LOSING THE WAR ON DRUGS

It was a day to celebrate at least an intermediate victory in the war on
crime in Lawrence.

Last July 27, before assembled neighborhood group leaders, city officials
and business leaders, Lawrence Mayor Patricia A. Dowling and Police Chief
John J. Romero laid out the numbers: Violent crime -- murder, rape,
robbery, aggravated assault -- had dropped by an average of nearly 50
percent in the past two years. Burglary and larceny were down by similar
amounts. The only major category police had failed to dent significantly
was auto theft.

But hidden beneath those pleasing statistics is a different, much
more grim number. In Lawrence alone, so far this year, police say there
have been 11 confirmed deaths from heroin overdoses, with another three
virtually certain. That's more than four times the homicide rate of three
so far this year. During a one-month period beginning in June, four men
were found dead from heroin.

And that is just one, tragic piece of evidence of a stark reality: Three
decades after the nation launched the War on Drugs, heroin is cheaper,
purer and more accessible than ever before. While there are no hard numbers
on overdose deaths, virtually everybody in public health and law
enforcement says they are up. According to a recent federal study, drug
addiction is up, nationwide and in Massachusetts. State Sen. James P.
Jajuga, D-Methuen, a former state police officer, says Essex County has
been and continues to bea major drug-trafficking destination.

In Lawrence, the problem may well be worse than police can even say. Those
14 deaths are just the ones police know about. If a person dead or dying of
a drug overdose ends up at a local hospital without any police involvement,
there is no legal requirement to notify law enforcement. The hospital's
only mandate is to notify the state medical examiner's office.

"I'm sure there are others, but if we (police) aren't involved in finding
them, we don't know about them," says Lawrence police Capt. Michael S. Molchan.

Of course, it isn't a crime to die from a drug overdose. The cops can't
arrest a packet of heroin residue.

But those deaths are a direct spillover from the criminal drug trade. State
Commissioner of Public Health Dr. Howard Koh, an Andover resident, calls
drug overdoses "one of the major public health issues of our time. And it
doesn't just affect the individual user," he says. "The impact on the
community is extraordinary. It fuels joblessness, child abuse,
homelessness, violence, driving under the influence."

Dr. Wayne Pasanen, head of emergency services at Lowell General Hospital
and medical director of Habit Management Institute, the methadone clinic in
Lawrence, agrees. That's why it is a mystery to him that it tends to float
below the radar of public awareness.

"One of the most dramatic experiences I've had recently as an emergency
room physician was when they brought in a young man who was dead on arrival
froma drug overdose," he says. "There were nurses, pulling back the sheet,
looking at the body, who seemed to be totally unaffected by it. The police
were coming in, looking at the body like it was a piece of meat.

"And I said to myself, 'How biased and ignorant are we, that we don't get
upset about this?' There is all this hysteria about the West Nile virus,
when we don't even have one case of it in the region, while all around us,
people are dropping like proverbial flies."

Of course, nobody chooses to get bitten by a mosquito, while overdose
victims tend to be addicts, who made a choice to start taking drugs, and
who live below the public radar anyway, so when they disappear, it causes
barely a ripple. "At one level it's a problem," says Essex County District
Attorney Kevin M. Burke, "but at another level, it's not something that
affects the community directly."

The War Over The War

Still, while heroin overdoses may not be creating public hysteria, they are
prompting increasingly shrill debate over the seemingly endless "War on
Drugs." Those in law enforcement, while acknowledging a "public health"
dimension to overdoses, contend that the best way to deal with the problem
is to continue the war, with better strategies and more money.

Their opponents -- an expanding coalition of grassroots organizations,
political parties, treatment specialists and even some front-line police
officers -- say the drug war doesn't work, is far too expensive, is
essentially a war on people rather than drugs and is as doomed as
Prohibition was in the 1930s.

And in the war over the War, it is still law enforcement that has the
money, the votes in Congress, and the law -- in other words, the full
weight of government -- on its side.

