News (Media Awareness Project) - US OR: In Heroin's Grip - Part 2 of 2 |
Title: | US OR: In Heroin's Grip - Part 2 of 2 |
Published On: | 1999-12-05 |
Source: | Register-Guard, The (OR) |
Fetched On: | 2008-09-05 14:00:28 |
IN HEROIN'S GRIP
THE NEW FACE OF ADDICTION
Heroin Traps Increasingly Younger Users As Parents And Counselors
Struggle To Treat Them
IN THE END, after all of the lies and the losses, she summoned two
large men to come to her house at 6 in the morning and take her son
away.
They escorted him to a drug treatment center in Western Samoa, an
ocean away from his comfortable northeast Eugene neighborhood. It cost
her family $25,000, but Jan Mackey says she had no choice. It was
either send him away, visit him in prison or bury him.
Her son, G.H., was only 17 but had been using heroin for a year. To
buy heroin, he'd stolen silver dollars from his little brother and
raided his mom's purse. He'd been high at the ice cream parlor job his
parents insisted he take to fill up his time - deep in a lethargic
heroin nod while beating a drum and singing "Happy Birthday" to little
kids who came to the parlor for their parties.
He and his girlfriend burrowed into his savings and spent $2,000 on
heroin in a two-week binge. In fact, that's the way his mother
discovered the depth of his addiction. Riding in the car after picking
up G.H. and his girlfriend, she suggested that G.H. use his money to
buy a bicycle he'd been eyeing. The girlfriend, distraught over what
they'd done, burst into tears.
He'd hidden it so well for so long. Mackey unwittingly helped him
through three withdrawal periods, mistaking his dope-sick symptoms for
the flu even though she's a nurse.
But now, in June 1998, she had desperately summoned the men to take
her son away.
They arrived in a rental car. Two men she'd never met. Before they
could knock, Mackey opened the door and began to cry. "Please be
kind," she begged them. "He is a good boy."
They assured her they wouldn't manhandle G.H., and she led them to her
son's room.
She would recall later how peaceful G.H. looked, sleeping. Angelic,
she would describe it. But then, the monster deep within her son
rarely showed its face. He'd remained compliant at home; polite, doing
his chores, kissing his mom good night. This was a boy with a soft
spot for his pet ferret, Alice, and whose Lab-mix dog, Thatcher, slept
on his bed.
Yet he was a heroin addict.
"Wake up, sweetie," Mackey told him.
His eyes fluttered open and he saw the men. He looked into his
mother's eyes and she saw that he knew.
He didn't try to run, but he didn't return her hug, either. When the
men led him to the car, he didn't look back. His mother wouldn't see
him again for a year.
Younger Addicts
In many ways, the story of G.H. represents the new face of heroin
addiction. Once easily stereotyped and perhaps dismissed as the drug
of emaciated thieves and prostitutes, it has spread during the past
five years into the suburbs and has been taken up by teen-agers.
Lane County had its first teen-age heroin overdose death in 1998 - a
19-year-old girl. Bob Richards, director of the Buckley House
detoxification center in Eugene, heard of a 12-year-old girl who was
addicted.
In October, Eugene police began looking into a report that an adult, a
young man, was giving heroin free to teen-agers hanging out on the
downtown mall. The investigation is still open; police suspect the man
was trying to establish a customer base. Some teens are sexually
exploited by dealers once they're hooked, and others sell marijuana to
get money to buy heroin, police say.
In the past six months at the Skipworth Juvenile Detention Center,
seven boys and girls have gone through heroin withdrawals after being
brought into custody. Medical Director Lynnette Kline said those were
the first cases she's seen in the 2 1/2 years she's been on the job.
In addition, Kline found 10 cases of hepatitis C among the Skipworth
kids. The disease is common among intravenous drug users who share
needles, and all of the kids said they were heroin users, Kline said.
She estimates that 10 percent to 30 percent of the kids rotating in
and out of detention this fall were heroin users; the detention center
usually holds 30 to 40 youths.
In one case, a 15-year-old girl brought into custody on an unrelated
charge had two golf ball-size chunks of heroin hidden in her vaginal
cavity. The heroin was worth an estimated $2,500; police theorized she
was holding it for a dealer.
The heroin wasn't discovered until the girl gave it to a staff member
before going into juvenile court. Although sealed in plastic wrap, it
easily could have leaked and killed the girl, Kline said.
Little Help For Kids
Kline has a tough time comprehending teen-agers' use of heroin, but
she says the Skipworth kids have so much trouble in their lives, and
heroin is so seductive, that they believe the risk is worth it.
"Heroin must be real sweet," Kline said. "It numbs them to whatever
pain they're going through."
But when they inevitably come crashing down, they find little help
here: Lane County has no detox centers for juveniles. Richards said
opening one for kids would be his first priority in the battle against
heroin addiction. There probably aren't any now because liability
issues and insurance costs make facilities for adolescents extremely
expensive to operate, he said.
Kline hopes to open a detox facility in the medical wing of the new
juvenile justice center under construction on Centennial Boulevard,
but for now she's had to send kids to hospitals or make do with advice
from doctors.
Lane County also lacks a residential treatment program for youths who
haven't been ordered into treatment through court. If the juvenile
hasn't committed a crime, a parent looking for a local residential
program is out of luck.
Kathy Donais, director of the private, nonprofit Looking Glass
Adolescent Recovery Program, told of a 17-year-old homeless boy who
wanted help, but couldn't get it here. Donais hired someone to drive
the boy to a juvenile detox center in Portland, then to take him to a
residential treatment center in Pendleton.
But it isn't just down-and-out kids who are using heroin. Many of them
are like G.H., living in nice homes, lacking for nothing and with
parents who are professionals. A Los Angeles addiction specialist who
spoke in Eugene this fall described them as kids with "access to excess."
They're inspired rather than repelled by popular musicians and actors
who die of heroin overdoses. The grim depiction of heroin use in
movies such as "Trainspotting" looks like fun to them. They hear the
emaciated look of fashion models described as "heroin chic" and figure
that must be a good thing.
It's a national problem. The incidence of first-time heroin use among
youths ages 12 to 17 quadrupled from the mid-1980s to 1995, according
to an estimate by the National Institute on Drug Abuse.
State and county studies show the same trend. Although the number of
users is still small, the percentage of 11th-graders who reported
using heroin in the previous 30 days increased to 0.9 percent in 1998
from 0.5 percent in 1996, an 80 percent increase, according to the
Oregon Public School Drug Use Survey.
In Eugene and Springfield, juvenile arrests for heroin possession or
distribution increased 250 percent between 1993 and 1997, according to
statistics gathered by the Lane County Prevention Coalition.
And to the alarm of local drug counselors, these new young users don't
have the inherent fear of heroin that previous generations had. Many
of them start by smoking it, which they don't equate with using
needles even though doctors say the method is just as addictive.
"It's a very attractive lifestyle, and heroin is a very comfortable,
sedating substance," Donais said. "The attraction is the
risk-taking."
Why They Use It
Unlike cocaine and methamphetamine, which have very noticeable effects
on people, heroin use is more easily hidden at first, Donais said.
Users can conceal the "tracks" of needle use by injecting themselves
in places that don't show, such as between their toes or in their thighs.
Users who have smoked heroin say the smoke produced is wispy and more
difficult to detect than marijuana smoke, for example, or easily
covered up with cigarette smoke.
"Heroin is still the secret, hidden addiction," Donais
said.
One young woman, now in recovery, says heroin is particularly alluring
to girls. "It becomes our new boyfriend," she said.
Another Eugene woman, an 18-year-old named Rebeca, said smoking heroin
became a romantic, bonding experience for her boyfriend and her. The
ritual of it appealed to them: placing the heroin on tin foil, waving
the lighter underneath, inhaling the vapors with a homemade funnel cut
from a plastic pop bottle.
They would sit on a couch, watch TV and smoke, with a blanket handy to
throw over the top of everything if a parent walked in. Rebeca even
smoked heroin while she baby-sat children.
"It makes you feel on top of the world," she said. "It's like, `I've
got a secret and you don't know about it.' "
"It was so planned out and perfect," said her boyfriend, B.L., also
18.
Another user, Devon, 23, began using heroin while living in Seattle
with four friends. All of them had family or personal problems, and
they considered themselves free thinkers, misfits and artists.
"All of us didn't care, we were up for anything," she
said.
She jumped right into needle use, although she couldn't inject herself
the first time.
"I couldn't do it myself," she said. "I held out my arm and closed my
eyes and let my friend do it."
Within a few months she was hooked. She woke up one morning sweating,
with muscle spasms and stomach cramps. She realized she was going
through withdrawals. After fighting it for a couple of days, she
decided, "Screw it, I don't care. I'm just going to use."
Like many of the users interviewed for these stories, G.H., Rebeca,
B.L. and Devon asked to be identified only by their first names or
initials because of embarrass-ment.
