Drug Abuse

REPORT of the GRAND JURY OF BALTIMORE CITY

SEPTEMBER TERM 1994

SEPTEMBER 12, 1994 - JANUARY 6, 1995

Honorable Joseph H.H. Kaplan, Administrative Judge

Horable Edward J. Angeletti, Grand Jury Judge

Ernestine K. Thomas, Jury Commissioner

Marilyn Tokarski, Deputy Jury Commissioner

Vanessa A Pennington, Foreperson

Tegan B. Harby, Assistant Foreperson

Susan V. Ellison, Secretary

Robert H. Cormier, Jr Chairperson Penal Committee

Richard P. Ahlfeldt, Doorman

Geraldine Anderson. Oath Clerk

Bruce W. Baumgarter

Tanja Desmond

Paul R. King

Natalie C. Jackson

Myra P. Johnson

Kevin D. Lewis

Juanita D. Lopez

Joseph A. Macri, Jr

Theodora B. McGlone

Vicki A. Migues

Barbara D. Oliver

Catherine E. Spahn

Jeanette Torain

Lywanda S. Utley

Theresa J. West

Curtis S. Whitaker

Cynthia D. Wilson

TABLE OF CONTENTS

REFLECTIONS FROM THE FOREPERSON

Charge to the 1994 September Term Grand Jury

INTRODUCTION, Controlled Dangerous Substances

DEFINITIONS OF LEGALIZATION, DECRIMINALIZATION AND MEDICALIZATION

The Problem

Drug Addiction

The Community

Medical Concerns

Criminal Justice Concerns

What is being done?

Is it Working?

SOLUTIONS, OPTIONS, RECOMMENDATIONS, AND COMMENTS

One Juror's Opinion

The Drug Policy in the Netherlands

SOURCES, RESOURCES, AND ACKNOWLEDGEMENTS

PENAL COMMITTEE REPORT

REFLECTIONS FROM THE FOREPERSON

On September 12th when I took the oath as foreperson of the 1994 September Term Grand Jury, I was not quite sure what to expect. Reading my Grand Juror's Handbook and meeting with Judge Angeletti had assured me that I understood the task at hand. I was excited and anxious to begin my job. But I was also a little apprehensive, and afraid the responsibility might be too daunting. When Judge McCurdy issued his charge to our panel, niy thoughts raced ahead as I wondered how 23 ordinary citizens could respond to the serious issue of drug legalization.

The first few days were filled with meeting fellow Grand Jury members and briefings provided by prosecutors from the State's Attorney's and Attorney General's offices. Law enforcement, social service, and criminal justice personnel familiarized the panel with terms, laws, and concepts (many of which I'd never explored in detail) relative to our impending investigations. Discussions about our ~ and learning the routine kept us busy. Additional details about Grand Jury responsibilities and expectations were revealed. Information received during this orientation proved invaluable when listening to testimony and during Grand Jury deliberations and determinations.

During our term, we met with the Mayor at City Hall and the State's Attorney at the Clarence M. Mitchell, Jr. Courthouse, and were briefed by the Police Commissioner and Department Bureau Chiefs at Central District Police Headquarters. The panel investigated numerous penal institutions, our findings of which are included in this report. We toured police headquarters, a drug treatment center, and Baltimore City at night (to witness illegal activity and learn about the crime problem firsthand). We experienced situations confronted daily by law enforcement officers at a "Police Use of Deadly Force" Training Seminar. Every day, the prosecutors presented evidence and witnesses gave testimony regarding widespread criminal activity occurring in Baltimore City. The panel then made determinations regarding indictments of the accused. There were a few tense moments during Grand Jury deliberations, but I looked forward to spirited discussions about case details and events. There was never a shortage of homicide, narcotics, sexual abuse, child abuse, economic crime, or fraud incidents requiring a decision from this panel. Some days the prosecutors and witnesses were in line, waiting for an opportunity to present their cases. We were required to examine exhaustive details about criminal activity in Baltimore--the magnitude of those activities I'd previously denied. My service on the Grand Jury permits me to undeniably confirm that crime is not someone else's problem. It affects every single community--and every individual in Baltimore.

