Doubt Greets Claims of Drop in Cocaine Use

A dramatic drop in cocaine-related hospital emergency room cases, ballyhooed by the Bush Administration this week as evidence that Americans are being persuaded to eschew the narcotic, actually may indicate only that drug dealers are diluting their wares, according to police and medical experts in Los Angeles and elsewhere around the nation.

In interviews, the investigators and emergency room workers who serve as foot soldiers in the nation’s battle against drug abuse were skeptical of the Bush Administration’s interpretation of a 22% drop nationally in cocaine-related emergency room cases in the last quarter of 1989.

On Monday, Health and Human Services Secretary Louis W. Sullivan, in announcing the decline, had said it was evidence that anti-drug education campaigns were paying off and “we are making significant headway in our efforts to establish a drug-free America.”

While not disputing that a drop in emergency room traffic has occurred and continues, numerous law enforcement officials and hospital workers said in interviews that they believe any decrease in emergency room activity may have more to do with shifting economics in the commerce of street drugs and more careful use by wary consumers rather than any reduction in the number of addicts.

Specifically, they said, a campaign of drug seizures appears to have cut into supplies, forcing profit-minded dealers to stretch their wares by cutting them with flour, sugar, baby laxatives and the like--making doses much less potent and dangerous to users.

For a time, so much cocaine was flooding the country that street dealers felt no need to maintain their practice of diluting the drug with other powdery substances.

Federal drug agents said a current supply shortage, created by their interdiction efforts, has driven up wholesale prices for kilograms of cocaine by about 33% in California cities from San Diego to San Francisco. But the price of small “bindles” of cocaine remains a steady $75 to $100, indicating that dealers are cutting the drug to stretch their supplies and maintain profit levels.

“Bindles are definitely being cut,” said an official with the California Department of Justice’s Bureau of Narcotics Enforcement, which analyzes the purity of drugs seized throughout the state. “This has increased in recent months.”

Phil Jordan, a spokesman for the U.S. Drug Enforcement Administration office in Dallas, said there was “a slight decrease in the number of cocaine-related deaths and injuries in Dallas in 1988 and ’89.”

He added that the availability and price of the drug on the street has remained constant, suggesting to him and others that cocaine is being marketed in a more diluted form.

“There are reports from intelligence that some of the cocaine sold in the Dallas-Ft. Worth area has been cut down,” he said.

Health officials said diluted drugs should be expected to translate into fewer overdoses and other cocaine-related symptoms ranging from seizures to paranoia.

Irma Strantz, director of the Los Angeles County Drug Abuse Program, said, “What we are seeing in terms of this drop could be the beginning of a long-term downward trend or an aberration due to the quality and availability of cocaine on the streets right now.”

In addition, some hospital workers say drug users appear to have become more savvy, taking greater care so as not to wind up in an emergency room with an overdose. Cocaine-related telephone calls to Los Angeles County’s drug abuse hot line also are running 14% below the number of calls a year ago.

“That is an indication to us that there is some change in the behavior of people out there using the line for themselves or others,” said Rene Topalian, assistant director of the county Drug Abuse Program.

Dr. Xylina Bean, a neonatologist at Martin Luther King Jr./Drew Medical Center, said the number of drug-exposed babies reported at that hospital since January has fallen by about 30%, but she did not necessarily see it as evidence that fewer drugs are being used.

“The funny thing is, my mothers don’t seem to have trouble getting the drug,” Bean said. “We’ve asked ourselves whether they are learning to use the drug, or if the drug isn’t as strong.”

Beyond that, Bean also feared that cocaine users in the poorest sections of the city may be supplanting their old addictions with new ones.

“Until you address the underlying problems in the communities where there is heavy drug use, such as high unemployment, low education,” Bean said, “you won’t affect the overall use of drugs.”

Not all hospital workers are convinced there has been a decline in cocaine casualties. For example, at New York City’s Harlem Hospital, the emergency room on average has treated seven cocaine-related patients a day for the last year.

“We certainly have not witnessed a decline,” said Dr. Henry McCurtis, associate director for the hospital’s department of psychiatry.

Sullivan’s announcement Monday seemed designed to counter the damaging effect of a report last week by Senate Judiciary Committee Chairman Joseph R. Biden Jr. of Delaware, who contended that the Bush Administration vastly underestimates the extent of cocaine addiction in the United States.

Sullivan could not be reached for comment on Wednesday. But a spokesman for Health and Human Services agreed there could be “other reasons for this decrease,” adding: “But whatever the reasons for the drop, I would interpret it as good news.”

Richard Rawson, who heads an agency that treats and conducts research on cocaine abusers, disagreed, with reservations:

“It’s nothing to dance in the streets about, although it probably reflects a hopeful trend. Unfortunately, if you look at other types of drug use--alcohol, meth, heroin--you’ll probably find cocaine addicts have switched to other drugs.”