Devon and her boyfriend became regular users, trying now and then to
quit but always returning. By last year, they were spending $40 per
day each and financing their habits by stealing from his parents.
"The first thing I'd do in the morning was shoot up," Devon said. "In
the depths of it, I needed it every eight hours."
They both quit using this past summer, and split up because they
believed they were weaker-willed together. It was Devon's eighth
attempt to kick the habit. She moved in with her mother in Eugene and
began attending Narcotics Anonymous meetings.
"I've hit my bottom," she said. "If I go out there again it will kill
me, and I know that."
Staying clean is no picnic either.
"Once you're sober, you're facing all the stuff you've done to people
- - all the debts and the lying," she said. "It's hard for me to know
where to start sometimes, how to fix things."
And heroin still calls to her.
"There's part of me that thinks about it every day," she
said.
As she told her story this past summer, Devon sat in her mother's
sunlit living room, with philodendrons in the corner and art on the
walls. She had been clean since June. She said sobriety was scary.
By September, she wasn't returning phone calls. In mid-November, her
mother said Devon and her boyfriend were living on the streets of
Portland, using again and stealing to feed their addictions.
"Heroin won out again," Devon's mother said.
The Story Of G.H.
G.H. had to touch bottom before beginning his journey to recovery.
Even then, it took the close touch of death to change his thinking.
He and a small circle of friends started smoking heroin about the same
time. A dealer told them it was opium, and they believed him at first.
By the time they learned the truth, they didn't care.
Always seeking a better high, they began taking what they called "nose
drops." They broke off the tip of a syringe, liquefied the heroin with
water and heat, and squirted it up their nostrils.
The circle of friends included J.B., a tall and gangly boy, a gifted
musician, a soul so gentle and socially conscious that his family
called him "our '90s hippie."
Like G.H., he came from a solid family, with educated, caring and
involved parents. They were a family with seemingly so much going for
them that, as J.B.'s mother said, "We used to get up in the morning
and say, `We are so rich.' "
Heroin ultimately would rob them blind.
Meanwhile, G.H. had begun injecting heroin to get an even better
high.
G.H. had used many other drugs, but in heroin he discovered what
seemed to be a powerful, reinforcing ally.
"It was exactly like how I wanted to feel," G.H. said. "There was
nothing better, it was so perfect.
"Ever since I was real little I felt like I didn't fit in. When I did
heroin, it was like that missing piece fell into place. It's so
powerful; it makes you feel like anything that can possibly happen
will be OK, as long as you're doped up."
He told friends he would be happy living under a bridge, as long as he
had heroin. All of his money was going into it, his relationships with
family and friends were deteriorating, but he didn't care.
But he came crashing to the ground when his mother had him taken to
Western Samoa. There, he and other teen-agers lived in shipping
containers that had been converted into huts. They slept on grass
mats. They attended school most of the day and gathered in group
therapy sessions at night.
There was little sense in running away. They were on an island, there
was no place to go and no heroin to be found. And the Samoans knew
that any white kid wandering by himself probably was supposed to be at
the treatment center. They beat them up and took them back.
But heroin doesn't let loose easily.
"Even when I was in Samoa, I said I wanted to go home and use heroin
one more time, to say goodbye to it," G.H. said.
Senseless Loss
He'd been in Western Samoa for nine months when word came that J.B.
had died of an overdose. It was stunning news. The five friends who
had used heroin together remembered how they'd once sat around talking
about a statistic that one in five heroin users eventually dies of an
overdose.
They'd all looked around the room. No one thought it would be
J.B.
The death shattered J.B.'s family and confounded everyone who knew
them.
"It's just unbelievable that this would come into my family," J.B.'s
mother said. "People who knew us used to come up and say, `You did
everything right.' "
They were a happy, active, well-traveled family. They never dreamed
heroin would enter their lives. Their concerns were those of Eugene's
upper-middle class neighborhoods: Are the kids wearing their bike
helmets? Are they smoking cigarettes?
They learned J.B. was using heroin after he was cited for drug
possession at a party near the University of Oregon in spring 1998.
They enrolled him in a treatment program, but J.B. was an 18-year-old
kid among older, hardened users and now his parents wonder if the
program did him more harm than good.
They also wonder if they missed some signals. J.B. was quiet,
introverted and a deep thinker. His oldest brother had died in an
accident and J.B. had taken it hard, but he didn't seem unduly
depressed. Did they miss something there? What hid in the silence
behind J.B.'s smile?
"We go over and over in our heads what we could have done," J.B.'s
mother said.
But J.B. completed the treatment program and they thought he was
clean. In January 1999, he moved to Portland and began living with one
of his brothers. He took a job at a convenience store.
He bought heroin with his first paycheck. On March 19, he shot up in
his brother's bathroom and died of an overdose.
The senseless loss of the young is always hard to take, but J.B.'s
addiction and death were particularly baffling. He was fluent in
Spanish and had been an exchange student in Mexico and Costa Rica. He
was class president of his alternative school.
He hiked and biked. He'd traveled to Spain, Portugal, Morocco, France
and England. He played mandolin, piano, guitar and drums.
A friend, a fellow musician, wrote a song posing the question no one
but J.B. could answer:
"Everyone wants to know why," went the chorus.
J.B.'s father and brothers took his ashes to Central Oregon. They
intended to place him on the South Sister, but bad weather kept them
from climbing the mountain.
"We left him at a shelter," his father said, his voice catching on the
memory.
"Just an old shelter, open frame, overlooking the South Sister. We dug
out some of the boards and left him there."
His parents say J.B. was naive and trusting. But they also say it was
ultimately his fault.
Far away, in Western Samoa, the news seared G.H.
"When he died, even the thought of heroin made me sick to my stomach,"
G.H. said.
He was changing, slowly. Not so much because of the treatment program,
but because he was away from heroin. Away from the drug, he was left
with himself.
"We knew we were buying him a year off drugs," said his mother, Jan
Mackey. "A year of growth without drugs altering his
perceptions."
G.H. and two other boys drew the attention of a Samoan chief in a
nearby village. The chief befriended them, and in a ceremony gave them
Samoan names. For G.H. he chose "Suiga," which means "Change."
The villagers impressed G.H. They were so poor, they had so little
compared to his life back in Oregon, but they were happy.
On his last day in Western Samoa, G.H. went to a tattoo artist. The
man looked him over and said, "I know what you need."
The work took three hours and can be seen high on G.H.'s upper right
arm. One of the designs is a circle of fish, which means G.H. can
provide for his family. Another is a circle of centipedes, which means
he can withstand pain and make it through hard times.
"To me it symbolizes what I went through, and why I'm doing what I'm
doing," G.H. said.
"He told me that if he uses again, J.B.'s death will be in vain," his
mother said.
G.H. is living with his mother and stepfather and attending the
University of Oregon. He hopes to become a psychologist. "I've been in
a lot of therapy; I think I'd be good at it," G.H. said.
In the meantime, he attends substance abuse group meetings. With
heroin, you take no chances.
"I told him I won't rescue him again," his mother said. "It will break
my heart if he uses again, but it is his life, it is his addiction."
[First Sidebar]
METHADONE OFFERS CHANCE AT CHANGE
By Eric Mortenson
The Drug, While Relieving Withdrawal Symptoms, Allows Heroin Addicts
To Function Normally
THEY ARRIVE ABOUT 7 each morning and stand outside the door, smoking
and talking quietly. They're like a bunch of coffee shop regulars who
all know one another, waiting for the place to open.
One hundred yards and a lifetime away are the Eugene Hilton and the
Hult Center for the Performing Arts, and all the privilege, success
and glamour they represent. To the people lined up outside the drab,
low-slung Lane County methadone clinic on East Sixth Avenue, they
might as well be in another universe.
These are people who have known the degradation, damage and utter
despair of heroin addiction. They have little time now for grand
vistas. For them, each day's focus is on staying clean.
The clinic doors open, and they file in - 70 to 100 during the course
of the day. Many of them carry backpacks or lunch sacks, and are
stopping here on their way to school or work.
Inside, they step up to a window set in a hallway and greet pharmacist
Harold Bucholtz, who's seen many stories, happy and sad, in his 22
years of preparing medication for recovering heroin addicts.
The banter is unforced and breezy. The talk is of fishing trips and
plans for the weekend. Bucholtz chuckles when someone suggests he's
like a bartender.
"I keep telling them to leave a tip on the bar," he says. "I've been
doing this a long time, and I only know how to make one kind of drink."
That would be pre-measured doses of methadone, mixed with orange Tang
and served in paper cups. Clients gulp it down, say goodbye to
Bucholtz and are on their way.
Many of them are required to "dose up" like this in person six days a
week and receive a sealed dose to take home and drink on Sunday. Some
visit two or three days a week and have earned the right, by staying
clean, to four or five "takeouts" a week. Some will stay for group
counseling meetings. Some will be chosen for random urinalysis and
will be monitored by a staff member as they provide a sample.