On behalf of the 1994 September Term Grand Jury, I would like to thank everyone who assisted us during our service. Thank you to the Jury Division for professionally handling administrative details. Thanks also to the prior Grand Juries for their guidance and the conveniences they provided for future Grand Jury panels. Thank you Judge Mccurdy for your direction and Judge Angeletti for your vote of confidence. Thank you to our court reporter, Ernie Koreck, for his daily dose of support, patience, and humor. And finally, a very special thank you from me, to the 22 jurors who served during the 1994 September Term. You have helped me to grow and learn. I wish for you the very best. I'll count this experience as one of my most rewarding. This panel encourages and challenges every citizen of Baltimore City, when summoned, to willingly accept Grand Jury service. Our tenure has provided invaluable insight that has influenced this jury's view of our circumstance, our responsibilities, and our lives as citizens of Baltimore.

Respectfully submitted,

Vanessa A. Pennington

CHARGE TO THE 1994 SEPTEMBER TERM GRAND JURY

A very serious problem of grave public concern is "drug-related" felonies. Murders, robberies, thefts, burglaries, and domestic violence account for approximately 80 percent of all felony cases in Baltimore City.

There is growing sentiment, among some citizens, that some drugs should be legalized. The concept would include a procedure for licensed distribution of certain narcotic drugs and needles, but would not otherwise legalize the distribution of narcotics; in other words, trafficking in drugs would still be a crime.

Many citizens feel that the "war on drugs" has not succeeded, and that we have to look at this problem anew from a more realistic point of view. These are our findings and report. We hope that this report will be shared with the citizens who are affected by the devastation of drug-related activity. We cannot be afraid to examine all options for managing this dilemma openly, honestly, and objectively.

INTRODUCTION

Before this panel could seriously examine the legalization option, we discerned a need to learn more about drugs and understand the extent of the drug problem in Baltimore City. Narcotics cases overwhelmed the Grand Jury docket. Drugs were involved in approximately four out of five violent crimes. Our first objective was to define the schedules of controlled dangerous substances and identify their effects on our community. Since the controlled dangerous substances involved in most Grand Jury indictments were cocaine, heroin, and marijuana, we focused on these.

Although Judge McCurdy included a definition of legalization in the charge, throughout our investigation we repeatedly heard conflicting meanings for the terms legalization, decriminalization, and medicalization. We suspect this confusion may be creating a stumbling block when a dialog on the issue is suggested. We then, for the purposes of this writing, discerned differences in these terms that are often used interchangeably, but are obviously perceived quite differently.

Finally, we examined current policy and formulated comments, proposals, and recommendations for managing the problem. Our views and recommendations throughout this process were as varied as our backgrounds and experiences. We hope that these recommendations will be seriously considered and employed to improve the quality of life for all of Baltimore's citizens.

CONTROLLED DANGEROUS SUBSTANCES (CDS)

The Controlled Substances Act of 1970 created schedules for drugs, altered penalties for violations, and strengthened regulation of the pharmaceutical industry. This Act, intended as a model for state legislation, has been adopted by the state of Maryland.

A drug is scheduled and controlled with respect to: its actual or relative potential for abuse; scientific evidence of its pharmacological effect, if known; state state of current scientific knowledge regarding the substance; its Ilistory and current pattern of abuse; the scope, duration, and significance of abuse; what if any use there is to the public health; its psychic or physiological dependence liability; and whether the substance is an immediate precursor of a substance already controlled (The Annotated Code of Maryland, 1992). Schedule I CDS has 1) a high potential for abuse; 2) no accepted medical use in the United States; and 3) a lack of accepted safety for use under medical supervision. Schedule II CDS has 1) a high potential for abuse; 2) accepted medical use in the U.S. or currently accepted medical use with severe restrictions; and 3) the potential for severe psychic or physical dependence if abused. Schedules III, IV, and V have less potential for abuse, have currently accepted medical use in the U.S., and result in moderate or low physical dependence and limited-to- high psychological dependence, relative to the schedule immediately preceding it.

