In the middle of a kiss, she saw her boyfriend suddenly turn into the devil. She watched him enter the bathroom and heard running water, and she was certain he was going to drown her. Scanning the room for an escape, she chose the window. She would jump.
"I was on the fourth floor. I thought I was going mad," the woman recalled recently. Then her boyfriend emerged from the bathroom with a damp cloth to wipe her perspiring forehead.
That experience convinced the 27-year-old woman, who had been using about $700 a week worth of PCP, heroin, pills and "anything I could get," that she was an addict.
After several unsuccessful attempts to rid herself of drugs, she asked for help at the Washington Hospital Center's detoxification unit for heroin addicts, but she was told that she would have to wait a month for treatment.
She is one of hundreds of drug abusers in the District who are told to wait weeks, or even months, when they finally muster the courage to cry out for help. Meanwhile, city officials recently turned down a suggested increase of several million dollars in proposed drug abuse treatment and prevention funds.
Last month, Mayor Marion Barry said that the city is experiencing a drug epidemic and that "I wish this community would rise up against this epidemic to assist us. It's not the government's responsibility to do all of this."
Not long before, however, the mayor had rejected several million dollars in funds for drug abuse programs. According to City Council members John Wilson (D-Ward 2) and John Ray (D-At Large), they and other members wanted to add $8 million to the fiscal 1986 budget for that purpose, but Barry objected, saying that the city would not be able to spend the money because it did not have the necessary programs in place. The council voted to add $4 million.
"The drug problem in the city is devastating and tragic," said Ray. "Of all the things we had to consider in the budget, it deserved the most critical attention. We had found an additional $4 million, but the mayor came down and said he couldn't spend the money."
Betsy Reveal, the mayor's budget director, said that if the entire council had wanted to increase the drug abuse budget by a total of $8 million, it could have done so, regardless of what the mayor felt.
"Nobody has an answer to exactly what should be done, because if we had an answer we would be doing it," said Reveal. " . . . If you're putting dollars after the problem without defining the problem, you're going to have problems effectively spending it."
For addicts seeking help, the delay in entering a program can be agonizing.
"I thought I would probably die out there because I was using everything to get high -- PCP, heroin and Valium," said the 27-year-old woman, who asked that her name not be used. "I was scared. I had never gone five days without being high."
Although the wait at the hospital center was reduced to a week, the woman was again using drugs before she entered the drug treatment program. Now, at age 29, she works as a secretary, has been drug-free for 16 months and is a volunteer working with drug addicts.
These extended waits for help in escaping the bondage of drug dependency often are devoted to prostitution, burglary, theft, drug peddling or whatever means addicts know to support their habit. Or they end up in the city's unintentional detoxification center, which has neither fees nor a waiting list -- jail.
At the District government's Alcohol and Drug Abuse Services Administration, drug abusers who seek help are scheduled for appointments. Last Friday, the appointment list contained the names of 66 persons whose wait for an evaluation would range from one to 12 days. Once those people are interviewed, the maximum wait before placement in a program, if needed, would be three days, according to officials.
The Washington Hospital Center maintains a waiting list of 15 to 20 persons for its private 10-bed heroin detoxification unit. RAP Inc., a private drug education and rehabilitation program, has added 100 persons to its waiting list since Janauary. Second Genesis Inc., another private program, limits its waiting list to 25 and tells addicts that the wait is from 60 to 90 days.
"People call back for two or three weeks and ask if we have room yet," said Donna Alexander, a program therapist for Second Genesis. "When the calls stop, we call just to stay in touch with them, and many of them say they are no longer interested."
The city's budget for the drug services administration has more than doubled, from $9.8 million in actual expenditures in 1983 to planned expenditures of $21.9 million for fiscal 1986. Lonnie Mitchell, the agency's chief administrator, said the city has made major progress in its drug treatment and prevention programs. He said that the agency admitted 2,734 persons to drug treatment programs and treated a monthly average of 2,199 alcohol and drug abusers in 1984.
In the near future, Mitchell said, the city plans to release a five-year comprehensive plan for dealing with the city's drug problems and to use money in the fiscal 1986 budget for new programs. He stressed, however, that a ward-by-ward attack on drugs is the real answer, not money.
