HEROIN ADDICTS GETTING YOUNGER

Drug-related Deaths, Illnesses Are On The Rise

WORCESTER-- Peter Stefan sees more than his share of the misery caused
by heroin addiction. His business, Graham, Putnam and Mahoney Funeral
Parlors on Main Street, is the next-to-the-last stop for many who have
enjoyed a final dose of what has become the drug of choice for
addicts. Among drug abusers in Massachusetts, heroin has surpassed
cocaine, crack and marijuana.

In fact, its use has increased steadily since 1992, while addicts' use
of alcohol, cocaine and marijuana has declined. The rise has been
steady despite the dangers of contracting AIDS, hepatitis and other
diseases from tainted hypodermic syringes, and the very real danger of
dying. "I see a lot of deaths from overdose and lot of young people
dead," Mr. Stefan said, adding that he handles funeral arrangements in
many such cases. "We do so many, we can't keep track," he said. "It's
sad here and difficult to work here seeing some of the things I see.
"I don't think any of them overdose intentionally," Mr. Stefan added.
"It just happens.

Do I prejudge them? No, I don't prejudge anybody." The statistics kept
by authorities serve to indicate the scope of the problem. From
January 1996 through December 1998, the last year for which figures
are available, 292 Worcester County residents died from drug
overdoses, many involving illegal narcotics and some involving
medications available by prescription. And the actual tally of
drug-related deaths may be higher. Physicians and medical examiners
who certify the causes of deaths may list the primary one as heart or
renal failure resulting from a range of circumstances, which may or
may not include drug abuse.

Other causes of death sometimes cannot be certified because toxicology
reports have not been done, or have been delayed. It is not unusual,
state and local health officials say, for a death certificate to
include the phrase "pending toxicology results" under the heading of
cause of death. Health officials, police and social service workers
say there are many reasons why heroin is a preferred drug among
addicts, and why it causes so many deaths. It is inexpensive, readily
available, and of exceptional purity. "Heroin for the last four to
five years at least has been 50 to 60 percent and sometimes 80 to 90
percent pure," said one veteran police officer. "The market is out
there." The quality of heroin today makes it a better value for the
money than it was years ago, when it often was mixed with other
substances. "Everything is cyclical," the officer said. "Heroin is
just another drug that has come back around again.

There is a whole new flock of young people out there who think they're
reinventing the wheel, when, in fact, they're just one of the spokes."
The Rev. Charles Carnahan, executive director of AIDS Project
Worcester, lauded efforts by law enforcement personnel to take heroin
and other illegal drugs off the streets.

But those efforts, he said, have not resulted in a reduction in the
need for services to addicts and people infected with HIV. "From our
agency's standpoint, we have not witnessed any sort of decrease in the
number of people seeking services over the last three to five years,"
Rev. Carnahan said. "Most of our clients present to this agency with
intravenous drug use as their primary or secondary mode of
transmission. ... Those numbers continue to go up." Charles J. Faris,
chief executive officer of Spectrum Health Systems Inc., of Marlboro,
said that despite the efforts of law enforcement agents, the sale of
heroin is "business as usual" these days. "I think it is increasing,"
he said. "Heroin has made a big comeback in the last several years and
it's being used as extensively now as it ever was. The price has come
down quite a bit and the quality has gone up. Availability has gone
up." Heroin, he said, is the "primary drug of choice" among those who
seek help from Spectrum's treatment centers in Central Massachusetts.
"In our two detox centers in Central Massachusetts," he said, "we had
about 6,500 admissions last year and about 70 percent of those were
using heroin." His agency, he said, has a number of methadone
treatment programs targeted at people who use heroin and other
opiates. "We have 1,200 people in treatment and the demand continues,"
Mr. Faris said. "The phone keeps ringing -- and these are not
necessarily the same people who have just relapsed and are
recirculating through the system." The age of his agency's clients has
declined. In past years, heroin users who sought treatment were
generally in their late 20s and early 30s. Now, many clients are in
their mid-20s. Mr. Faris said he wholeheartedly supports the efforts
of federal, state and local drug enforcement agents to interdict
shipments and arrest traffickers. But those efforts may have a limited
impact on the availability of the drug so long as there is a demand
for it. "The profits on this are so high that someone will step in to
fill the void," he said. "You may capture stuff with several million
dollars in street value.

But I think even the people in the federal government will tell you
this is probably only a small percentage of the stuff that's getting
through.

The people who import this stuff recognize that they will have so much
loss and build that into their prices.

It's a business." But such sterile economic factors do not describe
the nonmonetary cost of heroin abuse.

For Mr. Stefan, the cost cannot be measured at all in economic terms.
"It's extremely bad for the families," Mr. Stefan said. "These are the
people I feel bad for. You see the little kids hanging on to the side
of the casket looking in at their mother or their father.

Or you see the mother and father looking in at their kids. "There are
days when I walk out of here just shaking my head. We see the worst of
the worst.

I take them all; I don't refuse anybody." The single overriding sorrow
of it, he said, is that the life that has led to the death is a matter
of choice. "It's a matter of choice what people do with their lives,"
he said. "They get hooked and then it's hard to kick this stuff. ...
But it's the kids that suffer; it's the families that suffer."