Narcotics research, rehabilitation, and treatment. Hearings, Ninety ...

)169period of addiction prior to the current incarceration was 7 years (1). Ttierefore,the discrepancy between the St. Louis data and the District of Columbiadata may reflect the acute epidemic in Washington in recent years. This hypothesisgains some support from the fact that the BNDD list for Washington rosesharply from about 1,100 each year from 1965 through 1968 to 1,743 by December31, 1970. The earlier BNDD figures for Washington for 1965 through 1969 were:1,116, 1,164, 1,106, 1,162, and 1,636.Where do heroin addicts live in the city?Based on the opioid overdose deaths and NTA patients, and assuming thatthere are a total of 16,800 heroin addicts in the city, it is possible to describe ageographic profile of addiction in the city.( See table 3 and fig. 6.The rates of heroin addiction range from less than 0.1 percent for the relativelyaffluent northwest section of the city west of Rock Creek Park, to the rateof 4 percent in the model cities area, area 6. These rates of addiction closelyparallel reported crime rates and other indicators of poverty and socialdisorganization.(See table 4.)Using this same data it is possible to estimate the number of addicts perthousand people in various sex and age groups in the Washington, D.C.,population.From statistics based on opioid deaths, several conclusions can be drawn.Addiction is concentrated almost exclusively between the ages of 15 and 45.Sixty^five percent of the addicts are under 26 and 31 percent are younger than21 years of age. For the age range 15 through 19, the citywide rate for boys is10.7 percent and for girls 2.2 percent. The next older age bracket, 20 through 24,has rates of 19.8 percent and 3.2 percent respectively for boys and girls. From25 through 29, the rates are 6.2 and 5.0.( See fig. 7 and table 5.Relating this data to the geographic distribution data and using the distributionof NTA patients indicates that in service area 6 (the model cities area) 20percent of the boys between the ages of 15 and 19, and an astonishing 38 percentof the young men between the ages of 20 and 24 are heroin addicts. The Districtof Columbia model cities area begins six blocks north of the White House, andextends east above Massachusetts Avenue to four blocks north of the U-S.Capitol.How much does the heroin addiction epidemic cost the community?The most certain and tragic cost of heroin addition in 1970 was the 63 peoplewho died of opioid overdoses. In addition, almost all heroin addicts commitcrimes to support their expensive habits. Based on an estimate of 15,0(X) heroinaddicts, and assuming an average habit of $40 per day, a recent study estimatedthat the annual value of proijerty and services transferred because of addictionthrough robbery, theft, prostitution, drug sales, et cetera, was $328,100,000 (6).One of the common ways to support a habit is to sell heroin. This spreads theepidemic. The indirect costs of heroin addiction to the community from urbandisorganization and fear of crime are equally staggering.What can be done about the epidemic?Heroin addiction is a treatable disease for most addicts. There is excellentevidence that methadone maintenance is safe and effective (7). Therapeutic communities(such as Synanon, Day top, and Phoenix House) and community selfhelporganizations (such as Blackman's Development Center in Washington)offer promise of success with many addicts.A recent study of the narcotics treatment administration program performancewith 475 randomly selected patients for the 6-month period from May 15through November 15, 1970, showed that 55 percent of all patients in the programon May 15 were still in the program 6 months later. The retention rate for highdose methadone maintenance was 86 percent after 6 months. Arrest rates weredown and employment was up for the patient population. Only 7 percent of thepatient population was still regularly using illegal drugs and 55 percent showedno evidence of illegal drug use during the sixth month of treatment (S).Seventy -six percent of NTA patients were voluntary, self-referred walk-insto one of the 10 NTA centers located throughout the city. Twenty-four percentwere referred by agencies of the criminal justice system, such as probation and60-296 O—71—pt. 1 12