What's a young, single psychiatrist from an artsy section of Manhattan doing in Salt Lake City?

Making a change in his life - and in the lives of Utahns suffering from alcohol and drug abuse.Dr. David Brizer is the new chief of a 16-bed recovery unit at the Western Institute of Neuropsychiatry. He's more than 2,000 miles and almost as many cultures away from his former practice on the East River of the Big Apple.

There he was director of the alcohol clinic at Manhattan's overcrowded, under-funded inner- city medical facility - Bellevue Hospital. His patients were the socially disadvantaged - the homeless, the hopeless.

In the evenings, Brizer's work - in trendy Tribeca - took a 150-degree turn. Once dominated by warehouses, textile industries and factories, Tribeca has become a gathering place for working and would-be performers and artists, a place something like Soho and Greenwich Village.

Here, in a loft overlooking endless art galleries, the 36-year-old physician lived and practiced psychiatry. His patients, the socially advantaged, included accountants, lawyers, stock brokers and performers.

Brizer, a New York native, was also the substance abuse consultant for the Performing Arts Center for Health - an organization for dancers, artists and musicians seeking quality but affordable medical care.

Their lifestyles shared little resemblance to the city's bag people. But Brizer's clients had one thing in common: They abused drugs to feel and perform better.

"The patterns of drug abuse differ from one segment of society to another, which only makes sense. People abuse the kinds and amounts of drugs that their peers do," said Brizer. "If you are talking about the Bowery, you are talking about people who drink cheap wine - using whatever they can afford to get high."

Cocaine is more popular among higher economic classes - in New York and across the country.

"Drug abuse in many segments of society has been vastly under-reported by families, co-workers and medical professionals," said Brizer. "The number one disorder among psychiatric patients is substance abuse. Anywhere from 25 to 60 percent of people with psychiatric problems have substance abuse problems as well.

"Alcoholism alone costs this country at least $100 billion a year in lost work hours, hospitalization, accidents."

Utahns count heavily among the staggering statistics.

"If what I am already seeing is typical of what is going on across the state, Utah has its share of problems. A big share," said Brizer, whose office reflects the newness of his arrival and the intensity of his work. Framed medical documents from New York Hospital and Albert Einstein College of Medicine are stacked on the floor, waiting to be hung. Medical books remain in boxes.

His time in Utah has been dedicated to troubled people seeking an escape through medication. But, unlike those at Bellevue, his new patients can look to a recovery unhampered by severe poverty and lack of social supports.

"At Bellevue, our goal included getting these people places to live, food to eat. Getting them sober," he said. "Surprisingly and gratifying enough, many of those people did straighten out; we were able to help."

But the economic state of the city and of the city hospital made it difficult to work there year after year.

"I never felt that we were able to offer them as much as we would have liked to."

That has changed since he set down roots in Salt Lake City this month.

The New York psychiatrist, on staff at the University of Utah Health Sciences Center, is working in a new, state-of-the art facility. And his patients have resources important in helping them overcome drug and psychiatric problems.

Unlike the homeless from the Bowery, most of Brizer's patients who complete treatment at the Institute of Neuropsychiatry return to solid support systems.

"The fact that so many of these patients are returning to their jobs, families and churches means their outlook is that much brighter," he said.