IV HEROIN SHOOTS INTO THE SUBURBS

A new study suggests that shooting up heroin -- one of the most
addictive and dangerous forms of drug abuse -- is a growing problem
among young adults and is shifting from the cities to suburbia.

Based on data from more than 200 New Jersey drug treatment clinics, the
study by the state Department of Health and Senior Services found that
the number of 18- to 25-year-olds who get their heroin by injecting it
increased sharply, from 587 in 1993 to 1,326 in 1999.

Those findings reversed what had been a 15-year decline in the
popularity of injected heroin and show that the problem is no longer
confined largely to the inner cities.

From 1993 to 1999, admissions of young adults into treatment for heroin
addiction -- both snorted and injected -- nearly tripled for those from
suburban and rural areas but fell 46 percent for those from cities. By
1999, among young adults seeking treatment, suburban and rural heroin
users who injected the drug outnumbered their urban counterparts 2 to 1.

"The popular image has been that this is an urban problem. Clearly we
have documentation here that it's a problem for all of New Jersey," said
George DiFerdinando, deputy commissioner for public health services.

He said he worries that suburban and rural drug users are not getting
the message, which has been emphasized in urban areas, that intravenous
drug use carries a risk of spreading AIDS and other diseases such as
hepatitis. The department will be intensifying its efforts to spread
that warning in suburbia, he added.

The study is being published in today's editions of Morbidity and
Mortality Weekly Report, published by the federal Centers for Disease
Control and Prevention.

Because it studied drug users entering treatment, DiFerdinando cautioned
that it may not mirror trends among the estimated 90,000 to 100,000
heroin users in the state. But as a public health official, he said, he
has to take seriously the threat that intravenous drug use and its
associated risk of AIDS are on the rise.

Anna Kline, director of research at the health department's division of
addiction services and the study's lead author, said, "What's really
happening is this dramatic shift from the urban areas to the rural and
suburban areas."

Health officials are not sure why, but they have some theories. One is
that urban drug users have seen firsthand the devastation of AIDS, while
suburban and rural users have been "quite insulated," Kline said. "They
haven't seen their friends and family members dying from it."

That, coupled with the fact that heroin is now very cheap and
exceptionally pure, may have gotten suburban users hooked on snorting
the drug before graduating to injecting it, Kline said.

Interviews with law enforcement officials, drug treatment specialists
and addicts support that theory.

At $10 a bag for heroin that is 60 to 65 percent pure, the drug is a
cheap high that lures suburban buyers, according to Capt. James Durkin,
commander of the Union County Narcotics Strike Force.

"Nearly all of the people we arrest are from out of county, from places
like Toms River, North Brunswick," Durkin said. "Many are from
surrounding well-to-do communities. They travel to the city to buy
heroin, otherwise known on the street as 'diesel,' because it is cheaper
in the cities."

Edison police Lt. John Weglos, commander of the department's narcotic
enforcement bureau, said his detectives are arresting more young people
for heroin.

"There's noticeably more," Weglos said. "People are getting started
snorting heroin. They may have experimented snorting cocaine or crank
(methamphetamine) and are graduating quicker to heroin."

"Heroin use is way up," said Jerry Barone, clinical director at High
Focus Center, based in Cranford. "It's found its way into suburbia, more
available than before, not as costly, like $10 a bag."

That low price, less than the cost of a music compact disc, is part of
the reason for heroin's popularity with the young, according to Morris
County Prosecutor John Dangler, who has seen "a noticeable increase in
heroin use among girls, 15- to 17-year-olds."

The exceptional purity of the heroin on the market is also part of the
reason. Thirty years ago, heroin sold on the street was so impure "that
in order to get high, you needed to shoot up," said Bill Warner,
clinical director of inpatient rehabilitation at the Carrier Clinic in
Belle Mead.

That was enough to scare away many suburban and rural youngsters who
"don't want to have anything to do with needles," Warner said. But at
the higher purity levels on the street today, they can get high -- and
hooked -- without shooting up.

"They start off snorting or smoking because they can get a powerful
high, but eventually because of the tolerance they build up, they need
to use more and more to get the high they want," Warner said.
"Eventually, they can't get high from snorting or smoking, and so many
who never would have had anything to do with needles start to shoot up
because they hear from other people that it is much more powerful."

One 18-year-old Warren County woman now undergoing rehabilitation at the
Carrier Clinic went down that path in a remarkably short time. Speaking
on condition of anonymity, she said she started using heroin when she
was 14 and had just graduated from the eighth grade in Morris County.

"I started with an ex-boyfriend. It was just kind of something we were
both trying," she said. "I started sniffing in July and started shooting
in March of that (next) year. A lot of people around me were doing it. I
wanted to see what was so good about it. The high is different; you get
a rush. But the sickness is also different."

Warner said the young woman, who arrived at the clinic Sunday night,
lost bladder and bowel control until yesterday and has been vomiting and
has a swollen tongue. "This is the first day she's been able to keep any
food down," he said.

Kline said her statistics showed the increase in shooting up heroin is
most dramatic among 18- to 25-year-olds. It is up slightly among 26- to
34-year-olds entering treatment and declining among those over 35, she
added.

She said the department has too little data about those under 18 to draw
any conclusions. But Joe Hedden, executive director of Daytop-NJ, an
adolescent drug treatment center in Mendham, Morris County, said he sees
more people under 18 coming in for heroin addiction.

"Six years ago, I doubt if we had one or two adolescents using heroin.
Right now, 60 percent of our kids are addicted to heroin," Hedden said.
"It's become the drug of choice for adolescents in the New Jersey
suburbs."