HEROIN'S DEADLY LEGACY

What US Attorney Donald Stern is calling ''a virtual epidemic of people
overdosing on heroin'' in Massachusetts cannot be stopped by law
enforcement alone. Local police departments, courts, hospitals,
treatment centers, and the state need to start collecting and sharing
information, at a minimum, to stem the tide of drug-related deaths.

Armed with a grant from the US Justice Department, Stern has been
focusing on heroin use in Lynn, a city of 80,000 with more drug deaths
than homicides. Between 1996 and 1999, 402 drug overdoses were reported
to police in Lynn, including 30 fatalities. This is almost certainly an
understatement of the actual problem, since many people are treated at
hospitals with no police involvement.

Stern emphasizes that Lynn is far from the heroin capital of New
England, though the small city can be a research model for the region.
Massachusetts as a whole was cited in a federal survey last week as
having among the nation's highest levels of substance abuse involving
marijuana, alcohol, and other drugs besides heroin.

Heroin use is on the rise generally, Stern says, because prices are low
and the drug's purity is so great that users can get high on small
doses without using needles. But oddly, in a state that requires health
officials to keep data on everything from domestic violence to nursing
home abuse, the state Department of Public Health does not collect
uniform statistics on drug overdoses. Improved data collection is key
both to understanding the scope of the problem and to identifying
solutions.

Similarly, court probation officers and treatment centers should do a
better job of tracking drug users. Stern believes that many overdoses
occur just as ex-addicts are returning to the streets after prison
terms or stints in rehab, when their drug tolerance is lowest. Inmates
with drug histories should be intensively tested for drug use as a
condition of their release. Follow-up for graduates of rehab centers
can not only protect individuals but should help assess which treatment
programs have the most successful models and which are failing.

Tracking drug crimes is made more difficult by the balance needed
between law enforcement and saving lives. If every witness to a drug
overdose were hauled into court, for example, users may be frightened
off from calling the police or emergency technicians if they see a
friend overdosing.

Heroin addicts are not the most sympathetic figures in society; some
people may feel that overdosing is merely an occupational hazard, a
fate to be expected. But heroin abuse goes hand in hand with criminal
activity that society cannot wish away. Stern's research showed that 71
percent of the addicts who overdosed in Lynn had a criminal history,
including not just drug charges but offenses involving guns, violence,
and domestic abuse. This kind of complex criminal overlay makes drug
abuse everyone's problem.