Still, Mitchell said, "We could spend any amount of money the City Council could provide."
The District, officials estimate, has 12,350 heroin addicts and 60,775 multiple-drug users. Budget records show that the city drug administration failed to spend $553,000 of its planned $10.6 million budget in fiscal 1984.
Meanwhile, health officials and City Council members express concerns that the city is not responding adequately to drug users who seek help.
City Council members say addicts and their relatives and friends have asked for help in locating treatment programs. Social workers lament the absence of a city drug detoxification center for youths or adults. The names of addicts are shuffled back and forth from one agency to another in search of a suitable treatment program.
"The mayor's argument was that he couldn't spend the money, and every agency I meet with says it is absolutely overwhelmed" with requests for help, said council member Wilson. "Even if a small percentage of the junkies walked in and said they wanted to quit, we wouldn't have anywhere to put them."
Recently, a 22-year-old woman who was four months pregnant and experiencing side effects from a dose of heroin stumbled into the Community of Hope, an inner-city neighborhood support group, and asked for help, said the Rev. Tom Nees, the center's director.
"She had no insurance, and there was no place to take her," said Nees. "I took her to my home for three days. I've done that often for people who need to detox. I've been working with addicts for years, and some become drug-free by going cold turkey on their own. But I know a lot more drug addicts that died than got well."
Officials for Second Genesis and RAP, two of the treatment programs that have service contracts with the District government, say that the city is not footing the total bill for District patients.
Second Genesis, at 1320 Harvard St. NW, spends $506,785 to make available 65 beds for District drug users, but the city pays only $265,000 of the bill, said Ruth Cavanagh, a spokeswoman for the program. The program, she said, gets the remainder of its money for District clients through receiving grants, holding fund-raisers and helping indigent clients apply for welfare payments and food stamps to supplement their stay at the facility.
In response to the high demand for its services, RAP recently instituted a new policy: Anyone who leaves the 18- to 24-month residential program will not be allowed to return. RAP has a waiting list of 400 names that dates to September. Ron Clark, RAP's executive director, said private programs have underbid for city contracts because the city offers less than the actual cost of treatment.
"We either walk out and say, 'Sorry, we can't do it,' and go out of business, or adjust to fit in the program," said Clark. "We've been subsidizing the District government for the last 10 years. When they didn't give us enough money to operate, we took care of it ourselves. We've been operating at a loss for the last five years. We've got a $100,000 deficit."
Drug services administration chief Mitchell said the city has contracted for outside drug services based on the city's ability to pay.
Some officials of other private agencies that work with drug addicts say that many addicts desperately need city services because they do not have the money or the insurance to pay for private help.
The Psychiatric Institute of Washington, a private organization that receives high praise from many health professionals, runs an inpatient drug program for youths that costs $641 a day and an adult drug program at a cost of $495 per day, according to an institute spokeswoman.
Mitchell said some drug addicts, after special arrangements, are going through detoxification at an alcohol center on the grounds of D.C. General Hospital.
"We don't want it well known that we are detoxifying drug addicts in an alcohol ward," Mitchell said, because that is not the facility's primary purpose.
The city's principal method of dealing with heroin addicts is to administer methadone, which is also addictive but temporarily wards off the pain of heroin withdrawal. Mitchell said that 1,500 of the drug abusers in the city's treatment programs receive methadone and that he wants the city to stop using the drug.
"It is simply a substitute for heroin and has a number of negative health consequences, and we're not looking to keep people addicted," said Mitchell.
Within 60 days, Mitchell said, the city plans to begin a pilot program using the nonaddictive drug Naltrexone, which was approved by the Food and Drug Administration in November.
Mitchell said the city plans to open a youth PCP detoxification center at D.C. General Hospital this year and an adult detoxification center in 1986.
Meanwhile, council members say that the city needs to make a real commitment to drug treatment and prevention.
"The people you see on the street corners tend not to be those who raise a lot of ruckus with city hall," said council member Ray. "So the city chases those people from one location to another, and frankly it is a lot easier to deal with addicts that way than to make a financial commitment to do treatment."