Cocaine is the most potent stimulant of natural origin (Siegel, Binford, & Foster, 1991). Cocaine, which has been grown in the Andean highlands of South America since prehistoric times, is extracted from the leaves of the cocoa plant. Illicit cocaine is usually sold as a white powder substance, cut with various other ingredients--commonly sugar. Cocaine can be snorted or injected into the bloodstream. "Crack" cocaine results when powdered cocaine is heated to remove the hydrochloride (producing cocaine base), leaving chunks or rocks. This substance makes cracking noises when smoked, hence its name.

Crack goes directly to the brain via the bloodstream and produces an instant, powerful, but brief high. Cocaine and crack are Schedule II CDS.

Heroin is a Schedule I COS. First synthesized from morphine in 1874, heroin was used as a pain reliever at the beginning of the century (Siegel et al., 1991). Congress passed the Harrison Narcotic Act of 1914 to control the use of heroin because the drug proved to be highly addictive. Pure heroin is a bitter-tasting white powder. Due to the presence of additives such as food coloring, cocoa, or brown sugar and/or impurities left from the manufacturing process, illicit heroin may vary in both color (from white to dark brown) and form. Heroin, which is also highly addictive, is usually dissolved and taken intravenously.

The leaves and flowering tops of the cannabis plant are harvested and dried into marijuana a tobacco-like substance. When users smoke marijuana, their altered states may last for up to three hours. Marijuana is a Schedule I COS. Recent studies indicate that one in four eighth graders in the United States have tried this substance.

DEFINITIONS OF LEGALIZATION, DECRIMINALIZATION. AND MEDICALIZATION

Legalization would make the use of a drug(s) lawful. The affected substance could be bought and sold openly like any other legal drug.

Decriminalization would eliminate legal penalties for possession (for personal use) of small amounts of a drug. Drug trafficking would still be a crime.

Medicalization would begin with the recognition of drug abuse as a medical problem, rather than a crime. Individuals charged with narcotics use or possession would not necessarily face incarceration. Drug addicts would be given the option of treatment in lieu of jail time. Treatment-on-demand for drug users who want it might also be available, as would a widespread needle exchange program. Health care professionals might also be allowed to legally dispense certain Schedule I and II CDS to some drug abusers. The sale and distribution of CDS would remain illegal for anyone other than designated, licensed distributors. Educational programs identifying the dangers and harm of substance abuse, and emphasizing prevention, would be continued, enhanced, and directed to all age groups.

The possible benefits of these options are seen as a relief in prison overpopulation, a reduction in the spread of HIV from using shared needles, a reduction in random crime committed by persons attempting to obtain monies to buy narcotics, elimination of the need to obtain substances criminally, and a reduction in the unlimited profits of illegality. Serious consideration of any of these options would include determinations regarding the substances to be affected, the people to be served, the methods of administration, and the effect implementation would have on the community.

THE PROBLEM

Illegal drugs destroy lives. Despite attempts by the world's governments to end drug trafficking, society continues to be a victim of this multi-billion dollar per year industry. The problems of drug abuse in Baltimore City are manifested in the social and economic dilemma that show little sign of subsiding. Drug addicts, distributors, community members, families, medical systems, and the criminal justice system are affected.

DRUG ADDICTION

Drug addiction is one of the leading problems that plague our city. It can be defined as the inability to stop ingesting drugs despite negative consequences. Drug addictions have emotional and physical characteristics.

The drug that clearly exemplifies physical addiction is heroin. Once heroin is taken over a period of time (usually within a month), it becomes extremely difficult, if not impossible, to stop. Usually, when a heroin addict is withdrawing, he/she will experience such physical symptoms as running nose, cramping, sweating, and diarrhea.

The drug most commonly associated with emotional addiction is cocaine.

The withdrawal process includes sleeping late and spending every waking moment thinking of ways to get drug money.

Why do people become addicted? There is no clear cut answer. Addicts attempting a response often say the addiction just happened. They don't know how. Most cocaine addicts respond by explaining that usage usually begins socially but progresses to dependency over time (the "recreation turned desperation" explanation). Curiosity, along with peer pressure, is another reason. In addition, abusers explain that drug use aids escape from reality, personal problems, and responsibilities.

