Maryland health officials, alarmed by a worsening statewide "epidemic" of cocaine abuse, have proposed creating the nation's first government-funded residential clinic for the short-term treatment of cocaine users.

Establishing a 25-bed cocaine clinic "is one of the highest priorities of the year," declared Richard L. Hamilton, director of the state Drug Abuse Administration, an arm of Maryland's health department.

Hamilton, interviewed here today at a national conference of 150 of the nation's leading experts on drug abuse, said the clinic proposal has won the initial approval of state Health Secretary Adele Wilzack. The Maryland legislature and Gov. Harry Hughes would have to approve the estimated $150,000 needed to open the clinic, which would offer help to cocaine users who cannot afford costly private care.

"We're being stuck now," said Hamilton. "We're getting more and more indigent people who use cocaine as an adjunct to heroin. Those and many middle-class people who abuse cocaine cannot afford treatment at a hospital or private clinic."

Hamilton's proposal for a clinic and a 28-to-35-day treatment program is in part an outgrowth of a new emphasis by state officials to handle the growing problem of cocaine addiction and abuse. It comes amid a surge in the number of persons -- especially those in the Baltimore-Washington corridor -- who are seeking help for cocaine-related problems. The number of patients with grave cocaine problems seeking help at 55 drug-treatment centers around the state has doubled in two years to more than 3,600 so far this year, according to Hamilton, who called the increase an "epidemic."

Several jurisdictions in Maryland also report sharp increases in cocaine trafficking and some have taken steps to try to control it. In Montgomery County, a brisk cocaine trade is conducted on weekend nights at several bars on Rockville Pike. Anne Arundel County police have confiscated four pounds of illegal cocaine in the last three weeks in the largest numbers of seizures in two years, a spokesman said yesterday.

In Baltimore County, officials recently set up a telephone hotline to help cocaine abusers.

However, Hamilton expressed some frustration yesterday at the public's perception of cocaine. "The general public is not aware of how bad the situation is, that a perfect stranger can walk into any number of bars and obtain cocaine."

Ronald K. Siegal, a University of California psychologist who has studied cocaine use for more than a decade, told conference members today that cocaine "is the ideal drug to use and get away with."

Siegal warned that unless major preventive measures are taken, the United States will soon witness increases in highly dangerous and addictive forms of cocaine use.

In Maryland, cocaine has replaced alcohol as the secondary drug favored by heroin addicts, said Hamilton, who added that the proposed clinic could help detoxify patients with cocaine and multiple drug-use problems.

The drug-abuse administration now provides about $10 million each year to county governments to fight drug abuse, but the proposed clinic would be the first facility in Maryland to receive its primary funding directly from the state and be geared expressly for cocaine abusers.

Because the clinic proposal is working its way through state budget offices, several officials declined to comment on the project, other than to say its future was still unpredictable.

But Hamilton sounded optimistic, saying some of Maryland's expected budget surplus might well be used next year to establish the cocaine clinic.