If the Schmoke administration wants to ease the problems created by drug abuse, the city must spend far more money on drug treatment -- even if it means raising taxes, a new report by the Abell Foundation says.
"Baltimore's capacity to offer quality treatment is diminishing just when it is most sorely needed," the study says.
"I was startled at how Baltimore was getting worse, and how little the city spends on treatment -- especially in terms of the city government's view of how important drug treatment is," said Robert C. Embry, Jr., the Abell Foundation president.
Nearly $15 million in government funds will be spent on drug treatment programs in Baltimore this year, but the city is contributing only $150,000, the report says. Meanwhile, Mayor Kurt L. Schmoke is advocating a new national approach to addiction, stressing drug treatment as an alternative to jail.
The Abell report -- titled "Baltimore's Drug Problem. It's Costing Too Much Not to Spend More on It" -- says that drug use is at the heart of many urban ills: Crime rates are up. HIV infections are rising. Emergency rooms report increases in drug-related visits.
And there is "a less tangible but equally debilitating impact of substance abuse," the report adds: "the psychological fear it spreads across Baltimore." More people are afraid to come into the city, which leads to people and businesses moving out, the Abell report says.
There are real costs, too. A year in jail costs taxpayers between $25,000 and $50,000 per inmate, the report says. A year's worth of AIDS treatment costs about $100,000. But a year's worth of outpatient drug treatment costs only $2,000 to $2,500 per addict.
Despite Mr. Schmoke's belief that addicts should be steered into treatment, the city spends far less for addiction programs than other jurisdictions, the report says.
The city's share of government funds spent for drug treatment this year amounts to 1.05 percent of the $15 million total, according to the foundation report. That's far below the state average, the report says.
Other Maryland jurisdictions contribute 8.9 percent in local funds to the total government budget for drug treatment, the Abell staff found. Nationally, according to the National Association of State Alcohol and Drug Abuse Directors, local communities contribute 11 percent of the government funds going to drug treatment.
In Baltimore, city officials are looking for ways to pay for more police officers to keep the streets safe, said Mr. Embry. "If we want to reduce crime, is that the most cost-effective way to do it? Or should you be spending money in other ways?"
The report notes that it may not be fair to compare more affluent jurisdictions' contributions to drug treatment with Baltimore, which is chronically strapped for funds. But because the problem is more severe in the city, the report says, Baltimore must find ways to compensate.
Mr. Schmoke was unavailable to comment on the Abell report yesterday afternoon. But Dr. Peter Beilenson, the city health commissioner, said he had read the report and agrees that the number of treatment programs should be increased. Last month, a mayoral panel recommended a substantial increase in treatment programs as well as retraining doctors and nurses to help identify and treat addicts.
"The mayor is very actively looking at federal, state and local funding opportunities and will have something to say about it in the near future," Dr. Beilenson said. "We are looking to foundations for more money."
The Abell report says the city could triple the number of spaces it has available for treatment of addicts from the 5,700 now available. Dr. Beilenson said he thought the city could indeed use another 10,000. City health department officials have estimated there are 35,000 addicts in Baltimore.
Where would the new money for drug treatment programs come from? The report suggests foregoing tax cuts considered by the City Council and putting that money instead into drug programs "or even increasing the rate by five cents in order to provide resources for additional treatment slots."
"You could be asking the state for more money, the federal government for more money, foundations for more money," Mr. Embry said.