Washington's suburbs had worse drug abuse problems with cocaine and PCP than any other suburban area nationwide and ranked second only to Detroit's suburbs in the level of heroin abuse, according to some indicators contained in a new Rand Corp. report that was previewed yesterday.
The District of Columbia's problems with heroin and PCP abuse were even worse than those of its suburban neighbors, but Prince George's, Montgomery, Fairfax and Arlington counties and the City of Alexandria together led the city by 50 percent in 1986 in cocaine-related emergency room admissions.
Among the 26 largest metropolitan areas in the nation, excluding New York City, the Washington area ranked first in PCP- and heroin-related deaths and third behind Boston and Miami in deaths related to cocaine.
When viewed overall, the figures show that the depth of the drug abuse problem in the Washington region is virtually unmatched, according to the report, which documents for the first time the degree to which suburban drug use is contributing to the area's drug epidemic.
"The Washington region seems to be suffering more from the tragedy of drug abuse than most other urban jurisdictions in the nation," said Edward F. Mitchell, president of Potomac Electric Power Co. and chairman of a private-sector task force that commissioned the report. "It is not an inner city problem. It is truly a regional problem. It is not a problem that is bounded by race, age, profession or income level. It affects every segment of our society and our community."
The report, whose statistical base extends only through 1986, does not take into account the recent and rapid rise in the use of crack cocaine, which law enforcement officials say has surpassed PCP in use in the District and which is fueling drug turf wars and is behind soaring homicide rates in the city and Prince George's County.
Nonetheless, its authors say it portrays the scope and depth of the drug problem in the city and in the suburbs and, in the process, shatters some myths about who is abusing drugs and where.
Among the report's other key findings are these:Although D.C. suburbs were ranked second behind Detroit's suburbs for the rate of heroin-related emergency room admissions in 1986, that suburban ranking was higher than the rankings of most of the largest cities except the District itself, San Francisco, Seattle, Phoenix, New York, Los Angeles and Detroit.
In Prince George's and Montgomery counties, 45 percent of the people admitted to treatment programs for heroin in 1986 were white. And in those same counties, 60 percent of all people in drug treatment during that year were white.
High school students in the District and in the suburbs are more likely than their counterparts nationwide to be using PCP.
Between 1978 and 1986, admissions to drug treatment programs increased by 135 percent, the report says. But the treatment network is seriously underfunded and overwhelmed by referrals from the courts.
Drugs arrests in the Washington area increased by 70 percent between 1981 and 1986. In the District alone, arrests for drug distribution increased thirteenfold. Prosecutions, convictions, prison commitments and average minimum sentences at least tripled, "making drug enforcement the major focus of the entire criminal justice system in the District," the report says.
"Nevertheless, there is no evidence that the District's intensified enforcement efforts have reduced drug abuse in the short run."
To many who work in the fields of law enforcement and drug abuse treatment on a daily basis, the report provided few new and startling details. The four-member team of Rand researchers who compiled the $100,000 report over 15 months did not conduct original research, but instead drew on existing statistics that were gathered by other sources, including the National Institute on Drug Abuse, police departments and drug treatment programs. The report is the first product of the Washington Fund for the Prevention of Substance Abuse, which is composed of key members of the Federal City Council, the Community Foundation, the Greater Washington Board of Trade and the Greater Washington Research Center, which released yesterday's preview. The final report will be released in April.
The report is not intended to present a "policy prescription," said Peter Reuter, its chief author. Rather, it is a first attempt at characterizing the region's drug problem and providing area policy-makers with a basis for coordinating their efforts, Reuter said during an interview before its release yesterday.
"It is intended to provide as much as anything else a description," Reuter said. "By putting together very disparate kinds of data that aren't normally joined together, I would say this represents a best effort at characterizing the drug problem as a whole for the metro area and also an effort to try to characterize how programs relate to the problems."
According to the report, law enforcement efforts, which account for 75 percent of the region's antidrug expenditures, cannot by themselves be expected to reduce the drug problem.
The District's Operation Clean Sweep, for instance, has been successful in bringing relief to some drug-infested neighborhoods by detering drug dealing and violence there. But the operation has not reduced the drug problem as a whole.
"I'm not saying it is a failed policy," Reuter said at yesterday's news conference. "I'm saying that the judgment about the effectiveness of these policies can't be made simply on the basis of their impact on drug use. They have effects that go well beyond that."