Once the cycle of addiction begins, addicts find it easier to adjust to being "high" rather than being "straight." As mentioned earlier, the heroin addict feels that he/she has to continue using to avoid the symptoms associated with a nonmedical detoxification. The cocaine addict, particularly the cocaine-base or "crack" addict, continues to use cocaine hoping to duplicate the original high. Consequently, the addict becomes more and more addicted. In several interviews, addicts indicated that they prefer drugs to sex, have lost children and homes, and are unable to stop using. The overall consensus was that most addicts didn't realize they were addicted until the problem was out of control, thus making it extremely difficult or impossible to stop.

Appropriate treatment may not be an option for an addict. Addicts are often forced into treatment by Social Service agencies or by the criminal justice system. This approach routinely fails because addicts are most successful at remaining drug free when it is their own decision to stop using. Forced treatment for an addict who is not ready to change often assures failure. Although a genuine effort may be made to quit, the addict often reverts to using. Relapse may result in a jail sentence and/or disruption of the family unit (failed marriages, children placed in foster care for extended periods, alienation from friends and relatives). Additionally, the "continuum of care process" is not a reality for more than half of the addicts requiring treatment. The continuum usually begins with detoxification (depending upon the history of use) followed by inpatient/residential care, intensive outpatient treatment, and after care treatment with support organizations in place. Many addicts are unable to endure the entire procedure.

Because the city lacks adequate residential resources, an addict in need of residential treatment is usually placed in a detoxification facility for two to four days and subsequently released to an intensive outpatient program. The few residential programs that exist have limited, if any, indigent beds. Those residential programs that accept indigent clients have no less than three to eight week waiting lists. It is unreasonable to expect addicts, who are often transient, to exhibit responsible behavior by maintaining contact with a treatment facility while waiting for admission. Hard core addicts could relapse or lose interest in treatment before a space becomes available. Prior to the abolition of state medical assistance and the closing of some residential programs (X-cell, Second Genesis), treatment availability looked hopeful. However, it seems that treating addiction is not a priority for our city. By closing programs, we get further and further away from accomplishing the goal of adequately treating the addict.

THE COMMUNITY

Drugs and crime go hand in hand. Drug sales, profit, users, and dealers are a major concern to everyone in our community. Drug dealers killing one another, users trying to get money for drugs, and incidental crime resulting from chaos in the streets are consequences of drug abuse. Most violent crime results from drug use and abuse.

Violent drug dealers tend to live and operate in poor, inner city neighborhoods. They work out of "common nuisance houses--places where drugs are cut (mixed with other substances to affect the purity, quantity, and value of the drug), distributed, and stashed--in every city neighborhood. ln some instances, dealers just commandeer empty dwellings and conduct business from there. Some nuisance houses have been fortified with steel doors and bars that deny access to everyone (including law enforcement officers) except the dealer. Guns are the weapons of choice, and dealers do not hesitate to maintain, stockpile, carry, and use them. Dealers can expect assassination or incarceration as a result of their involvement with drugs. Children have been caught in the crossfire of territorial drug disputes. Casualties of the drug wars are common.

Baltimore's citizens have become prisoners in their homes, as they attempt to avoid the trafficking, crime, and aggressive behavior exhibited by drug dealers and users. There were 353 homicides in the city last year, and we are quickly approaching that number again in 1994. The U.S. Department of Justice found that two-thirds of all criminals arrested in 1989 were using at least one drug at the time of arrest (Siegel et al., 1991). Robbery, burglary, assault, and prostitution are just a few of the crimes committed by people who are under the influence of drugs. Officials have removed public telephones that were being used in the drug trade from most street corners. Baltimore youths are distracted from legitimate pursuits such as education and employment and are lured into "the business" by the promise of fast, easy money and notoriety.