For nearly 300 people in Lane County, with varying degrees of success,
this is the daily routine that helps them sidestep opiate addiction.
The treatment is called "methadone maintenance" because it allows them
to function normally, but some of these people may need to take
methadone for the rest of their lives.
"It simply makes you feel normal," says Rosie Crist, 44, of Corvallis,
who has been on methadone for nearly 13 years. "Methadone is a
wonderful thing, I'm glad we have it. If more people were on it, it
would take care of a lot of the crime, death and a lot of the illness."
How It Works
Methadone is a powerful drug in its own right. The Nazis synthesized
it as a painkiller during World War II and used it to treat the
wounded after the Allies cut off Germany's access to opium, from which
morphine is derived.
Methadone has a black market value of up to $10,000 per liter and is
said to be the most strictly regulated drug in the world. The Drug
Enforcement Administration, for example, requires clinics to crush
empty bottles so drug users won't rummage through Dumpsters and lick
the containers.
Some of the doses Bucholtz dispenses would kill people who aren't
accustomed to it. Administered properly, however, it relieves painful
withdrawal symptoms and reduces the craving for heroin.
Methadone is an opiate and binds to the same nerve receptors in the
brain that heroin reaches, but it doesn't produce a high - probably
because it has a long half-life, with the effects lasting for more
than 24 hours. Heroin, by comparison, binds to the receptors so
quickly and in such concentration that it creates an intense feeling
of euphoria that users call a "rush."
Because methadone attaches to the same nerve cell receptors and breaks
down much more slowly, it blocks the rush addicts would otherwise get
if they used heroin at the same time.
The effects of methadone typically last for at least a day, compared
with four to six hours for heroin.
This allows patients to take a dose each morning, for example, and
carry on their normal daily activities, where heroin addicts must
constantly seek out the next fix.
Also, because methadone can be taken orally and the supply is
federally controlled, the risks of needle use and contamination are
eliminated.
But using methadone to treat heroin addiction has been controversial
since it was first introduced nearly 30 years ago. Critics argue that
it amounts to exchanging one type of drug dependence for another, and
they contend that addicts would be better served by 12-step programs
and giving up drugs altogether.
In July 1998, for example, New York City Mayor Rudolph Giuliani called
for abolishing the city's hospital methadone clinics in favor of
abstinence programs. He abandoned the idea five months later,
acknowledging that he had been unrealistic, but it was an example of
the mind-set methadone doctors face.
Critics of methadone programs also include some people at the other
end of the treatment spectrum: those in the "harm reduction" movement.
Simply stated, the harm reduction principle holds that total
abstinence from drug use is very difficult to accomplish and not the
only measure of success. In the interim, any positive change - such as
reducing use or starting needle exchange programs that cut HIV and
hepatitis rates - should be recognized and encouraged.
In Eugene, for example, a needle exchange program run by the HIV
Alliance has resulted in 4,400 used needles being turned in for new
ones in a two-month period.
Some harm reduction subscribers would take it further by allowing
methadone users to determine their own dosages, giving injectable
methadone to those who prefer to shoot it rather than drink it, and
not punishing patients who use other drugs while in a methadone program.
"They Can Live Normally"
But supporters of traditional methadone programs say they have
something that works. It reduces opiate abuse in more than 80 percent
of patients, slows the spread of AIDS and decreases crime, they say.
They compare it to diabetics controlling their illness with insulin.
"Look at the outcome," says Dr. Douglas Bovee, medical director at a
private, nonprofit west Eugene clinic called CODA Addiction Treatment
Services. "People can live functional lives, go to school, carry on a
job - they can live very normally."
Bovee, an addiction specialist, says he entered the methadone field
because he was failing at abstinence treatment.
"If they're on medication and they succeed in life because they're
using medication, great," Bovee says. "That's the goal. Methadone can
help people do that."
The problem is, there aren't enough clinics to meet the need. Seven
states don't allow methadone treatment, and in Oregon, there are no
methadone clinics on the coast or east of the Cascades. The two
methadone clinics in Eugene - the county's and CODA's - have waiting
lists three to four months long. Bovee estimates there are at least
1,000 more local heroin addicts who could use the treatment.
"The day our phones went into effect in August 1997, the phones
started ringing and never stopped," Bovee says.
Pregnant addicts automatically go to the head of the clinics' waiting
lists because methadone gives them a much better chance of having
healthy babies. Others must wait their turn and work up the lists. At
the county clinic, for example, clients earn points by calling in each
week. They drop off the list and have to start over if they go a month
without checking in.
And once stabilized on a methadone program, it's not uncommon for
clients to relapse and use heroin again. Many clients start and drop
out several times before the therapy takes.
Complete abstinence remains the goal of methadone programs, but drug
counselors say there's merit in the "harm reduction" approach to
treating heroin addiction.
"If they're using every day, three or four times a day, then over time
any reduction in use is good for the individual, good for his family
and good for the community," says Linda Hill, a counselor at the
county clinic. "It is important to acknowledge that is an improvement,
it has a ripple effect. But on the other hand, we wouldn't want to
just settle for that."
"Saved My Life"
Clients say it's worth the struggle.
"Methadone definitely saved my life, there is no question about this,"
says D.A., 47, who used heroin for 12 years and has been on and off
methadone programs for just as long. Like most methadone clients, she
asked to be identified only by initials or first name.
Despite her spotty record - the longest she's been clean after leaving
a methadone program was six months - D.A. is a firm believer in the
treatment.
"I noticed that for the first time in possibly my life, I felt
balanced," she says. "The more balanced that I felt, the more I was
inclined to go back to work and put my life back in order."
One man, Tom, drives to Eugene from North Bend three times a week
because it's the closest methadone clinic to his home. In eight years
of being on methadone programs in Salem and Eugene, he's put nearly
400,000 miles on his car.
Driving to Eugene and back for methadone doses and mandatory group
meetings eats up 18 hours a week. He says it's like having a part-time
job.
"Just to come here and stand at that window takes five hours," he
says. "Just to come here and stand there for five seconds."
He's 48 and first used heroin when he was 20. In the end, it left him
strung out, without a job and on the verge of bankruptcy. "By the
grace of God I'm here to tell this story," he says.
Arturo, 56, rolls up his sleeves to display heavily tattooed arms that
are scarred and discolored. All of his veins collapsed during his
decades of shooting up, he says, so he began injecting into the fatty
tissue of his arms, which created abscesses.
"These are just old tracks," he says, tracing a dark line that marks a
collapsed vein.
This is his third try at a methadone program. He's been clean for a
year and managed to complete probation during that time. He's spent
about 15 years in prison and believes he'd be there again if it
weren't for methadone. He sold stolen property to get money for heroin.
"The habit doesn't wait for you just because you can't get some," he
says.
Venisa, 38, says she was a prostitute in Eugene to support her habit.
She's been on methadone since March and has been reunited with her
four children, who were taken away because of her drug and
crime-ridden life.
"I had to get on the methadone or I'd probably be dead by now," she
says. "Yesterday was my first clean birthday I've had since I was 12
years old."
Her children, ages 10 to 15, are happy that she's clean, Venisa says.
Among other things, they make sure she catches the bus in time each
morning to go to the methadone clinic.
"They say, `Mama, you got to go to dose,' " Venisa says. "They're a
lot of help to me, a lot."
Expensive Treatment
The state helps a lot, too, because the Oregon Health Plan picks up
the cost of methadone treatment for nearly 75 percent of the local
patients. Many heroin addicts are finally driven to treatment only
when they run out of money, and Oregon's rising tide of addiction is
reflected in the treatment costs paid by the state's low-income health
insurance plan.
The Oregon Health Plan paid $3.2 million for methadone treatment in
1997, and the payments jumped to $4.2 million in 1998. Methadone
treatment makes up 25 percent of the claims that the health plan pays
for all forms of chemical dependency treatment.
Other health plan statistics indicate the long-term and complicated
nature of battling heroin addiction. Because they must "dose up" at
clinics so often and must attend counseling sessions and provide urine
samples, methadone patients averaged 119 clinic visits per person in
1998. In contrast, other drug abuse clients required an average of 38
such service dates per year.
The figures are significant because methadone clients make up only 16
percent of the patient load, yet take up 50 percent of all the clinic
visits attributed to chemical dependency clients, according to Oregon
Health Plan statistics.
Still, counselors and doctors say it beats the alternative. At about
$10 to $15 per day per client, methadone programs are cheaper than the
$25 to $100 per day habits of many junkies, who often support it
through prostitution, robbery or selling stolen property.
National studies drive home the point. According to a 1994 report by
the federal Alcohol, Drug Abuse and Mental Health Administration, an
untreated drug abuser costs society $21,500 over six months. A patient
in a methadone maintenance program costs society $1,750 during that
time, according to the report.
And for clients such as Rosie Crist, methadone maintenance - even if
it takes the rest of her life - beats opiate addiction any day.
