Dr. Robert Schwartz, Open Society Institute, Baltimore, Maryland July 12, 2004: Dr. Schwartz works for the Baltimore field office of the Open Society Institute. He first became involved in the treatment field while completing his psychiatry residency in New York City.

On drug abuse treatment effectivenes:

Treatment is not a cure- you have to get passed that hurdle first- but no one would say that people shouldn’t get Cancer treatment because it doesn’t cure everyone!... Another interesting thing about treatment it that people may look at studies and say, “sure, it works in New York, or Philadelphia, but does it work here?” But no one would say ‘sure, insulin works in California, but…” There is an underlying cynicism with drug treatment.

“Are we more worried about the treatment or the disease?! There are more deaths from Tylenol each year than Methadone!”

I think about drug treatment like infectious disease- if you have a large population with a certain disease or condition, like AIDS, then you have to get known effective treatments out at the population level, not just the individual level. Cocktail [for AIDS patients] trials showed success at the individual level, but didn’t affect the national mortality rate. But once [cocktails were] widely available, the mortality rate began to drop precipitously. Similar with drug treatment; if you have a city or town where most people are not in treatment you won’t see an effect [in crime rates, drug abuse rates, etc.]. You won’t see it until you reach that tipping point. In the case of Baltimore we really need over 70% in treatment, for us that is 35,000+ people, in order to see a dramatic citywide effect.

On waiting lists:

We know treatment is best, yet there is infinite space in jails and waiting lists for treatment programs. Jail is very expensive and treatment is cheap- so even if you are coldhearted it makes no sense to have waiting lists [for treatment]. It never made sense to me having waiting lists- people walk around and talk about how bad the drug problem is and wonder what we can do about it- hello!

On Baltimore:

The people in Baltimore are very tolerant and accepting of harm reduction and drug treatment… maybe because drugs have been around for so long… it’s not controversial at all. Like needle exchange- just part of the fabric of the community. And there are plenty of cities in the U.S. with drug problems that just don’t address it.