At the federal level, U.S. Attorney Donald Stern, responding to pleas from
Lynn Police Chief John Hollow and Mr. Burke's office, conducted a pilot
project in Lynn during 1999 that found, to nobody's surprise:

"Large numbers of people are overdosing and dying" from heroin. Actually,
the numbers in Lynn were not nearly as bad as they are in Lawrence.
According to the study, 30 people died in Lynn during a period of a little
less than four years, ending in August 1999. Nearly half that number died
in Lawrence in less than nine months.

Those dying of overdoses typically had "extensive prior court involvement,"
including arrests for violent offenses and restraining orders.

Perhaps more surprising, however, was the finding that "neither the law
enforcement nor the public health system has systematically tracked the
numbers of deaths from heroin overdoses." In other words, while officials
know that overdoses are killing perhaps hundreds each year statewide, there
is no collection of data that shows precisely how many and where those
deaths occurred.

So Mr. Stern's "action plan" calls for better data collection. But it also
calls for the traditional approach in the drug war -- "increased sanctions
on offenders."

Meanwhile, at the county and local levels, a similar "enforcement" battle
continues, pretty much as it has for years. Mr. Burke's office reported
earlier this year that the Essex County Drug Task Force had made 1,059
drug-related arrests and seized large quantities of cocaine, heroin,
marijuana and Ecstasy in 1999 -- close to the numbers it had for 1997 and 1998.

In Lawrence, where the problem of drug dealing is the most acute in the
region, there are almost weekly headlines about it. Lawrence police Officer
John M. Ragosa, of the department's Crime/Disorder Analysis Unit, says
there were 841 narcotics-related arrests for the first eight months of
2000, up from 752 the previous year. The department conducted 15 narcotic
sting operations, many of them producing dozens of arrests.

Throughout the region, most other police departments don't collect
statistics on drug arrests, seizures and overdoses, but officers in those
departments all say the numbers, especially regarding heroin, are up.

"If we really pushed it, you can't imagine the number of arrests we could
come up with," says Methuen police Lt. Ted Hoyle. "The use of heroin is
definitely up."

The war is not all punitive. It does include "treatment and prevention."
According to Dr. Koh, there are 115,000 yearly admissions statewide to the
drug-treatment system, which includes inpatient residential services, acute
detox, residential recovery homes, outpatient clinics with methadone
support, counseling and "pharmaceutical interventions."

Locally, besides Habit Management Institute, there is a wide range of drug
treatment and counseling available in Lawrence, including the Pegasus Youth
Residential home for recovering teens, and Women's View, a residential
recovery home for women. Greater Lawrence Family Health Care, on Broadway,
has a drug-treatment program at Centro Panamericano on Amesbury Street. And
there is the Lawrence Teen Coalition, with services covering everything
from drug abuse to teen pregnancy, suicide, abuse and neglect.

Then there is the public relations effort. September was National Alcohol
and Drug Addiction Recovery Month, and the Massachusetts Organization for
Addiction Recovery sponsored a day of "information, awards, open
discussions and guest speakers" on Sept. 27 at the Statehouse.

Chronic Habits

With all that, one might expect a press conference announcing a 50 percent
drop in drug dealing, addiction and use. Instead, things seem to be headed
in the other direction, even with few hard statistics on such things.
Heroin is more plentiful, more pure and about as cheap as it has ever been.
Lawrence police Lt. Anthony Lorenzo says a decade or more ago, a bag of
heroin that was about 8 percent to 10 percent pure cost $30. "Now it is
about 90 percent pure, and costs $5 to $6 a bag if you buy in a pack of 10,
which most people do," he says.

And the addictive hold of the drug remains powerful, even years after
people have remained clean. Indeed, the faces of addiction are everywhere.
If addicts are among the enemies of the War on Drugs, Lt. Lorenzo says he
saw a familiar one just during the past couple of weeks, when a man he had
known in school, and then later as an addict from about 10 years ago, was
cruising through one of the neighborhoods.

"I knew exactly what he was doing," he says, "so I let him go around a
corner, and then I came around the other way. There was a dealer walking up
to his car, and he took off as soon as he saw me. I pulled up and the guy
got out of the car. He said, 'Hey, Tony, I didn't know it was you.' I asked
him what he was doing, and he said he was working at Raytheon, but since
they had been on strike, he didn't have anything to do.