"It consumed every part of every waking minute," she says. "Can I get
my supply for today? Where can I get it? Do I have money to get it? It
took over my mind.
"It breaks your morals down, too," Crist says. "I am known in the
community now as an honest person, but there was a time when I would
go through your medicine chest if I was in your house."
Bovee, the CODA medical director, says the community must make
treatment available to more people. It would help matters if drug
counselors were paid better, so more people would go into the field,
he says. Also, he believes it should be easier to open methadone
clinics in neighborhoods without a public uproar.
"Something we've got to get to eventually is getting people into
treatment quickly," Bovee says. "We're not even close to that now.
"Opiate dependency is a serious brain disease," he says. "People don't
set out to become opiate addicts and develop these illnesses. The good
news in the case of heroin dependency is that we've got good treatment
in terms of saving lives, reducing the spread of disease and reducing
crime."
[Second Sidbar]
USER BATTLES TO STAY CLEAN
By Eric Mortenson
A 24-Year-Old Woman Gets Another Chance To Reclaim Her
Life
JULIE McGREGOR had been clean for 10 months when she returned to
Eugene on Sept. 10. She was proud of kicking heroin, proud enough to
stop in at the Whiteaker Public Safety Station and thank police
officers for arresting her and setting her on the right path.
The visit floored officers who work the Whiteaker neighborhood. After
all, as even McGregor would acknowledge, she'd been an irritation to
police for four years. By her count, she'd been arrested 46 times for
prostitution, drug possession and drug sales. She wanted the officers
to know she was clean now, that she and her children were living with
her parents in La Pine and doing well.
"I was glad I went to jail," McGregor said. "That was where I found
Narcotics Anonymous and found a support group and found that life
isn't so bad without drugs.
"I can play with my kids every day, go to bed every night and wake up
in the morning and not stick a needle in my arm."
Within hours of her visit to the police station, however, McGregor
overdosed on heroin and nearly died.
Such is the power of heroin addiction. Drug counselors say the relapse
rate for heroin addicts is extremely high, up to 90 percent for those
who don't have follow-up treatment after a detoxification or
withdrawal period. Even methadone patients, who receive a synthetic
narcotic that blocks the craving for heroin, commonly go through
treatment two or three times before they can stay clean.
McGregor, 24, doesn't remember what happened that night. She saw some
old friends and visited some of the old places where she used to hang
out. At the Side Pocket Tavern, she asked a man to give her a ride
back to La Pine. He declined to do that, but allowed her to stay in
his apartment on West Fourth Avenue in the Whiteaker neighborhood,
according to a police report.
She passed out and didn't stir for 12 hours. She was barely breathing
by the time people in the apartment called for an ambulance; they told
police they thought she was just sleeping it off.
She was comatose for a week and afterward had symptoms as if she'd
suffered a stroke. She couldn't sit up by herself or walk. She
couldn't see. She eventually recovered, but spent several weeks in
care facilities and still has some paralysis on her right side.
McGregor recognizes that she put herself in a bad situation.
"You can't be clean and try to start a new life and continue to do the
same things you did before," she said.
McGregor's parents were outraged by the turn of the
events.
"All it took was some idiots down there that could care less," said
Christy McGregor, Julie's mother. "I've got a lot of anger about the
Eugene area. That problem is so out of hand; it's everywhere, but
Eugene is a bad area."
Julie's angry and grief-stricken father, Jimmy McGregor, drove to
Eugene and parked his pickup truck at Scobert Gardens, looking for the
man he suspected gave his daughter heroin.
"I sat down there with a shotgun because I was going to kill the son
of a bitch," McGregor said.
The McGregors had suffered heartache after heartache in trying to save
their daughter from heroin. Once they kidnapped her in Eugene and took
her back to La Pine. They sat up with her for two nights, trying to
get her through the painful withdrawals.
At the first opportunity, however, Julie slipped out the back door and
headed to Eugene again.
It seemed at times she was doomed to live out a heroin nightmare. She
says she began using hard drugs in high school in Central Oregon after
being gang raped at a party. Afterward, she had an older boyfriend who
supplied her with drugs in high school.
She and yet another boyfriend moved to Eugene, where the boyfriend
began using heroin. McGregor soon followed.
Still, she was smart and had prospects. She studied early childhood
education and taught preschool at one point, but her addiction
overtook her.
"I wanted to work with troubled youth and became one myself," she
said.
She was fluent in Spanish, but mainly used it to make connections with
the Latino dealers who dominate the heroin trade in Eugene.
Her life here was a mess. She was stabbed in the side in a dispute
over drugs. She had to be treated for a painful abscess on her
stomach, caused by injecting heroin. She stole from dealers and sold
drugs herself. An abusive john tried to kill her when she was turning
tricks in the Whiteaker area. He tried to put a cloth over her face,
perhaps to smother her, and nearly ran her over when she scrambled out
of his car.
The jail was her second home, she was in and out so many times.
Sometimes she stayed well by smuggling heroin into jail, slitting her
bra to tuck the drug inside or stuffing small bags up her nose. In one
of her trips to jail she met Dixie Miller, the heroin addict and
prostitute who was strangled this past summer.
"That just broke my heart; that could have very well been me,"
McGregor said.
The turning point came a year ago. Arrested once again, she was sick,
worn out and covered with abscesses. Her boyfriend was in prison and
her children were living with her parents. She had no place to stay.
"It kept hitting me," she said. "I knew I'd better change something
pretty soon. My body was just tore up from IV use."
She pleaded guilty to two counts of possession of a controlled
substance and to providing false information to a police officer. Most
of her previous trips to jail were of the overnight variety; people
accused of drug crimes are typically released within hours to make
room for violent offenders.
But with so many arrests piled up in the past, she knew she wouldn't
be released soon this time. She would have time to sit in jail and get
clean.
"Something within me - when the judge said, `How do you plead?' - I
couldn't say I wasn't guilty," she said.
She was in jail from Nov. 10, 1998, to Feb. 20, 1999. She began going
to church services in the jail. She read inspirational stories. She
joined the Narcotics Anonymous group, and during one of the sleepless
nights while she was detoxing, she read an Narcotics Anonymous
recovery book cover to cover.
Thanksgiving passed, and Christmas. She vowed she would never spend
another holiday separated from her children.
When her time was up, she moved in with her parents and children in La
Pine. Before her near-fatal trip to Eugene, she was attending
Narcotics Anonymous meetings six days a week.
In late October, after her recovery, she began attending meetings
again.
"I'm proud of that 10 months," she said. "They can't take that away
from me.
"I'm starting over again."
[Third Sidebar]
FIND HELP FOR HEROIN USER AT THE FIRST SIGNS OF ADDICTION
By Eric Mortenson
IF YOU DISCOVER your teen-ager or other loved one is using heroin,
look for professional help immediately, says Kathy Donais, director of
the Looking Glass Adolescent Recovery Program.
Don't judge them and don't try to frighten them out of using, she
says.
"They know what they're doing is not good, but they don't know what to
do to get out of it," Donais says.
At the same time, don't ignore the problem and don't believe a heroin
user who claims he won't use again, she says. Without a change in
lifestyle, they will go back to using, she says.
Simply allowing them to go through withdrawals or a detoxification
facility without follow-up care is "a Band-Aid for the problem,"
Donais says.
Instead, contact any substance abuse treatment facility and ask for
help, she says. The agencies can make referrals to the proper program.
The following agencies may be able to help:
Aces, 84 Centennial Loop, Eugene, 344-2237.
Buckley House Detox, 605 W. Fourth Ave., Eugene, 343-6512.
CODA Addiction Treatment Services, 2055 W. 12th Ave., Eugene, 684-4901.
Lane County Methadone Program, 135 E. Sixth Ave., Eugene, 682-4464.
Lane County Department of Youth Services, 2411 Centennial Blvd.,
Eugene, 682-4700.
Looking Glass Adolescent Recovery Program, 1675 W. 11th Ave., Eugene,
485-8448.
Passages, 485-0457.
Prevention & Recovery Northwest, 1188 Olive St., Eugene, 484-9274.
Serenity Lane, 616 E. 16th Ave., Eugene, 687-1110.
Willamette Family Treatment Services, 140 Green Acres Road, Eugene,
338-9098; and 687 Cheshire Ave., Eugene, 343-2993.
SIGNS THAT YOUR SON OR DAUGHTER IS USING HEROIN
Changes: They may have new friends, lose weight or begin skipping school.
Cash and other items may disappear from the home.
Appearance: Heroin users often appear sleepy and lethargic, with pinpoint
pupils. They may scratch themselves; itchy skin is a common reaction to
opiates such as heroin and morphine.
Withdrawal symptoms: They may appear to have a severe flu, with
vomiting, shakes, muscle and bone aches, cramps, insomnia and
diarrhea. Symptoms may last for up to a week.
