Drug-Related Deaths Hit 10-Year Low in Baltimore

The number of drug-overdose deaths in Baltimore has fallen to the lowest level in 10 years, the apparent result of a huge effort by the city to make drug treatment readily available and to give addicts the capability to reverse some overdoses themselves.

In 2005, 218 people died of "drug intoxication" in the city, down from about 235 in 1996, and one-third below the peak of 328 in 1999, according to data collected by Maryland's chief medical examiner and presented at a drug-treatment conference yesterday in Baltimore. About 90 percent of deaths each year are from heroin and other opiate overdoses.

In the past decade, the city's slots for drug treatment for uninsured or under-insured residents rose 62 percent, from 5,136 to 8,295. Funding for drug treatment nearly tripled, from $18 million in 1996 to $53 million last year. In 2005, 23,000 people received drug treatment in publicly supported clinics -- a total of about 28,000 "treatment episodes."

A study released in January 2002 compared the experience of nearly 1,000 addicts the year before and the year after treatment. One year after treatment, there was a 69 percent reduction in heroin use, a 48 percent reduction in cocaine use, a 69 percent reduction in getting income by illegal means, and a 38 percent reduction in imprisonment.

In the past 10 years, the city has also seen downward trends in numerous other problems related to drug abuse, including emergency room visits related to cocaine and heroin use; homicides; violent crimes; property crimes; HIV infections linked to injected drugs; and rates of syphilis and gonorrhea.

Joshua M. Sharfstein, Baltimore's health commissioner, said a crucial element in gaining more money for treatment from the city and state governments was the argument that drug abuse was dragging down the entire city, not just its poor and addicted residents.

"People realized it was not only good health care, it would also help move the city forward. It makes the city safe, it stems the flight of people out of Baltimore, and I think it worked," he said.

About $9 million, used for both treatment and advocacy, came from the Open Society Institute, a foundation underwritten by billionaire currency trader George Soros. He said yesterday that he will spend an additional $10 million to help the city maintain its gains and will spend as much as $10 million elsewhere in the country to help other jurisdictions start similar programs.

"It really has produced tangible results," he said during a break between presentations at the two-day conference on public drug-treatment systems at Johns Hopkins University's Bloomberg School of Public Health. "It has been very successful in showing that there are alternative ways of dealing with the drug issue other than through incarceration."

Over the past eight years, his foundation has spent about $50 million in Baltimore to expand addiction treatment, reduce the social and economic costs of incarceration, boost the academic success of inner-city children, and foster local organizations and activists.

Baltimore developed an addiction epidemic in the late 1980s and early 1990s.

Heroin-related emergency room visits doubled from 1990 to 1991, and by 1996 the city had the highest rate of drug-related ER visits in the country. Seventy-five percent of its violent and property crimes were believed to be related to drug use or the drug trade. AIDS became the leading cause of death among black men and the second-leading cause among black women, with most of the infections acquired through drug use.

Two local foundations -- Abell and Weinberg -- called for more government investment in drug treatment and invested some of their own money.

Over the years, the city adopted controversial and innovative strategies. It began needle exchange for addicts in 1994. In the past two years, it has trained nearly 1,600 addicts and their loved ones how to do CPR and use naloxone (Narcan), an injected medicine that rapidly reverses opiate overdoses. As of the end of last year, 194 overdoses had been aborted, according to the data presented yesterday.

Soros, who is Hungarian by birth and lives in New York, had no connection to Baltimore before he chose it as a test site for investing in various social and economic policies he supports. New Haven, Conn., was the other place he considered.

Kurt L. Schmoke, a former prosecutor who was elected mayor of Baltimore in 1987, gained national attention when he advocated decriminalization of illicit drugs in a 1988 speech to the U.S. Conference of Mayors. Over his three terms in office, he became a leading advocate for the view that drug addiction should be viewed as a health problem, not a criminal problem.