HEROIN TREATMENT LAGS FAR BEHIND NEED TO HELP USERS

Experts Testified Before Congress About How Limited And
Underfunded Intervention Options Are

WASHINGTON - Facilities to treat heroin addicts are scarce or
inadequate, even though the drug is hooking younger, middle-class
addicts in the Philadelphia suburbs and elsewhere, experts and addicts
told a congressional panel yesterday.

"More middle-class and suburban youths are being introduced to
heroin," Charles O'Brien, director of the Center for Studies of
Addiction at the University of Pennsylvania, testified. "We even have
[Penn] university students involved in this."

He called on Congress to "implement the next phase of our nation's war
on drugs - ensuring that all of our heroin addicts have access to
effective treatment options."

Testifying before the Senate Caucus on International Narcotics
Control, O'Brien and seven others - including four recovering teenage
addicts - described how heroin is seeping into middle-class America.
They complained that parents had trouble finding places to treat their
children.

Most managed-care health plans and government-funded programs provided
limited treatment options and inadequate time in treatment facilities
to wean teenagers off the narcotic, which costs less than $10 per
stamp-size bag, they said, good for one or two doses.

"Increasingly, calls for help about heroin are coming from the
suburbs, and from parents, for the suburbs are heroin's latest venue,
and the targets are teens," said Mitchell S. Rosenthal, president of
Phoenix House, a nonprofit agency that runs substance-abuse treatment
centers in eight states, though not in Pennsylvania or New Jersey.

"What they need is treatment - the right kind of treatment, for the
right length of time."

Bill would provide $60 million

One of the lawmakers presiding over the hearing, Sen. Charles Grassley
(R., Iowa), introduced legislation yesterday that would provide as
much as $60 million in the first year for adolescent-treatment
programs, family-support programs, antidrug community coalitions and
research into heroin abuse.

Besides more federal funding for treatment, Sen. Joseph Biden (D.,
Del.), cochairman of the panel, said yesterday he would like to direct
more money to fighting drugs in Colombia, where much of the heroin is
grown.

The narcotic is cheaper and purer than in the past, allowing users to
snort or smoke it and to avoid needles and diseases such as AIDS.

Heroin-related deaths have shot up in the Philadelphia region, from 2
per 100,000 people in 1990 to 9 per 100,000 in 1998, according to an
Inquirer analysis of medical-examiner data.

Last year, heroin-related arrests by Philadelphia police accounted for
23 percent of all narcotics arrests, up from 8 percent in 1992.

Heroin arrests by the federal Drug Enforcement Agency, which targets
mainly large-scale traffickers, accounted for 40 percent of all drug
arrests in the region last year, up from 13 percent in 1992.

Addicts are getting younger. According to the U.S. Substance Abuse and
Mental Health Services Administration, the average age of first-time
heroin users dropped to 17 in 1997 from 27 in 1988.

In the Philadelphia and New Jersey suburbs, a third of those receiving
treatment for heroin addiction were 24 and under in 1998, up from 24
percent in 1995.

The treatment gap

Rosenthal testified there was a significant treatment gap. Certain
parts of the country have few substance-abuse treatment facilities of
any kind; some states do not even have methadone programs, he said.

Penn's O'Brien suggested that new medications to treat heroin abuse,
such as buprenorphine and naloxone, should be made available besides
methadone, which is used to treat mostly older, long-term addicts.

One reason for more options is that traditional three-to four-week
rehabilitation programs, favored by most private health plans and
government-funded clinics, often do not cure young heroin users of
their addictions, Rosenthal said. There are an estimated 14,000 slots
in long-term residential facilities nationwide - but of those only
about 2,500 were for adolescents, he said.

Three of the four teenage addicts who testified said in interviews
yesterday that they had attended short rehab programs, only to start
using heroin again when they left.

"Insurance companies don't acknowledge this addiction as a disease and
do not give adequate time for rehabilitation," testified Marie Allen
of Newark, Del., whose daughter Erin died of a heroin overdose at 21.