"I told him, 'Well, you're not doing the right thing here.' "

Another is Nancy Drew, a sweet-faced, 44-year-old Haverhill resident who
sits in an office at Habit Management Institute, talking proudly about her
8-month-old grandson.

Ms. Drew has been coming to the methadone clinic for eight years. She says
she will have to continue coming for the rest of her life, because for the
22 years before that, starting when she was 11 years old, she was a heroin
addict.

"I was very mature, physically and emotionally, she says, "and I had a
boyfriend who was much older. He was 20."

He was also an addict, who introduced her to heroin. "My curiosity got the
best of me," she says, admitting that she "liked what I saw that it did for
him. It made him feel better. And I was depressed, socially and because of
things in my family."

For more than two decades, she had a string of boyfriends who were all
dealers. "They took care of me," she says. But those relationships, and the
heroin that came with them, destroyed her health. "I have hepatitis B and
C. I have kidney problems. I have diabetes," she says now, without a trace
of bitterness. "It's (heroin) a killer."

Dr. Koh, simply repeating what every counselor or treatment expert knows,
says that drug addiction is "a chronic, relapsing disease."

At Pegasus, director Julie C. Vaux says one 18-year-old client was in his
23rd treatment. "You do have relapses. It's a process," she says.

Irresistible Forces

Those realities, say opponents of the War on Drugs, are just a few of the
reasons that it should be ended. Carla Howell, the Libertarian Party
candidate for U.S. Senate who is challenging Sen. Edward M. "Ted" Kennedy,
calls it "another Vietnam that has failed." By now, the Libertarian screed
against the drug war is becoming more familiar:

Mandatory minimum sentencing (which Sen. Kennedy supported) has doubled the
prison population, filling cells with nonviolent drug offenders -- a large
percentage of them minorities.

By creating a black market, the drug war promotes high prices and high
profits, which are always attractive to organized crime.

Civil liberties suffer, as citizens become subject to random urine tests,
highway checkpoints and government scrutiny of financial transactions.

As in Prohibition, the drug war makes the drug problem worse. According to
Ms. Howell, "in the 1920s, thousands died of alcohol overdoses or
poisoning" from adulterated booze.

"Now, it's so rare," she says, "that when something happens like the young
man (Scott Krueger) who died at MIT, it's so unusual that it's in the
papers for months."

Most drug users are not addicts, and are otherwise law-abiding citizens.
The cost of incarcerating peaceful drug users squanders money that would be
better spent on violent crime.

It breaks up families, by jailing otherwise good, productive citizens.

Obviously, the Libertarian take on the drug war is not yet shared by enough
of the population to have changed the law. Its contention that the drug war
creates high prices is just plain wrong, given that heroin is cheaper than
ever. But an increasing number of experts, like Dr. Pasanen, believe that
the war needs to shift to much more emphasis on treatment.

Those who are waving the white flag include even some front-line
law-enforcement officials, who agree with Methuen's Lt. Hoyle that, "If
there ever was a war, it was lost a long time ago. I'll probably get in
trouble for saying this, but I cannot, for the life of me, figure why we
arrest people with a medical problem," he says.

Dr. Pasanen says he doesn't favor legalizing drugs, although he says he has
seen no serious health or public-safety problems from marijuana. But he
says heroin addiction must be treated as a disease, not a crime. "Yes, you
do make a choice to start using heroin," he says, "but nobody -- nobody
ever starts using it with the intention of becoming an addict.

"What happens," he says, "is that, with regular use, heroin shuts off some
kind of switch that the body uses to produce its own endorphins. I equate
it to something like diabetes, where one day your body decides to stop
making insulin.

"So you lose the ability to choose. Can you imagine going in to see your
doctor with diabetes, and hearing him suggest that you should try to
control your blood-sugar level with will power? Addiction is one of the
most powerful forces known to man. It's like thirst, hunger or sleep."

When it comes to cost, Dr. Pasanen says, the choice should be obvious. "It
costs about $36,000 to keep somebody in prison for a year, and we can treat
them with methadone for about $100 a week," he says.