All Baltimore residents share in paying for the additional health, social, welfare, law enforcement, and criminal justice costs related to the use of illegal drugs. Baltimore's tax base continues to erode as middle and upper income residents flee the city. These deserters are moving to surrounding counties--taking advantage of much lower tax rates and trying to escape the violence. Public service costs increase as the number of people in the city living below the poverty level increases.

MEDICAL CONCERNS

The United States spent $15 billion to fight the War on Drugs in 1993. About two-thirds of that amount was allocated to fight the war criminally. Only one-third was used to address health concerns related to abuse. Violence and AIDS as a result of drug abuse contribute to years of productive life lost.

There are approximately 35,000 to 38,000 injection drug abusers in Baltimore City (Beilenson, 1994). Ten percent of them are HIV positive. The incidence of AIDS more than doubled in the past five years, increasing from 404 new cases in 1988-89 to 979 in 1992-93 (BSAS, Inc., 1994). Of all the AIDS cases in 1992-93, 55.3 percent had injection drug use as the primary risk factor.

While the number of new AIDS cases in Baltimore's older gay population has stabilized, 75 percent of all new AIDS cases belong to injection drug abusers, their partners, and their babies (Beilenson, 1994). For the past four years, injecting drugs has remained the predominant route of HIV/AlDS infection among Baltimore residents (BSAS, Inc., 1994). AIDS is the number one killer of 25- to 44-year-olds in Baltimore City.

Sixty-three percent (163) of Maryland's 1992 drug-related deaths occurred in Baltimore City. From 1988 to 1991, the Baltimore metropolitan area had a 47 percent annual increase in drug-related deaths--one of the highest in the U.S. (BSAS, 1994). Drug-related deaths in the Baltimore metropolitan area increased 177 percent from 1990 to 1991 (BSAS, 1994). Most of these deaths were caused by cocaine or heroin alone or in combination with alcohol. Baltimore ranks first among all U.S. cities in overdose deaths (Beilenson, 1994).

Drug abusers have a myriad of medical complications. Stroke, neurological complications, anxiety, and dizziness have been associated with cocaine and heroin abuse. Many long term heroin addicts suffer kidney disease, which results in the necessity for dialysis or transplant. Long-term cocaine use can cause heart damage. Many drug abusers just don't take care of themselves. They don't eat properly. Oral hygiene is poor and many have teeth. Health care is not a priority for most drug abusers (Kahier).

As mentioned earlier, there were 353 homicides in Baltimore City in 1993. This rate would probably be much higher if not for the trauma care available in Baltimore City. Approximately 80 percent of all homicides are drug-related.

CRIMINAL JUSTICE CONCERNS

Approximately 6660 inmates inhabit Baltimore City penal institutions.

Eighty percent of those inmates are incarcerated for drug related crimes

(Schmoke, 1994). The cost of housing each inmate is about $23,000 yearly.

Jail cells are filled before their construction is complete.

Law enforcement agencies and city prosecutors spend incredible amounts of time investigating and prosecuting drug related crimes. Fifty-five percent of the felony case load involves narcotics.

Individuals seeking drugs (heroin, cocaine, marijuana, and certain prescription drugs) can find them in any neighborhood in Baltimore City. These substances can be bought in vials, capsules, and bags for as little as $10. They can be snorted, injected, and smoked. Demand for drugs dictates the supply. Many dealers take the risk of selling drugs due to the profit involved. In 1993, one ounce of cocaine sold for $737 to $1563 depending upon its purity. One gram of heroin sold for $51 to $120 (BSAS, 1994). Depending upon the purity of the drug, street dealers can more than double or triple their initial investment. Most dealers think the benefits outweigh the risk of drug distribution.

WHAT IS BEING DONE?

Treatment is available for drug abusers in Baltimore City. The treatment and recovery system is currently composed of 46 publicly funded treatment providers and 32 privately and federally funded substance abuse treatment programs and hospital based detoxification units (The Mayor's Working Group on Drug Policy Reform, 1993).

Drug interdiction programs involve teams of officers who monitor courier activity throughout the city and state. Couriers, or mules, bring drugs from source locations (New York, New Jersey, Miami, Philadelphia, etc.) for distribution in Baltimore. The police arrest couriers and confiscate their drug stashes.

