Which way, Baltimore? Treatment or enforcement?

Following are excerpts from "Baltimore's Drug Problem: It's Costing Too Much Not to Spend More on It," published this month by the Abell Foundation. AS LONG as the drug war is fought primarily as a law enforcement problem rather than as a public health issue, the city will continue to suffer through the social wreckage wrought by a drug-torn community. Some drug abusers will be locked up, but the city lacks the capacity to put away all those who have become dependent on controlled substances.

Treatment helps eliminate drug addiction; jail does not. And while the city pours millions of dollars into law enforcement to fight crime that is heavily related to drug dependency, it will spend barely $150,000 this year to support treatment.


It is obvious that the lack of financial resources stands as a monumental wall against efforts to enhance drug treatment services in Baltimore. Underlying that barrier is the political and social attitude against treatment as a means of resolving the drug problem.

Over the past 12 years, with a Republican administration in Washington, for every dollar spent on treatment and prevention, $2 was allocated for interdiction and law enforcement. Between 1981 and 1992 federal expenditures on treatment increased 369 percent, while jumping more than 1,000 percent for interdiction and law enforcement. There had been hope in the treatment community in Baltimore City that the ratio would change with a Democratic administration.


But the first budget presented by the Clinton administration was a reaffirmation of the Reagan-Bush policy toward the campaign against drugs. Of the $13.04 billion anti-drug appropriation proposed by the Clinton administration, 64 percent will go to law enforcement and 36 percent for prevention and treatment -- a change of but 1 percent in the proportion the Bush administration allocated. Overall, the Clinton budget would add $178 million for drug treatment nationwide.

That is a drop in the bucket at a time when drug treatment experts in Baltimore suggest that the number of treatment slots needs to be increased, conservatively, by three-fold. City and state drug abuse officials maintain that if the number of treatment slots were tripled in Baltimore, there would be no trouble in filling them. City officials say the greatest need is for more methadone treatment programs. Several hundred slots could be filled immediately, according to officials.

Zoning restrictions requiring City Council approval before a methadone program can be established have inhibited drug treatment professionals from attempting to begin new programs recent years . . . Today, according to city and state officials, resources are so tight that even if zoning obstacles could be overcome, there is no public money to open new programs . . .

"What we are doing in Baltimore is criminalizing a health problem," a former director of Baltimore Substance Abuse Systems Inc. (BSAS) said of the emphasis in the city on law enforcement at the expense of treatment and prevention.

Public opinion, manifested in such actions as community opposition to neighborhood treatment facilities, must change if the political will for increased treatment services is to emerge. Professionals in the treatment field believe the public and its political leaders must be educated about the efficacy of treatment and its cost effectiveness versus non-treatment or incarceration. "We need more advocacy and education with the public, because we're spending far more and getting far less," says the former BSAS director, "and treatment provides the possibility for success. But what possibility for success do you have putting people in jail?"

Under existing fiscal conditions, however, those responsible for treatment services are reluctant to allocate money to education and promotion that otherwise would go for treatment. With a limited number of dollars at their disposal, drug treatment officials feel every penny must be spent on providing direct services to those in need of treatment.

With scant extra help to be expected from Washington or the state for at least the next year, Baltimoreans must decide for themselves how they want to fight drugs in the community -- by increasing law enforcement protection or by offering the opportunity of treatment to those afflicted.