Angling for a slice of the millions Maryland will spend on anti-smoking programs, Baltimore County begins today training its drug- and alcohol-abuse counselors to treat tobacco and gambling addicts.
"Why reinvent the wheel?" said Michael M. Gimbel, director of the county Bureau of Substance Abuse. "The state will be getting millions and millions of dollars in tobacco money, and much of the money will be spent on smoking-cessation programs. The question is, who is going to do it? It makes perfect sense to me to use the existing resources that we have."
In June, Gov. Parris N. Glendening proposed spending $30 million a year from the state's $4.4 billion tobacco settlement on anti-smoking programs.
He also proposed spending $10 million a year on addiction programs.
In response, Gimbel has scheduled a seven-hour training program for about three dozen county and not-for-profit counselors. They will learn the effects of smoking and gambling addiction, and available treatments.
His long-term goal is to have Baltimore County hire more staff and train them to handle more responsibilities with its share of the tobacco windfall.
"The cross-training is long overdue, not only at the county level but also statewide," said Valerie Lorenz, executive director of the Compulsive Gambling Center in Baltimore, who will speak to the counselors. "The impact will hopefully be that it will plant a seed. This training will be simply to create a little bit of awareness."
Gimbel and other professionals say many drug-users and alcoholics who seek treatment have other addictions.
Jackie Foreman, adolescent services coordinator for the county substance abuse bureau, knows where to look when it is time to round up the teen-agers enrolled in her drug education classes.
"They are off my property, across the street, smoking cigarettes at the mailboxes," Foreman said. "Kids and adults have more trouble kicking tobacco than any other addiction."
A broader outlook will benefit those with multiple addictions, said Dr. Martin P. Wasserman, chairman of the Governor's Task Force to End Smoking in Maryland.
"Recognizing tobacco addiction as a part of substance abuse, and often as a harbinger of substance abuse, is important," he said.
But Wasserman said he doesn't think the primary treatment for smoking addiction should come from drug-abuse counselors.
"I don't think we should start this [state] program with the stigmatization that tobacco use warrants substance-abuse treatment," he said.
Wasserman's opinion carries weight: Next month, his task force will recommend how to divide the $30 million the governor wants to spend on anti-smoking programs. The conclusions will include guidelines for how smoking-cessa- tion programs should be funded, and how much money will be available for them.
Peter Reuter, a professor at the University of Maryland School of Public Affairs who specializes in drug policy, agreed that substance abuse counselors shouldn't do it all.
"Whether it is sensible to treat all these things together is questionable," Reuter said.
In Baltimore County, the workers won't get all the tools they need to serve as one-stop treatment centers. Today's session will focus for about three hours each on tobacco and gambling problems, compared with the 2,000 hours of clinical work counselors must perform for their substance-abuse certification.
For Gimbel, it's an important start.
"I think this will just make the counselors better in what they do," he said. "I am forcing the system a little bit, but I don't want to wait. When the tobacco money comes down, we'll be ready to go."