Paraphernalia: Look for syringes, packaging material such as balloons or
plastic baggies and "cookers" made of cut-off beer or pop cans. Blackened
tin foil is a sign that the user is smoking heroin.
THE NEW FACE OF ADDICTION
Heroin Traps Increasingly Younger Users As Parents And Counselors
Struggle To Treat Them
IN THE END, after all of the lies and the losses, she summoned two
large men to come to her house at 6 in the morning and take her son
away.
They escorted him to a drug treatment center in Western Samoa, an
ocean away from his comfortable northeast Eugene neighborhood. It cost
her family $25,000, but Jan Mackey says she had no choice. It was
either send him away, visit him in prison or bury him.
Her son, G.H., was only 17 but had been using heroin for a year. To
buy heroin, he'd stolen silver dollars from his little brother and
raided his mom's purse. He'd been high at the ice cream parlor job his
parents insisted he take to fill up his time - deep in a lethargic
heroin nod while beating a drum and singing "Happy Birthday" to little
kids who came to the parlor for their parties.
He and his girlfriend burrowed into his savings and spent $2,000 on
heroin in a two-week binge. In fact, that's the way his mother
discovered the depth of his addiction. Riding in the car after picking
up G.H. and his girlfriend, she suggested that G.H. use his money to
buy a bicycle he'd been eyeing. The girlfriend, distraught over what
they'd done, burst into tears.
He'd hidden it so well for so long. Mackey unwittingly helped him
through three withdrawal periods, mistaking his dope-sick symptoms for
the flu even though she's a nurse.
But now, in June 1998, she had desperately summoned the men to take
her son away.
They arrived in a rental car. Two men she'd never met. Before they
could knock, Mackey opened the door and began to cry. "Please be
kind," she begged them. "He is a good boy."
They assured her they wouldn't manhandle G.H., and she led them to her
son's room.
She would recall later how peaceful G.H. looked, sleeping. Angelic,
she would describe it. But then, the monster deep within her son
rarely showed its face. He'd remained compliant at home; polite, doing
his chores, kissing his mom good night. This was a boy with a soft
spot for his pet ferret, Alice, and whose Lab-mix dog, Thatcher, slept
on his bed.
Yet he was a heroin addict.
"Wake up, sweetie," Mackey told him.
His eyes fluttered open and he saw the men. He looked into his
mother's eyes and she saw that he knew.
He didn't try to run, but he didn't return her hug, either. When the
men led him to the car, he didn't look back. His mother wouldn't see
him again for a year.
Younger Addicts
In many ways, the story of G.H. represents the new face of heroin
addiction. Once easily stereotyped and perhaps dismissed as the drug
of emaciated thieves and prostitutes, it has spread during the past
five years into the suburbs and has been taken up by teen-agers.
Lane County had its first teen-age heroin overdose death in 1998 - a
19-year-old girl. Bob Richards, director of the Buckley House
detoxification center in Eugene, heard of a 12-year-old girl who was
addicted.
In October, Eugene police began looking into a report that an adult, a
young man, was giving heroin free to teen-agers hanging out on the
downtown mall. The investigation is still open; police suspect the man
was trying to establish a customer base. Some teens are sexually
exploited by dealers once they're hooked, and others sell marijuana to
get money to buy heroin, police say.
In the past six months at the Skipworth Juvenile Detention Center,
seven boys and girls have gone through heroin withdrawals after being
brought into custody. Medical Director Lynnette Kline said those were
the first cases she's seen in the 2 1/2 years she's been on the job.
In addition, Kline found 10 cases of hepatitis C among the Skipworth
kids. The disease is common among intravenous drug users who share
needles, and all of the kids said they were heroin users, Kline said.
She estimates that 10 percent to 30 percent of the kids rotating in
and out of detention this fall were heroin users; the detention center
usually holds 30 to 40 youths.
In one case, a 15-year-old girl brought into custody on an unrelated
charge had two golf ball-size chunks of heroin hidden in her vaginal
cavity. The heroin was worth an estimated $2,500; police theorized she
was holding it for a dealer.
The heroin wasn't discovered until the girl gave it to a staff member
before going into juvenile court. Although sealed in plastic wrap, it
easily could have leaked and killed the girl, Kline said.
Little Help For Kids
Kline has a tough time comprehending teen-agers' use of heroin, but
she says the Skipworth kids have so much trouble in their lives, and
heroin is so seductive, that they believe the risk is worth it.
"Heroin must be real sweet," Kline said. "It numbs them to whatever
pain they're going through."
But when they inevitably come crashing down, they find little help
here: Lane County has no detox centers for juveniles. Richards said
opening one for kids would be his first priority in the battle against
heroin addiction. There probably aren't any now because liability
issues and insurance costs make facilities for adolescents extremely
expensive to operate, he said.
Kline hopes to open a detox facility in the medical wing of the new
juvenile justice center under construction on Centennial Boulevard,
but for now she's had to send kids to hospitals or make do with advice
from doctors.
Lane County also lacks a residential treatment program for youths who
haven't been ordered into treatment through court. If the juvenile
hasn't committed a crime, a parent looking for a local residential
program is out of luck.
Kathy Donais, director of the private, nonprofit Looking Glass
Adolescent Recovery Program, told of a 17-year-old homeless boy who
wanted help, but couldn't get it here. Donais hired someone to drive
the boy to a juvenile detox center in Portland, then to take him to a
residential treatment center in Pendleton.
But it isn't just down-and-out kids who are using heroin. Many of them
are like G.H., living in nice homes, lacking for nothing and with
parents who are professionals. A Los Angeles addiction specialist who
spoke in Eugene this fall described them as kids with "access to excess."
They're inspired rather than repelled by popular musicians and actors
who die of heroin overdoses. The grim depiction of heroin use in
movies such as "Trainspotting" looks like fun to them. They hear the
emaciated look of fashion models described as "heroin chic" and figure
that must be a good thing.
It's a national problem. The incidence of first-time heroin use among
youths ages 12 to 17 quadrupled from the mid-1980s to 1995, according
to an estimate by the National Institute on Drug Abuse.
State and county studies show the same trend. Although the number of
users is still small, the percentage of 11th-graders who reported
using heroin in the previous 30 days increased to 0.9 percent in 1998
from 0.5 percent in 1996, an 80 percent increase, according to the
Oregon Public School Drug Use Survey.
In Eugene and Springfield, juvenile arrests for heroin possession or
distribution increased 250 percent between 1993 and 1997, according to
statistics gathered by the Lane County Prevention Coalition.
And to the alarm of local drug counselors, these new young users don't
have the inherent fear of heroin that previous generations had. Many
of them start by smoking it, which they don't equate with using
needles even though doctors say the method is just as addictive.
"It's a very attractive lifestyle, and heroin is a very comfortable,
sedating substance," Donais said. "The attraction is the
risk-taking."
Why They Use It
Unlike cocaine and methamphetamine, which have very noticeable effects
on people, heroin use is more easily hidden at first, Donais said.
Users can conceal the "tracks" of needle use by injecting themselves
in places that don't show, such as between their toes or in their thighs.
Users who have smoked heroin say the smoke produced is wispy and more
difficult to detect than marijuana smoke, for example, or easily
covered up with cigarette smoke.
"Heroin is still the secret, hidden addiction," Donais
said.
One young woman, now in recovery, says heroin is particularly alluring
to girls. "It becomes our new boyfriend," she said.
Another Eugene woman, an 18-year-old named Rebeca, said smoking heroin
became a romantic, bonding experience for her boyfriend and her. The
ritual of it appealed to them: placing the heroin on tin foil, waving
the lighter underneath, inhaling the vapors with a homemade funnel cut
from a plastic pop bottle.
They would sit on a couch, watch TV and smoke, with a blanket handy to
throw over the top of everything if a parent walked in. Rebeca even
smoked heroin while she baby-sat children.
"It makes you feel on top of the world," she said. "It's like, `I've
got a secret and you don't know about it.' "
"It was so planned out and perfect," said her boyfriend, B.L., also
18.
Another user, Devon, 23, began using heroin while living in Seattle
with four friends. All of them had family or personal problems, and
they considered themselves free thinkers, misfits and artists.
"All of us didn't care, we were up for anything," she
said.
She jumped right into needle use, although she couldn't inject herself
the first time.
"I couldn't do it myself," she said. "I held out my arm and closed my
eyes and let my friend do it."
Within a few months she was hooked. She woke up one morning sweating,
with muscle spasms and stomach cramps. She realized she was going
through withdrawals. After fighting it for a couple of days, she
decided, "Screw it, I don't care. I'm just going to use."
Like many of the users interviewed for these stories, G.H., Rebeca,
B.L. and Devon asked to be identified only by their first names or
initials because of embarrass-ment.
Devon and her boyfriend became regular users, trying now and then to
quit but always returning. By last year, they were spending $40 per
day each and financing their habits by stealing from his parents.