The Baltimore City Police Department periodically conducts raids of open-air drug markets. The goal is to arrest and prosecute all major drug distributors and offenders in a target area. Other city agencies including the Departments of Public Works, Housing, Recreation and Parks, Health, and Animal Control, collaborate to clean up the area and work with neighborhood residents to ~take back their streets.~

IS IT WORKING?

Baltimore's treatment and recovery system can only help a very small percentage of drug abusers. The 5418 publicly funded treatment slots in fiscal year 1994 had 17,035 admissions (Beilenson). Two thousand eight hundred seventeen of the available slots were in methadone maintenance programs. There are an estimated 50,000 people using illegal drugs in Baltimore. Thirty-five thousand are heroin abusers, and approximately 20,000 are cocaine abusers. (Some addicts abuse more than one drug.) In addition, there are about 70,000 alcohol abusers in Baltimore City, many of whom also use illegal drugs (Mayor's Working Group on Drug Policy Reform, 1993). Clearly, treatment is not readily available.

Although many dealers are identified through drug interdictions, raids, and undercover operations, distributors outnumber law enforcement officers. For every distributor arrested, another appears to take his/her place. Turf wars continue, innocent people are dying, and young black men are killing each other in their quest for drug profits.

SOLUTIONS, OPTIONS, RECOMMENDATIONS, AND COMMENTS

It is time to take a very serious look at the drug problem in Baltimore City Removing the profit from the drug trade may be the only way to resolve it. However, the members of this panel are hesitant to say how that should be done. We do agree that every option should be discussed and alternative effects on the community should be researched by medical, law enforcement, economic, and criminal justice professionals before the option is implemented or dismissed.

1. Legalization is not an acceptable solution. American society is one of excess. Making drugs available the way that alcohol was legalized and distributed after Prohibition would probably exacerbate addictions The resulting problems would be similar to those that exist because of alcoholism. Increased drug use among the younger population may emerge and cause higher rates of addiction. The consequences of increased addiction may outweigh any benefit derived from demand drug availability. Although degrees of legalization have been implemented in other countries (United Kingdom, The Netherlands), it has not proven as

successful as initially hoped. Drug use in these countries has not decreased, and a younger population has started to experiment.

2. Consideration should be given to decriminalizing marijuana. Although it is classified as a Schedule I CDS, the potential for abuse and lack of accepted safety is debatable. There are no documented cases of marijuana overdose (Beilenson, 1994). Because of its classification, the marijuana supply is controlled by criminals who profit from its illegality. The volume of more serious drug crimes does not allow police and prosecutors time for marijuana simple possession cases. Since marijuana simple possession laws are seldom enforced, the laws are disrespected. Decriminalization of marijuana would be an honest response to a debatable issue.

3. Medicalization may be the best solution for managing addiction and drug proliferation. Although some drug abusers may be suspicious of a medicalization approach, recognition of abuse as a public health problem may encourage more abusers to seek help. Identifying which drugs could be dispensed would be the first priority. Procedures and circumstances where this approach could be used must be identified. Responsible regulation, disbursement, and security policy would have to be developed.

4. Drug trafficking is a crime. Individuals who import, make, or sell CDS should be prosecuted. Individuals who attempt to avoid prosecution by recruiting or soliciting juveniles into their drug trafficking organizations should receive additional penalties. Addicted drug dealers should be sentenced to treatment with no option to refuse. It costs $23,000 yearly to house one inmate. Drug treatment costs can start at $600. Treatment should include counseling, job training, and job placement.

5. Treatment for substance abuse exists but is not readily available. There are too few publicly funded slots accessible to those who request treatment, and private centers are out of the economic reach of all but the wealthiest abusers. Treatment-on-demand with continuum of care is necessary to assist drug addicts who want to stop using. Hospital-based recovery programs that admit any drug abuser requesting treatment should be open and accessible 24 hours a day, seven days a week. The addict should remain in hospital-based treatment until residential treatment becomes available.

