of Mr. Schmoke's positions, Mr. Rangel believes in strong law enforcement, coupled with treatment, the aide says.

Among people who've struggled to help drug addicts with treatment, any program that would make drugs more accessible is anathema.

"Every once in a while, someone with some prominence -- whether it be a politician, an academic, a judge -- says this drug problem is getting out of hand and what we have to do is decriminalize," says Dr. Herbert Kleber, of Columbia University's Center on Addiction and Substance Abuse.

But those people haven't seen the problem close up, he says. "You rarely hear it from people on the front lines treating for abuse. You rarely hear it from addicts themselves. And you rarely hear it from the addicts' families."

But advocates like Mr. Schmoke are certain that current drug policies are as big a failure as Prohibition was.

He was delighted to hear Ms. Reno, who said last week that she doesn't believe the nation's drug policies are working and must be reviewed.

"She'd like to do something more than interdiction," says Caroline Aronovitz, a spokeswoman for Ms. Reno. "She's interested in more treatment. It would be better use of money to give them punishment in some way, shape or form, with that punishment including treatment."

In Dade County, Fla., where Ms. Reno served as prosecutor, addicts are sentenced to long-term outpatient treatment programs, says Tim Murray, the county's director of substance abuse control.

"We have to wake up and recognize that our tired old way of dealing with the problem just isn't going to work," Mr. Murray says. Addicts there who go to a drug court spend an average of 17 months in treatment, far longer than conventional therapies. And if they relapse, they're pulled back in -- not sent to jail. "We stay with you," Mr. Murray says.

But Mr. Murray's advocacy of new policies stops short of the "medicalization" that Mr. Schmoke endorses.

"I have a problem with drugs being legally available, because I look at the ease with which alcohol is legally available," Mr.

Murray says. "And I have a problem with maintenance programs that skirt the real problem of addiction."

Dr. Kleber, of Columbia, says Mr. Schmoke's contention that current approaches don't work "is simply not true." The problem is that no one's really put enough money or faith into treatment programs, he says.

"If we have a more intelligent system where people have a choice of treatment, then we don't need to send so many people to prison to begin with," Dr. Kleber says. "Right now, treatment is an accident" that only a few addicts are steered to.

Mr. Schmoke agrees on the need for more treatment. But he also wants drugs legally available to addicts who need them.

"I view it as a public health regulatory regime, where public health officials -- doctors, physician assistants, nurses -- are specifically authorized to distribute substances of abuse to those addicts at maintenance levels," he says.

Mr. Schmoke says his model is a program in Liverpool, England, where addicts go to licensed clinics to receive maintenance doses of addictive drugs. The theory is that addicts can work and care for families if they know they will get drugs regularly. And because they know they will have a regular supply, the addicts theoretically have no reason to commit crimes.

"When I talk to groups, I ask, 'Have we won the war on drugs? Are we winning the war on drugs? Will doing more of the same allow us to win in the future?' " Mr. Schmoke says. "There is at least more of a tolerance to listen to me and my point of view, even if they don't accept my bottom-line conclusion."

He talks about this everywhere: in March, before the Trilateral Commission in Washington; in April, to the Delaware State Bar Association; in October, before state lawmakers in Annapolis; and routinely before local groups as he talks around the state. And he's consulting experts on how to devise a drug program.

Sometimes indecisive on local policy issues, Mr. Schmoke won't give up his advocacy on this issue.

Can he run for governor while espousing a change in drug laws?

"It's the issue in the polls I've seen on which I get the highest negatives," he says.

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