"The first thing I'd do in the morning was shoot up," Devon said. "In
the depths of it, I needed it every eight hours."
They both quit using this past summer, and split up because they
believed they were weaker-willed together. It was Devon's eighth
attempt to kick the habit. She moved in with her mother in Eugene and
began attending Narcotics Anonymous meetings.
"I've hit my bottom," she said. "If I go out there again it will kill
me, and I know that."
Staying clean is no picnic either.
"Once you're sober, you're facing all the stuff you've done to people
- - all the debts and the lying," she said. "It's hard for me to know
where to start sometimes, how to fix things."
And heroin still calls to her.
"There's part of me that thinks about it every day," she
said.
As she told her story this past summer, Devon sat in her mother's
sunlit living room, with philodendrons in the corner and art on the
walls. She had been clean since June. She said sobriety was scary.
By September, she wasn't returning phone calls. In mid-November, her
mother said Devon and her boyfriend were living on the streets of
Portland, using again and stealing to feed their addictions.
"Heroin won out again," Devon's mother said.
The Story Of G.H.
G.H. had to touch bottom before beginning his journey to recovery.
Even then, it took the close touch of death to change his thinking.
He and a small circle of friends started smoking heroin about the same
time. A dealer told them it was opium, and they believed him at first.
By the time they learned the truth, they didn't care.
Always seeking a better high, they began taking what they called "nose
drops." They broke off the tip of a syringe, liquefied the heroin with
water and heat, and squirted it up their nostrils.
The circle of friends included J.B., a tall and gangly boy, a gifted
musician, a soul so gentle and socially conscious that his family
called him "our '90s hippie."
Like G.H., he came from a solid family, with educated, caring and
involved parents. They were a family with seemingly so much going for
them that, as J.B.'s mother said, "We used to get up in the morning
and say, `We are so rich.' "
Heroin ultimately would rob them blind.
Meanwhile, G.H. had begun injecting heroin to get an even better
high.
G.H. had used many other drugs, but in heroin he discovered what
seemed to be a powerful, reinforcing ally.
"It was exactly like how I wanted to feel," G.H. said. "There was
nothing better, it was so perfect.
"Ever since I was real little I felt like I didn't fit in. When I did
heroin, it was like that missing piece fell into place. It's so
powerful; it makes you feel like anything that can possibly happen
will be OK, as long as you're doped up."
He told friends he would be happy living under a bridge, as long as he
had heroin. All of his money was going into it, his relationships with
family and friends were deteriorating, but he didn't care.
But he came crashing to the ground when his mother had him taken to
Western Samoa. There, he and other teen-agers lived in shipping
containers that had been converted into huts. They slept on grass
mats. They attended school most of the day and gathered in group
therapy sessions at night.
There was little sense in running away. They were on an island, there
was no place to go and no heroin to be found. And the Samoans knew
that any white kid wandering by himself probably was supposed to be at
the treatment center. They beat them up and took them back.
But heroin doesn't let loose easily.
"Even when I was in Samoa, I said I wanted to go home and use heroin
one more time, to say goodbye to it," G.H. said.
Senseless Loss
He'd been in Western Samoa for nine months when word came that J.B.
had died of an overdose. It was stunning news. The five friends who
had used heroin together remembered how they'd once sat around talking
about a statistic that one in five heroin users eventually dies of an
overdose.
They'd all looked around the room. No one thought it would be
J.B.
The death shattered J.B.'s family and confounded everyone who knew
them.
"It's just unbelievable that this would come into my family," J.B.'s
mother said. "People who knew us used to come up and say, `You did
everything right.' "
They were a happy, active, well-traveled family. They never dreamed
heroin would enter their lives. Their concerns were those of Eugene's
upper-middle class neighborhoods: Are the kids wearing their bike
helmets? Are they smoking cigarettes?
They learned J.B. was using heroin after he was cited for drug
possession at a party near the University of Oregon in spring 1998.
They enrolled him in a treatment program, but J.B. was an 18-year-old
kid among older, hardened users and now his parents wonder if the
program did him more harm than good.
They also wonder if they missed some signals. J.B. was quiet,
introverted and a deep thinker. His oldest brother had died in an
accident and J.B. had taken it hard, but he didn't seem unduly
depressed. Did they miss something there? What hid in the silence
behind J.B.'s smile?
"We go over and over in our heads what we could have done," J.B.'s
mother said.
But J.B. completed the treatment program and they thought he was
clean. In January 1999, he moved to Portland and began living with one
of his brothers. He took a job at a convenience store.
He bought heroin with his first paycheck. On March 19, he shot up in
his brother's bathroom and died of an overdose.
The senseless loss of the young is always hard to take, but J.B.'s
addiction and death were particularly baffling. He was fluent in
Spanish and had been an exchange student in Mexico and Costa Rica. He
was class president of his alternative school.
He hiked and biked. He'd traveled to Spain, Portugal, Morocco, France
and England. He played mandolin, piano, guitar and drums.
A friend, a fellow musician, wrote a song posing the question no one
but J.B. could answer:
"Everyone wants to know why," went the chorus.
J.B.'s father and brothers took his ashes to Central Oregon. They
intended to place him on the South Sister, but bad weather kept them
from climbing the mountain.
"We left him at a shelter," his father said, his voice catching on the
memory.
"Just an old shelter, open frame, overlooking the South Sister. We dug
out some of the boards and left him there."
His parents say J.B. was naive and trusting. But they also say it was
ultimately his fault.
Far away, in Western Samoa, the news seared G.H.
"When he died, even the thought of heroin made me sick to my stomach,"
G.H. said.
He was changing, slowly. Not so much because of the treatment program,
but because he was away from heroin. Away from the drug, he was left
with himself.
"We knew we were buying him a year off drugs," said his mother, Jan
Mackey. "A year of growth without drugs altering his
perceptions."
G.H. and two other boys drew the attention of a Samoan chief in a
nearby village. The chief befriended them, and in a ceremony gave them
Samoan names. For G.H. he chose "Suiga," which means "Change."
The villagers impressed G.H. They were so poor, they had so little
compared to his life back in Oregon, but they were happy.
On his last day in Western Samoa, G.H. went to a tattoo artist. The
man looked him over and said, "I know what you need."
The work took three hours and can be seen high on G.H.'s upper right
arm. One of the designs is a circle of fish, which means G.H. can
provide for his family. Another is a circle of centipedes, which means
he can withstand pain and make it through hard times.
"To me it symbolizes what I went through, and why I'm doing what I'm
doing," G.H. said.
"He told me that if he uses again, J.B.'s death will be in vain," his
mother said.
G.H. is living with his mother and stepfather and attending the
University of Oregon. He hopes to become a psychologist. "I've been in
a lot of therapy; I think I'd be good at it," G.H. said.
In the meantime, he attends substance abuse group meetings. With
heroin, you take no chances.
"I told him I won't rescue him again," his mother said. "It will break
my heart if he uses again, but it is his life, it is his addiction."
[First Sidebar]
METHADONE OFFERS CHANCE AT CHANGE
By Eric Mortenson
The Drug, While Relieving Withdrawal Symptoms, Allows Heroin Addicts
To Function Normally
THEY ARRIVE ABOUT 7 each morning and stand outside the door, smoking
and talking quietly. They're like a bunch of coffee shop regulars who
all know one another, waiting for the place to open.
One hundred yards and a lifetime away are the Eugene Hilton and the
Hult Center for the Performing Arts, and all the privilege, success
and glamour they represent. To the people lined up outside the drab,
low-slung Lane County methadone clinic on East Sixth Avenue, they
might as well be in another universe.
These are people who have known the degradation, damage and utter
despair of heroin addiction. They have little time now for grand
vistas. For them, each day's focus is on staying clean.
The clinic doors open, and they file in - 70 to 100 during the course
of the day. Many of them carry backpacks or lunch sacks, and are
stopping here on their way to school or work.
Inside, they step up to a window set in a hallway and greet pharmacist
Harold Bucholtz, who's seen many stories, happy and sad, in his 22
years of preparing medication for recovering heroin addicts.
The banter is unforced and breezy. The talk is of fishing trips and
plans for the weekend. Bucholtz chuckles when someone suggests he's
like a bartender.
"I keep telling them to leave a tip on the bar," he says. "I've been
doing this a long time, and I only know how to make one kind of drink."
That would be pre-measured doses of methadone, mixed with orange Tang
and served in paper cups. Clients gulp it down, say goodbye to
Bucholtz and are on their way.
Many of them are required to "dose up" like this in person six days a
week and receive a sealed dose to take home and drink on Sunday. Some
visit two or three days a week and have earned the right, by staying
clean, to four or five "takeouts" a week. Some will stay for group
counseling meetings. Some will be chosen for random urinalysis and
will be monitored by a staff member as they provide a sample.
For nearly 300 people in Lane County, with varying degrees of success,
this is the daily routine that helps them sidestep opiate addiction.
