HEROIN PLAGUING NATION'S NORTHWEST

The junkies drift along downtown streets, scrounging for change and another
hit. They cluster in alleys waiting for community vans to arrive with clean
needles. And by the hundreds they straggle into Kim Murillo's health clinic
here every month, doped up and wiped out by heroin.

"We're seeing so many people," she said. "Many of them are desperate to
quit, but the habit can be extremely hard to break. They think they need it
to survive. It's such a vicious cycle."

It's also an epidemic. No region in the country is having a deadlier
struggle with heroin than the Pacific Northwest. The problem isn't new, but
all signs suggest it's worsening.

Deaths from heroin overdoses have more than doubled in King County, which
includes Seattle, over the last decade. They have risen so much in the
nearest metropolitan area, Portland, Ore., during the same time that the
drug is now ranked among the leading causes of death among white men ages
25 to 54.

Treatment centers in both cities are handling record numbers of heroin cases.

Needle exchange programs are besieged. Jailed criminal suspects commonly
test positive for the drug. By some estimates, there are now as many as
20,000 heroin addicts around Seattle. In a report last summer, the federal
Centers for Disease Control and Prevention called some of those statistics
the most severe in the nation.

Heroin use has been rising nationwide, but the overdose fatality rate in
the Northwest is twice as high as the national rate.

"We have a pretty big chronic user population, and it seems like more and
more young people here keep getting recruited to the heroin scene," said
Gary Oxman, director of the Multnomah County Health Department, which
covers Portland. "It really is exacting a large social toll on the community."

Heroin has become a drug of choice, and a public health scourge, in the
Northwest for many reasons. It's plentiful, usually smuggled into the port
here or north of the border in nearby Vancouver, then whisked down the
Interstate 5 corridor by a sophisticated trafficking network. It's getting
cheaper, often sold for only about $20 a dose. What's available on the
streets is mostly a crudely refined "black tar" heroin made in rural
Mexico, whose potency is wildly unpredictable, making it more dangerous.

Both Seattle and Portland also draw transient youths fleeing the largely
rural Northwest. With no steady jobs or ties to the area, they fall prey to
the heroin culture because it's communal and easy to find.

"For some, this seems to fill a spiritual void," Murillo said.

Underground heroin circles have thrived particularly since Seattle became
popularized last decade as a hip haven for "grunge" slackers, artists and
musicians, drug counselors say.

Some local officials even wonder if the frequently rainy, cloudy weather
contributes to heroin use.

Oxman said he believes the heroin problem intensified when traffickers
changed their marketing strategy, essentially putting the drug on sale.

"They figured out it was more profitable to have more people hooked at a
lower price."

The clinic that Murillo directs, Stonewall Recovery Services, is in a
neighborhood near downtown, filled with fashionable coffee shops and
restaurants.

But it's also a hub for the heroin trade.

Each month at the clinic, about 400 addicts are counseled and some 36,000
clean needles are distributed, in hopes of protecting addicts from diseases
such as hepatitis or AIDS.