6. Expand Beginning Alcohol and Addictions Basic Education Studies (BABES) to all elementary school students. Drug education should begin immediately upon enrollment. Baltimore City, in coalition with community based organizations, business enterprises, and other and interested individuals, should provide liaison support for conducting seminars, classes, lectures, and tours that educate citizens about the effect drugs are having on our community, what to do about the problem, and where to go for assistance. A network of existing resources, volunteers, and public agencies should be established to support this educational effort.

7. Research into the development of new drugs for managing drug abuse should be a priority. Antidotes and substances that cause illness when opiates are used (similar to Antabuse for alcoholics) have not been manufactured. The use of ORLAAM, a medication that prevents the withdrawal symptoms associated with opiate addiction and blocks the "high" of street opiates, should be expanded to addicts who are emotionally capable of handling that treatment.

8. Continued attention must be paid to the social ills that contribute to problems of drug use and abuse. Joblessness, homelessness, poverty, hopelessness, breakdown of family units, and inadequate education are widespread. Any effort to correct social disorder is a positive step toward managing drug problems.

9. Inquiry and analysis of drug management efforts in other countries with an eye toward finding solutions should be performed. (See appendix for a brief discussion of the drug policy in the Netherlands. Their policies may be good ones to investigate.)

ONE JUROR'S OPINION

The drug problem today should be treated as a local and national epidemic. The police know it. The prosecutors know it. The hospitals that provide treatment as a result of the carnage on our streets know it. Certainly those people going about their daily lives in close proximity to the worst of the drug-infested areas know it is an epidemic.

What must be done to convince the rest of the population how serious the drug problem is? Citizens of Baltimore know there is a problem. We read about it in the papers, hear about it on the radio, and see it on TV. But in the media, this is happening to someone else. The impact of the problem doesn't hit home until it touches us personally.

Americans tend to react better and faster when circumstances are personalized. Some plan has to be devised so that the average person is made to feel the full impact of what is happening to "those other people's lives." The 1994 September Term Grand Jury visited Man Alive Research, Inc. The highlight of that trip involved listening to and questioning two people who volunteered to talk about their experiences involving drugs. Seeing and hearing these two individuals speak candidly was one of the most influential experiences we had during our investigation. Their openness gave us an actual sense of how drugs had affected their lives and the lives of their families. If there was just some way to get this message across to people on a personal level, we may be more willing to accept the fact that alternative solutions are needed. As stated in Time Magazine, 1'people need to understand the problems they face together and the costs and effort necessary to solve them~ the change in behavior and attitude sometimes, the sacrifices and above all the need to think and adapt."

APPENDIX

THE DRUG POLICY IN THE NETHERLANDS

The Dutch drug policy is administered by the Ministry of Welfare, Health and Cultural Affairs, in cooperation with the Ministry of Justice. The policy includes enforcing the Opium Act and prevention and treatment for drug abuse. The Opium Act has two main parts:

1) distinction between drugs presenting unacceptable risks and traditional hemp products (hashish and marijuana) and

2) distinction between drug users and traffickers/distributors. Cannabis (hashish and marijuana) is not a Schedule I drug but a nuisance drug. Under certain conditions, the sale of soft drugs in coffee shops is permitted in The Netherlands, as long as there is no dealing in hard drugs. The coffee shops must abide by the following rules: no sale to minors, no quantities greater than 30 grams may be passed over the counter, no advertising, and no public nuisance. The sale of soft drugs in coffee houses keeps the user from dealing with the underworld drug market and moving on to hard drugs. Possession of soft drugs for personal use is a misdemeanor.

The trafficking and distribution of hard drugs have the highest priority for investigation. The maximum penalty is 16 year's imprisonment plus a heavy fine.

The Netherlands policy on hard drugs states that the use of drugs is primarily a public health issue and not a problem of crime or justice. Prevention, care, and education are the priorities.

The principles are a multi-factional network of medical and social services from a local and regional level. Treatment and care are easily accessible for social rehabilitation of present and former addicts. Full use is made of general services and facilities, such as general practitioners and youth welfare services. Instead of publicity campaigns, preference is given to the general health of young people, including that pertaining to juvenile drug abuse. When arrested, problematic drug users are given a choice of drug treatment or prison.