The treatment is called "methadone maintenance" because it allows them
to function normally, but some of these people may need to take
methadone for the rest of their lives.
"It simply makes you feel normal," says Rosie Crist, 44, of Corvallis,
who has been on methadone for nearly 13 years. "Methadone is a
wonderful thing, I'm glad we have it. If more people were on it, it
would take care of a lot of the crime, death and a lot of the illness."
How It Works
Methadone is a powerful drug in its own right. The Nazis synthesized
it as a painkiller during World War II and used it to treat the
wounded after the Allies cut off Germany's access to opium, from which
morphine is derived.
Methadone has a black market value of up to $10,000 per liter and is
said to be the most strictly regulated drug in the world. The Drug
Enforcement Administration, for example, requires clinics to crush
empty bottles so drug users won't rummage through Dumpsters and lick
the containers.
Some of the doses Bucholtz dispenses would kill people who aren't
accustomed to it. Administered properly, however, it relieves painful
withdrawal symptoms and reduces the craving for heroin.
Methadone is an opiate and binds to the same nerve receptors in the
brain that heroin reaches, but it doesn't produce a high - probably
because it has a long half-life, with the effects lasting for more
than 24 hours. Heroin, by comparison, binds to the receptors so
quickly and in such concentration that it creates an intense feeling
of euphoria that users call a "rush."
Because methadone attaches to the same nerve cell receptors and breaks
down much more slowly, it blocks the rush addicts would otherwise get
if they used heroin at the same time.
The effects of methadone typically last for at least a day, compared
with four to six hours for heroin.
This allows patients to take a dose each morning, for example, and
carry on their normal daily activities, where heroin addicts must
constantly seek out the next fix.
Also, because methadone can be taken orally and the supply is
federally controlled, the risks of needle use and contamination are
eliminated.
But using methadone to treat heroin addiction has been controversial
since it was first introduced nearly 30 years ago. Critics argue that
it amounts to exchanging one type of drug dependence for another, and
they contend that addicts would be better served by 12-step programs
and giving up drugs altogether.
In July 1998, for example, New York City Mayor Rudolph Giuliani called
for abolishing the city's hospital methadone clinics in favor of
abstinence programs. He abandoned the idea five months later,
acknowledging that he had been unrealistic, but it was an example of
the mind-set methadone doctors face.
Critics of methadone programs also include some people at the other
end of the treatment spectrum: those in the "harm reduction" movement.
Simply stated, the harm reduction principle holds that total
abstinence from drug use is very difficult to accomplish and not the
only measure of success. In the interim, any positive change - such as
reducing use or starting needle exchange programs that cut HIV and
hepatitis rates - should be recognized and encouraged.
In Eugene, for example, a needle exchange program run by the HIV
Alliance has resulted in 4,400 used needles being turned in for new
ones in a two-month period.
Some harm reduction subscribers would take it further by allowing
methadone users to determine their own dosages, giving injectable
methadone to those who prefer to shoot it rather than drink it, and
not punishing patients who use other drugs while in a methadone program.
"They Can Live Normally"
But supporters of traditional methadone programs say they have
something that works. It reduces opiate abuse in more than 80 percent
of patients, slows the spread of AIDS and decreases crime, they say.
They compare it to diabetics controlling their illness with insulin.
"Look at the outcome," says Dr. Douglas Bovee, medical director at a
private, nonprofit west Eugene clinic called CODA Addiction Treatment
Services. "People can live functional lives, go to school, carry on a
job - they can live very normally."
Bovee, an addiction specialist, says he entered the methadone field
because he was failing at abstinence treatment.
"If they're on medication and they succeed in life because they're
using medication, great," Bovee says. "That's the goal. Methadone can
help people do that."
The problem is, there aren't enough clinics to meet the need. Seven
states don't allow methadone treatment, and in Oregon, there are no
methadone clinics on the coast or east of the Cascades. The two
methadone clinics in Eugene - the county's and CODA's - have waiting
lists three to four months long. Bovee estimates there are at least
1,000 more local heroin addicts who could use the treatment.
"The day our phones went into effect in August 1997, the phones
started ringing and never stopped," Bovee says.
Pregnant addicts automatically go to the head of the clinics' waiting
lists because methadone gives them a much better chance of having
healthy babies. Others must wait their turn and work up the lists. At
the county clinic, for example, clients earn points by calling in each
week. They drop off the list and have to start over if they go a month
without checking in.
And once stabilized on a methadone program, it's not uncommon for
clients to relapse and use heroin again. Many clients start and drop
out several times before the therapy takes.
Complete abstinence remains the goal of methadone programs, but drug
counselors say there's merit in the "harm reduction" approach to
treating heroin addiction.
"If they're using every day, three or four times a day, then over time
any reduction in use is good for the individual, good for his family
and good for the community," says Linda Hill, a counselor at the
county clinic. "It is important to acknowledge that is an improvement,
it has a ripple effect. But on the other hand, we wouldn't want to
just settle for that."
"Saved My Life"
Clients say it's worth the struggle.
"Methadone definitely saved my life, there is no question about this,"
says D.A., 47, who used heroin for 12 years and has been on and off
methadone programs for just as long. Like most methadone clients, she
asked to be identified only by initials or first name.
Despite her spotty record - the longest she's been clean after leaving
a methadone program was six months - D.A. is a firm believer in the
treatment.
"I noticed that for the first time in possibly my life, I felt
balanced," she says. "The more balanced that I felt, the more I was
inclined to go back to work and put my life back in order."
One man, Tom, drives to Eugene from North Bend three times a week
because it's the closest methadone clinic to his home. In eight years
of being on methadone programs in Salem and Eugene, he's put nearly
400,000 miles on his car.
Driving to Eugene and back for methadone doses and mandatory group
meetings eats up 18 hours a week. He says it's like having a part-time
job.
"Just to come here and stand at that window takes five hours," he
says. "Just to come here and stand there for five seconds."
He's 48 and first used heroin when he was 20. In the end, it left him
strung out, without a job and on the verge of bankruptcy. "By the
grace of God I'm here to tell this story," he says.
Arturo, 56, rolls up his sleeves to display heavily tattooed arms that
are scarred and discolored. All of his veins collapsed during his
decades of shooting up, he says, so he began injecting into the fatty
tissue of his arms, which created abscesses.
"These are just old tracks," he says, tracing a dark line that marks a
collapsed vein.
This is his third try at a methadone program. He's been clean for a
year and managed to complete probation during that time. He's spent
about 15 years in prison and believes he'd be there again if it
weren't for methadone. He sold stolen property to get money for heroin.
"The habit doesn't wait for you just because you can't get some," he
says.
Venisa, 38, says she was a prostitute in Eugene to support her habit.
She's been on methadone since March and has been reunited with her
four children, who were taken away because of her drug and
crime-ridden life.
"I had to get on the methadone or I'd probably be dead by now," she
says. "Yesterday was my first clean birthday I've had since I was 12
years old."
Her children, ages 10 to 15, are happy that she's clean, Venisa says.
Among other things, they make sure she catches the bus in time each
morning to go to the methadone clinic.
"They say, `Mama, you got to go to dose,' " Venisa says. "They're a
lot of help to me, a lot."
Expensive Treatment
The state helps a lot, too, because the Oregon Health Plan picks up
the cost of methadone treatment for nearly 75 percent of the local
patients. Many heroin addicts are finally driven to treatment only
when they run out of money, and Oregon's rising tide of addiction is
reflected in the treatment costs paid by the state's low-income health
insurance plan.
The Oregon Health Plan paid $3.2 million for methadone treatment in
1997, and the payments jumped to $4.2 million in 1998. Methadone
treatment makes up 25 percent of the claims that the health plan pays
for all forms of chemical dependency treatment.
Other health plan statistics indicate the long-term and complicated
nature of battling heroin addiction. Because they must "dose up" at
clinics so often and must attend counseling sessions and provide urine
samples, methadone patients averaged 119 clinic visits per person in
1998. In contrast, other drug abuse clients required an average of 38
such service dates per year.
The figures are significant because methadone clients make up only 16
percent of the patient load, yet take up 50 percent of all the clinic
visits attributed to chemical dependency clients, according to Oregon
Health Plan statistics.
Still, counselors and doctors say it beats the alternative. At about
$10 to $15 per day per client, methadone programs are cheaper than the
$25 to $100 per day habits of many junkies, who often support it
through prostitution, robbery or selling stolen property.
National studies drive home the point. According to a 1994 report by
the federal Alcohol, Drug Abuse and Mental Health Administration, an
untreated drug abuser costs society $21,500 over six months. A patient
in a methadone maintenance program costs society $1,750 during that
time, according to the report.
And for clients such as Rosie Crist, methadone maintenance - even if
it takes the rest of her life - beats opiate addiction any day.
"It consumed every part of every waking minute," she says. "Can I get
my supply for today? Where can I get it? Do I have money to get it? It
took over my mind.