What about spin-off crime? Dr. Pasanen says a well-known study that tracked
addicts in New York City and Philadelphia found that those placed on a
methadone maintenance program dropped from an average of 230 "days of
crime" per year to less than 10.

And to those who say methadone is simply switching from one addiction to
another, Dr. Pasanen says those on methadone are not high or impaired, and
can live productive, sober lives. Indeed, Ms. Drew says, methadone "saved
my life. I absolutely wouldn't be here without it."

Her friend "Mary," who didn't want her real name used, says she has been on
methadone for five years -- too late to save her marriage, but soon enough
to rescue her relationship with her children and grandchildren. "One of my
daughters gives me a piece of gold for every year I'm sober," she says
witha smile. "I'm working on six, now."

Don't Make It Worse

But if there is an end to the war, even against just users, it will
probably be a long time coming. While there is clear agreement from both
sides that drug overdoses are a public-health problem as well as a crime
problem, those in law enforcement are not about to agree that it is time to
decriminalize drug use. That, they say, will make things much worse than
they are now.

Andover Police Chief Brian Pattullo is one who believes users should be
targeted as aggressively as dealers. "I believe if we start hitting the
users, the dealers are going to feel it," he says. "If we weren't making
these arrests, how bad would it be? Everything can always be better, but
without the war on drugs, we'd be in a lot worse condition. It's not just
drug use, but what follows from it. It's very expensive for society."

District Attorney Burke says he believes in treatment for drug users. "But
when you're dealing with an addictive personality, you need the hammer as
well," he says. "You're not going to get people participating in treatment
unless you force it. Addicts are nothing if not creative."

His office has also been able to prosecute some drug dealers for
manslaughter, after drugs they sold killed a person. In two decisions
handed down in 1990, the state Supreme Judicial Court ruled that dealers
could be charged with manslaughter for "wanton and reckless conduct," in
selling to addicts. Still, First Assistant District Attorney Robert Weiner
admits that such cases are very difficult, since the prosecution has to
prove the dealer sold the drugs, and that it was those specific drugs that
killed the victim.

Lawrence Chief Romero says he believes "you just have to keep chipping
away," at drug use and crime.

"This is a very profitable business, and people are willing to take the
risks," he says, "but where I came from in Washington Heights (part of New
York City), we cut homicides from 119 in 1991 to nine in 1998. And most of
those were drug-related. Drugs fuel crime. Even if they were legalized,
people would still need the money to get drugs and would still commit the
crimes."

U.S. Attorney Stern's "action plan" for Lynn, which he says he hopes to
expand throughout the state, calls for better data collection, increased
sanctions on offenders and targeted prevention programs.

However, nearly a year after that plan was announced, little of it has been
implemented.

Better data collection may require legislation, which the statewide
association of district attorneys is considering filing, that would allow
hospitals to report drug overdose cases as they are brought in, without
being liable for violating patient confidentiality.

But so far, there has not been so much as a meeting to discuss possible
legislation. Holy Family Hospital President William Lane says he is more
than willing to talk about it. "Anything we can do to alert the public
without violating people's privacy -- we're happy to take that step," he
says. Mr. Lane says he has heard talk of district attorneys setting a
meeting with the Massachusetts Hospital Association, "but that hasn't been
scheduled yet."

Mr. Stern admits to being "disappointed that we have not made better
progress," but he says the Lynn project is a partial success. He says his
office has "gotten the right people together" to talk about better data
collection. And we have to remember that this (drug addiction) is one of
the most intractable, difficult problems around."

He says those who call for decriminalization are "crazy, if they think it's
going to make it (heroin) less available. Like Mr. Burke, he says the fact
that drug users can be charged with a crime gives law enforcement the
leverage it needs to force such people into treatment.

"Part of the concern Kevin (Burke) and I share is that people using heroin
are getting younger and younger. There used to be a stigma to it, because
it involved needles. But now, because of its purity, it is smokable and
snortable," he says, adding that he does believe law enforcement emphasis
should be on sellers more than users.

But he still firmly believes the war must go on. "Do we solve the problem?
No," he says. "But do we make a dent? Yes."