Mahmoud Baptiste was out in the D.C. government "drugmobile," preaching to the children at Wheatly Elementary in Northeast. He asked the third graders if they knew what PCP was. Smiles lit up their faces. They turned to each other with stories of their brothers and their cousins and the guy down the street who "freaked" and shot his mother in the face and the one who jumped naked from his fifth-story window.
"What other names does PCP have?" Baptiste asked the kids. "Lovely, Boat, Bucknaked," a chorus of children's voices shot back. And when Baptiste asked the kids how they recognized the hustler, the street term for pushers, they said: "Gold chains, Fila sweatsuits, Timberland boots and slick cars."
PCP has become the drug of choice among young people in Washington's inner city. Its use is on the rise in Washington even while it is declining in other cities. According to the National Institute on Drug Abuse, 35 percent of all drug-related emergency-room admissions here are for PCP users. In May, the District's Pretrial Services Agency, which tests almost all those arrested -- juveniles and adults -- found that of the 31 percent of juveniles who tested positive for drugs, 98 percent were using PCP.
PCP is cheap, accessible and relatively easy to manufacture. Any petty-drug entrepreneur can walk into a hardware store, buy the chemicals and turn $1,000 into $100,000 in the back seat of his van.
It is also dangerous. Playing with it is like playing Russian roulette. In one person it can cause a short euphoric high, in another a psychotic delusion and a sense of superhuman strength that can lead to such violent crimes as murder and sexual assault. It is the gruesomely violent crimes that have law enforcement officials worried.
Just why PCP is so much more prevalent here than in, say, Chicago, New York and Detroit is, in the words of Dr. David Fram of the Washington Psychiatric Institute, "something of a mystery." But one thing's for sure: the huge increase in the number of PCP-related crimes in Washington attests to a crisis. They rose from 2,850 in 1985 to 4,257 last year. Capt. William White III of the D.C. police department explains that some of these crimes are typical of other drug-related crimes: muggings and robberies to support a habit, assaults resulting from turf disputes between dealers. But PCP also causes those under its influence to commit gruesomely violent crimes with no apparent motive.
While the District has become the country's PCP capital -- a dubious distinction -- it also is on the forefront of attempting to treat users. With the city's emergency rooms filling up with PCP users, it became apparent that special attention needed to be paid to the drug and its victims. Under the direction of D.C. General's chief psychologist, Theodore Brown, the hospital established last year the country's only inpatient PCP-detoxification unit. It has 20 beds, half for adults and half for juveniles.
A significant number of those who end up in Washington's emergency rooms strung out on PCP are brought in by police after having attempted crimes or displayed psychotic rage often associated with the drug. Bringing PCP users down to the emergency room is no easy task; they have been known to break out of handcuffs, a feat that requires up to 70 pounds of pressure. And it might take six or more men to restrain a 15-year-old kid on PCP. Once the patient arrives at the hospital, a specially trained staff is needed to decide what kind of treatment the patient needs. Doctors must first decide if the patient needs immediate medical care -- neurological or other -- or if the patient first needs psychiatric attention. Sometimes split-second decisions have to be made with regard to whether or not the patient should be treated with drugs -- a risky decision to make given the volatile nature of PCP.
Brown, an expert on the drug, says medical knowledge of PCP is still "pretty crude." Little is known about the drug's short-term or, especially, long-term effects. Traditionally, drug treatment has been geared to the opiates -- heroin and methadone. Treating PCP patients is a whole new ballgame, requiring expertise in fields ranging from psychiatry and social work to violence management.
The clinic at D.C. General is doing important work, but detoxification units can only help the tiny fraction of addicts who voluntarily seek treatment. Meeting the challenge therefore is not just the responsibility of physicians. It is also a problem for the mayor, the police and the social services. It's tempting to call for the usual "crisis" response from the community -- calls for awareness and community involvement, role model rap stars singing about the dangers of drugs. But it will take more than that to reach third graders for whom PCP, far from being a crisis, is just part of normal life. -- Daniel Klaidman is a member of the editorial page staff.