"It breaks your morals down, too," Crist says. "I am known in the
community now as an honest person, but there was a time when I would
go through your medicine chest if I was in your house."
Bovee, the CODA medical director, says the community must make
treatment available to more people. It would help matters if drug
counselors were paid better, so more people would go into the field,
he says. Also, he believes it should be easier to open methadone
clinics in neighborhoods without a public uproar.
"Something we've got to get to eventually is getting people into
treatment quickly," Bovee says. "We're not even close to that now.
"Opiate dependency is a serious brain disease," he says. "People don't
set out to become opiate addicts and develop these illnesses. The good
news in the case of heroin dependency is that we've got good treatment
in terms of saving lives, reducing the spread of disease and reducing
crime."
[Second Sidbar]
USER BATTLES TO STAY CLEAN
By Eric Mortenson
A 24-Year-Old Woman Gets Another Chance To Reclaim Her
Life
JULIE McGREGOR had been clean for 10 months when she returned to
Eugene on Sept. 10. She was proud of kicking heroin, proud enough to
stop in at the Whiteaker Public Safety Station and thank police
officers for arresting her and setting her on the right path.
The visit floored officers who work the Whiteaker neighborhood. After
all, as even McGregor would acknowledge, she'd been an irritation to
police for four years. By her count, she'd been arrested 46 times for
prostitution, drug possession and drug sales. She wanted the officers
to know she was clean now, that she and her children were living with
her parents in La Pine and doing well.
"I was glad I went to jail," McGregor said. "That was where I found
Narcotics Anonymous and found a support group and found that life
isn't so bad without drugs.
"I can play with my kids every day, go to bed every night and wake up
in the morning and not stick a needle in my arm."
Within hours of her visit to the police station, however, McGregor
overdosed on heroin and nearly died.
Such is the power of heroin addiction. Drug counselors say the relapse
rate for heroin addicts is extremely high, up to 90 percent for those
who don't have follow-up treatment after a detoxification or
withdrawal period. Even methadone patients, who receive a synthetic
narcotic that blocks the craving for heroin, commonly go through
treatment two or three times before they can stay clean.
McGregor, 24, doesn't remember what happened that night. She saw some
old friends and visited some of the old places where she used to hang
out. At the Side Pocket Tavern, she asked a man to give her a ride
back to La Pine. He declined to do that, but allowed her to stay in
his apartment on West Fourth Avenue in the Whiteaker neighborhood,
according to a police report.
She passed out and didn't stir for 12 hours. She was barely breathing
by the time people in the apartment called for an ambulance; they told
police they thought she was just sleeping it off.
She was comatose for a week and afterward had symptoms as if she'd
suffered a stroke. She couldn't sit up by herself or walk. She
couldn't see. She eventually recovered, but spent several weeks in
care facilities and still has some paralysis on her right side.
McGregor recognizes that she put herself in a bad situation.
"You can't be clean and try to start a new life and continue to do the
same things you did before," she said.
McGregor's parents were outraged by the turn of the
events.
"All it took was some idiots down there that could care less," said
Christy McGregor, Julie's mother. "I've got a lot of anger about the
Eugene area. That problem is so out of hand; it's everywhere, but
Eugene is a bad area."
Julie's angry and grief-stricken father, Jimmy McGregor, drove to
Eugene and parked his pickup truck at Scobert Gardens, looking for the
man he suspected gave his daughter heroin.
"I sat down there with a shotgun because I was going to kill the son
of a bitch," McGregor said.
The McGregors had suffered heartache after heartache in trying to save
their daughter from heroin. Once they kidnapped her in Eugene and took
her back to La Pine. They sat up with her for two nights, trying to
get her through the painful withdrawals.
At the first opportunity, however, Julie slipped out the back door and
headed to Eugene again.
It seemed at times she was doomed to live out a heroin nightmare. She
says she began using hard drugs in high school in Central Oregon after
being gang raped at a party. Afterward, she had an older boyfriend who
supplied her with drugs in high school.
She and yet another boyfriend moved to Eugene, where the boyfriend
began using heroin. McGregor soon followed.
Still, she was smart and had prospects. She studied early childhood
education and taught preschool at one point, but her addiction
overtook her.
"I wanted to work with troubled youth and became one myself," she
said.
She was fluent in Spanish, but mainly used it to make connections with
the Latino dealers who dominate the heroin trade in Eugene.
Her life here was a mess. She was stabbed in the side in a dispute
over drugs. She had to be treated for a painful abscess on her
stomach, caused by injecting heroin. She stole from dealers and sold
drugs herself. An abusive john tried to kill her when she was turning
tricks in the Whiteaker area. He tried to put a cloth over her face,
perhaps to smother her, and nearly ran her over when she scrambled out
of his car.
The jail was her second home, she was in and out so many times.
Sometimes she stayed well by smuggling heroin into jail, slitting her
bra to tuck the drug inside or stuffing small bags up her nose. In one
of her trips to jail she met Dixie Miller, the heroin addict and
prostitute who was strangled this past summer.
"That just broke my heart; that could have very well been me,"
McGregor said.
The turning point came a year ago. Arrested once again, she was sick,
worn out and covered with abscesses. Her boyfriend was in prison and
her children were living with her parents. She had no place to stay.
"It kept hitting me," she said. "I knew I'd better change something
pretty soon. My body was just tore up from IV use."
She pleaded guilty to two counts of possession of a controlled
substance and to providing false information to a police officer. Most
of her previous trips to jail were of the overnight variety; people
accused of drug crimes are typically released within hours to make
room for violent offenders.
But with so many arrests piled up in the past, she knew she wouldn't
be released soon this time. She would have time to sit in jail and get
clean.
"Something within me - when the judge said, `How do you plead?' - I
couldn't say I wasn't guilty," she said.
She was in jail from Nov. 10, 1998, to Feb. 20, 1999. She began going
to church services in the jail. She read inspirational stories. She
joined the Narcotics Anonymous group, and during one of the sleepless
nights while she was detoxing, she read an Narcotics Anonymous
recovery book cover to cover.
Thanksgiving passed, and Christmas. She vowed she would never spend
another holiday separated from her children.
When her time was up, she moved in with her parents and children in La
Pine. Before her near-fatal trip to Eugene, she was attending
Narcotics Anonymous meetings six days a week.
In late October, after her recovery, she began attending meetings
again.
"I'm proud of that 10 months," she said. "They can't take that away
from me.
"I'm starting over again."
[Third Sidebar]
FIND HELP FOR HEROIN USER AT THE FIRST SIGNS OF ADDICTION
By Eric Mortenson
IF YOU DISCOVER your teen-ager or other loved one is using heroin,
look for professional help immediately, says Kathy Donais, director of
the Looking Glass Adolescent Recovery Program.
Don't judge them and don't try to frighten them out of using, she
says.
"They know what they're doing is not good, but they don't know what to
do to get out of it," Donais says.
At the same time, don't ignore the problem and don't believe a heroin
user who claims he won't use again, she says. Without a change in
lifestyle, they will go back to using, she says.
Simply allowing them to go through withdrawals or a detoxification
facility without follow-up care is "a Band-Aid for the problem,"
Donais says.
Instead, contact any substance abuse treatment facility and ask for
help, she says. The agencies can make referrals to the proper program.
The following agencies may be able to help:
Aces, 84 Centennial Loop, Eugene, 344-2237.
Buckley House Detox, 605 W. Fourth Ave., Eugene, 343-6512.
CODA Addiction Treatment Services, 2055 W. 12th Ave., Eugene, 684-4901.
Lane County Methadone Program, 135 E. Sixth Ave., Eugene, 682-4464.
Lane County Department of Youth Services, 2411 Centennial Blvd.,
Eugene, 682-4700.
Looking Glass Adolescent Recovery Program, 1675 W. 11th Ave., Eugene,
485-8448.
Passages, 485-0457.
Prevention & Recovery Northwest, 1188 Olive St., Eugene, 484-9274.
Serenity Lane, 616 E. 16th Ave., Eugene, 687-1110.
Willamette Family Treatment Services, 140 Green Acres Road, Eugene,
338-9098; and 687 Cheshire Ave., Eugene, 343-2993.
SIGNS THAT YOUR SON OR DAUGHTER IS USING HEROIN
Changes: They may have new friends, lose weight or begin skipping school.
Cash and other items may disappear from the home.
Appearance: Heroin users often appear sleepy and lethargic, with pinpoint
pupils. They may scratch themselves; itchy skin is a common reaction to
opiates such as heroin and morphine.
Withdrawal symptoms: They may appear to have a severe flu, with
vomiting, shakes, muscle and bone aches, cramps, insomnia and
diarrhea. Symptoms may last for up to a week.
Paraphernalia: Look for syringes, packaging material such as balloons or
plastic baggies and "cookers" made of cut-off beer or pop cans. Blackened
tin foil is a sign that the user is smoking heroin.
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