Sources, Resources and Acknowledgements:

Beilenson, Peter, M.D., M.P.H., Commissioner of Health, Baltimore City Health Department. Grand Jury lecture on the needle exchange program in Baltimore City. Clarence M. Mitchell, Jr. Courthouse, Baltimore, Maryland, October 24, 1994.

Caltrider, Jr., William R., President, Center for Alcohol and Drug Research and Education. Grand Jury lecture on the problems associated with drug legalization. Clarence M. Mitchell, Jr. Courthouse, Baltimore, Maryland, November 14, 1994.

Daiker, Ruth, Executive Director, The Counseling Center. Grand Jury lecture on substance abuse prevention, education and abstinence. Clarence M. Mitchell, Jr. Courthouse, Baltimore, Maryland, December 13, 1994.

Frazier, Thomas C., Commissioner, Baltimore City Police Department. Grand Jury lecture on the effects of drug abuse in Baltimore City. Baltimore City Police Department Headquarters Building, Baltimore, Maryland, November 17, 1994.

Special thanks to the many Baltimore City Police Department employees who testified before the Grand Jury, escorted us on the headquarters, Shoot-Don't-Shoot, and night tours, and addressed many concerns and technical questions during this term.

Kahler, Linda, Research Associate/Coordinator, National Institutes of Health, National Institute on Drug Abuse. Grand Jury lecture on health problems related to illegal drug usage. Clarence M. Mitchell, Jr. Courthouse, Baltimore, Maryland, November 18, 1994.

Reese-Austrich, Karen, Executive Director, Man Alive Research, Inc. Visit to Man A~ive Research, Inc. November 22, 1994.

Special thanks to Michael Hayes, M.D., Sheri Cohen, HIV Coordinator, and Dianne Hare, R.N., staff members at Man Alive Research, Inc. We also express our sincere appreciation and gratitude to the clients of Man Alive Research, Inc., who openly and willingly shared their experiences and answered our numerous probing and personal questions. You cannot imagine the effect your presentation had on members of this panel.

Satterfield, Frank, Executive Director, Glenwood Life Counseling Center. Grand Jury lecture on methadone detoxification and maintenance. Clarence M. Mitchell, Jr. Courthouse, Baltimore, Maryland, December 13, 1994.

Schmoke, Mayor Kurt L. Discussion of the drug problem in Baltimore City. City Hall, Baltimore, Maryland, October 18, 1994.

Simms, Stuart 0., State's Attorney for Baltimore City. Grand Jury lecture on drug abuse from a law enforcement perspective. Clarence M. Mitchell, Jr. Courthouse, Baltimore, Maryland, October 13, 1994.

Special thanks to the Deputy and Assistant State's Attorneys who presented cases, addressed the panel, taught us about the law, and raised our consciousness level with respect to crime in Baltimore City.

The Annotated Code of the Public General Laws of Maryland, 1957 (Article 27 Crimes and Punishment, Section 279) Volume 2. Charlottesville, VA: The Michie Company-Law Publishers, 1992 Replacement Volume.

Arts and Entertainment Investigative ReDorts (A&E series): "War On Drugs: RIP." A&E (Channel 51), Baltimore, September 23, 1994.

The drug policy in The Netherlands (February 1994). The Netherlands: Ministry of Welfare, Health and Cultural Affairs, Ministry of Justice.

The Dutch drug Dolicy: Some facts and figures (May 1994). The Netherlands: Ministry of Welfare, Health and Cultural Affairs, Alcohol, Drugs, and Tobacco Policy Division.

Siegel, Mark A., Binford, Shari M., and Foster, Carol D. (1991). Illegal drugs and alcohol: Hurting American societv. Wylie, Texas: Information Plus.

The Mavor's Working GrouD on Drug Policy Reform (November 1, 1993). Baltimore City: Mayor's Working Group on Drug Policy Reform.

Selected indicators related to alcohol and drug abuse (October 1994). Baltimore City: Baltimore Substance Abuse Systems Inc.

©html 1966 mario lap drugtext