BLEAK TIMES AHEAD FOR PACIFIC NORTHWEST AS HEROIN EPIDEMIC TAKES HOLD

Easy Availability And Low Prices Led To Fatality Rate Twice National Average

Seattle -- 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 Seattle's
port 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 and essentially put 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 an estimated
36,000 clean needles are distributed, in hopes of protecting addicts from
diseases such as hepatitis or AIDS. The clinic also enlists a brigade of
recovering addicts to roam the area and try to persuade other drug users to
get help.

"A lot of people want to quit, but the availability of heroin around here
makes it almost impossible for them to stop,'' said Luke, 26, one of these
outreach workers. He declined to give his last name. "You can find it
almost on any corner.''

In Seattle and Portland, officials are expanding programs that provide
addicts with methadone, an opiate that satisfies a craving for heroin
without the same destructive effects. They're also dispatching more health
workers into the field to seek out and help heroin junkies. But hundreds of
addicts still spend months on waiting lists for treatment.

Seattle Mayor Paul Schell recently appointed a community task force to
study how the city can better treat heroin addiction. Health officials also
are urging the county and the state to shift their philosophy toward "harm
reduction'' rather than abstinence. Providing addicts with CPR lessons or
safe injection rooms supervised by nurses could save lives and reduce
crime, they say, as well as slowly but surely lure junkies in for medical
help to break their habit. But some elected officials say the steps could
promote more heroin use.

Police also are cracking down. Last month, after a two-year undercover
investigation, Seattle narcotics investigators and federal agents arrested
nearly two dozen people and charged them with running one of the city's
more organized heroin distribution rings. But they suspect other
traffickers are still on the I-5 corridor.

The recent raid temporarily dried up some of Seattle's heroin market. Now
health officials are bracing for a rash of overdoses because heroin
addicts, desperate for a fix that lately has been harder to find,
apparently are buying and injecting even cruder forms of the drug, or
mixing it with other drugs.

Last year, about 110 people each in metropolitan Portland and Seattle died
from heroin overdoses. More than 1,500 heroin addicts are in treatment
around Seattle.

Addicts are a diverse group, officials say. Some are middle-aged and middle
class, from a wide range of prosperous jobs until they succumbed to addiction.

"They aren't necessarily just the young, inexperienced, rock-crazed types
that people expect,'' said David Solet, an epidemiologist in the King
County Health Department.

Public health officials in Portland and Seattle say they're starting to see
encouraging results from recent steps to expand treatment and needle
exchanges and from the greater use of recovering addicts as mentors to
junkies. Overdose deaths have even declined a bit lately. But no one
predicts a swift end to the crisis.

"We're making progress, but we're in for a long struggle,'' Oxman said.
"Among young people, this has become just another drug. And I wouldn't say
that heroin has just been glamorized to them. The main thing is that it has
been normalized. It's regarded with a lot less concern and fear than it
once was.''