Police should continue to crack down on drug trafficking wherever it exists, the report says, but officials in the various jurisdictions also should begin to focus more money and manpower on drug treatment and prevention.
In addition to the overcrowded treatment network, the report says the success of various drug treatment methods is unclear.
PCP presents a unique problem for the area, not only because of the numbers of people using it but also because little is known about how to effectively treat the users.
In 1986, for example, 68 percent of PCP users who were in treatment programs in Prince George's and Montgomery counties did not complete their treatment.
The report recommends that more efforts be made to develop PCP treatment programs that work, and that programs for treatment of all drugs be expanded.
While over the last several years the use of the drug methadone to treat heroin addicts has been criticized as substituting one addiction for another, the Rand report recommends that methadone maintenance be expanded. Heroin addicts in the District represent a static, aging segment of the drug-abusing population, the report says. They commit crimes when they are in search of the next fix, Reuter said.
In addition, intravenous drug users such as heroin addicts are at high risk of contracting the AIDS virus and thus they represent a threat to the population at large. Methadone could help reduce that risk because users take it orally, rather than intravenously and thus do not risk contamination through a dirty needle.
In contrast to the difficulty of designing successful PCP and cocaine treatment programs, methadone maintenance for heroin addicts is "something we know how to do and what we can get out of it," Reuter said.
The report also recommends a dramatic increase in efforts to design and implement drug prevention programs, which it calls "the principal long-term hope for controlling" the problem. Reuter called prevention the "stepchild" in the antidrug effort. Prevention efforts in the Washington area -- as in the rest of the nation -- receive no more than 5 percent of public antidrug expenditures, according to the report.
Mitchell said the task force plans to use the Rand report as the beginning of more efforts by the private sector to work to find solutions to the area's drug problems.
"I think the business community has increasingly become aware of the economic costs" of drug abuse, which he said has "a very real, potentially tragic impact on a whole generation of young people."
-------------- EMERGENCY ROOM MENTIONS OF DRUG USE----------------
------- PER 1,000 ADMISSIONS IN 10 TOP-RANKED AREAS, 1986*--------
-------------------- HEROIN --------- COCAINE -------- PCP ------
---------------- CITY - SUBURB --- CITY - SUBURB -- CITY - SUBURB
San Francisco......5.96.. .75......2.90...1.46......1.39..... .20
Detroit..........4.59....1.52......4.21...1.58...... .04..... .09
Los Angeles......4.58.... .73......6.15...1.17......4.15..... .65
New York City....2.08.... .35......2.97...1.01...... .25..... .04
Seattle..........1.52.... .33......1.29... .89...... .04..... .03
Phoenix..........1.4..... .27......1.31... .54...... .19..... .02
Miami............1.15.... .10......5.35...1.11...... .62..... .01
Newark........... .81.... .90......1.83...2.42...... .02..... .11
*The 27 participating metro areas are: Atlanta, Baltimore, Boston, Buffalo, Chicago, Cleveland, Dallas, Denver, Detroit, Indianapolis, Kansas City, Los Angeles, Miami, Minneapolis, New Orleans, Newark, New York, Norfolk, Oklahoma City, Philadelphia, Phoenix, St. Louis, San Antonio, San Diego, San Francisco, Seattle and Washington D.C.
**These figures do not reflect upsurge in use of "crack" cocaine derivative since 1986.
NOTE: Emergency room mentions of drug use were collected from 19 area hospitals in 1986: nine in D.C.; 10 in the suburbs. There were 640,000 emergency room admissions in those 19 hospitals during 1986: 325,000 in the district; 315,000 in the suburbs. "Suburbs" included: Prince George's, Montgomery, Arlington and Fairfax counties and City of Alexandria.
SOURCE: National Institute on Drug Abuse
OTHER DRUG CULTURE FACTS
-- Greater Washington Center's report show Washington area high school students were more likely than their counterparts in the nation as a whole to be using harder, more dangerous drugs.
-- In 1986, 45 percent of treatment admissions in Montgomery and Prince George's counties for heroin -- long perceived as a "black, inner-city drug" -- were white. And 60 percent of people receiving drug treatment in the two counties were white.
-- The Washington area's heroin addict population is static and aging because recruitment into use of the drug peaked in the early 1970's. But heroin was still the primary drug of abuse for 55 percent of all treatment admissions in the District in 1986.