ANATOMY OF ADDICTION

It's the end of the school year. Soon the streets will be full of
teenagers, in the park, down at the beach, out at the video arcade, looking
for kicks. This summer they may or may not try drugs. It might be a joint,
maybe a line of speed, or it might be a cap of heroin. Recent reports say
dealers on the streets of Melbourne are giving heroin away to recruit new
users or selling it for $7 - less than the cost of a packet of cigarettes.

Most teenagers will turn their backs on the offer of heroin, no matter how
cheap it is. They're not stupid, they have heard all the horror stories.
But some, inevitably, will be curious, they'll want to see what all the
fuss is about.

Figures released last week by the Anti-Cancer Council suggest that 4 per
cent of Australian high school students have tried heroin or other opiates.
The survey of more than 30,000 students aged 12 to 17 found that 1.2
percent had used opiates (for non-medical purposes) in the past month,
indicating that most had used the drug experimentally, rather than
habitually. Geoff Munro, director of the Centre for Youth Drug Studies,
says drugs are prevalent in our community and it's inevitable young people
will be exposed to them, and that some will try them.

Of course, not every kid who tries heroin will become an addict. They may
try it once, perhaps a few times, then put it behind them, marking it down
to a wreckless experiment. But some will be entranced, they'll use it again
and again, they will get hooked, they will become another statistic,
another of the rapidly growing number of addicts.

Why do some people become addicted to heroin, while others can use it
recreationally without developing a habit? What is it that separates these
people? Is it an unhappy childhood? Difficulties at school? A family
history of addiction? The wrong crowd?

Experts can't predict who will use heroin, or who will become addicted, but
research shows that some people are at a higher risk of developing an
addiction due to a range of social and economic factors, physiology and
access to drugs.

Richard Tregear, a community worker, has been pondering the question of
addiction for nearly 25 years. But, he admits, he doesn't have a definite
answer.

He has seen many young people, including friends, become dependent on
"Ronnie', the old euphemism for heroin. Some are still stmggling with their
addiction 20 years later. "I'm starting to think maybe heroin chooses you,
you don't choose heroin - and it's not the availability of the drug to the
people, it's the availability of the people to the drug," says Tregear.

Dr Alison Ritter, head of research at the Turning Point Alcohol and Drug
Centre in Collingwood, puts it simply. People use drugs because they are
incredibly pleasurable. "The message from our society is, if you don't feel
well, take something to make it better. Is it any wonder that we have
problems with drug use in our community?" Everyone is using drugs of some
description, she says, whether it's caffeine, nicotine, heroin, ecstacy,
alcohol, even prescription medication.

Ritter says people enjoy using drugs for various reasons, including the
pleasurable physical and psychological effects, as well as social aspects.
Drugs wipe out negative feelings, she says, and people use them when they
feel angry depressed or anxious.

Yet, she says, only about 5 per cent of the population becomes addicted.
"The process of moving from experimenting and being under some form of peer
pressure to develop a dependence is not something we really understand very
much about." In order to become addicted to heroin, someone would probably
need to use the drug two or three times a week for a couple of months, but
it varies enormously, she says.

Many of those who do become addicted end up at Turning Point, which offers
withdrawal programs, counselling and referrals. The service sees 2000 to
3000 people with drug and alcohol problems a year and its 24-hour telephone
service, Direct Line (tel: 9416 1818), takes about 40,000 calls annually.

Most heroin addicts say they became addicted in a social situation, says
Ritter, but they don't blame peer pressure. "Most young kids experiment
with drugs, and peer pressure is involved in that experimental phase. The
vast majority of adolescents don't then go on to develop serious problems
with drug use. Most of them at some point choose to say no, or move out of
those particular circles, or just grow up and become more responsible,
basically."

Ritter says there is a genetic component to addiction and some people may
be physiologically predisposed towards developing an addiction of some sort.

But the evidence suggests that a whole range of childhood experiences also
play a significant role in who is vulnerable. A senior lecturer in
adolescent health at Melbourne University's Centre for Adolescent Health,
Dr John Toumbourou, says it is not possible to predict which young people
will try heroin or those who will become addicted. But it is possible to
identify those who are generally at risk of adjustment problems and
therefore more predisposed to abuse and addiction.

He says the centre's research over the past five years, along with
international studies, show that predictors for adjustment problems fall
into into five key areas affecting adolescent development. Family
background is the most significant factor, he says, with experience at
school, peer groups, availability of drugs within the community and
biological factors also - playing important roles. Access to community
programs, such as mentorship and after-school recreational programs, have
been shown to protect some children from behavioral problems.

Before a child is 12, visible family conflict (not necessarily physical)
and child abuse are very damaging in terms of later behavioral problems.
Good parenting during the adolescent years is also very important.
particularly forming a close bond with a child, good communication and
parents making themselves available, he says.

People who are from economically disadvantaged families have higher rates
of substance use, including smoking and illicit drug use, but substance
abuse is still surprisingly high among children from privileged families,
says Toumbourou.

Children who perform badly academically are at risk, as are those who don't
feel a sense of connection with their school, he says. Extra-curricular
activities and involvement in school councils or peer education programs
can help provide that sense of connection.

Toumbourou says it is important that society gets each of the socialisation
environments right to prevent adolescent substance abuse and to reduce the
risks of a multiplicity of other behavioral problems, such as delinquency
and mental health disorders.

"You can't stop people bringing heroin in, but what you can do is develop
socialisation experiences for young people that ensure the majority of them
won't be interested." says Toumbourou.

"There is a tremendous amount we can do about the problem if we can form
good partnerships with schools, with parents, if we can get going with good
peer education programs. The message is we need to invest in these areas."

Anthony's story

"Anthony", 21, was 13 when he became addicted to heroin. It wasn't peer
pressure. It never is, he says. Everyone has a mind of their own. It was
curiosity that almost killed the cat.

He had been feeling bad, "scattered' from using amphetamines and had gone
off cannabis. Maybe heroin would get him off the speed and make him feel
better. He believed heroin was a wonder drug, "a potion to cure everything".

"I kept hearing all these things about the stuff, so I said: 'Oh, well,
I'll try it' - like I'd try marijuana or a drink of alcohol," he says. "I
decided to try heroin."

The crowd he was hanging around with knew where to get heroin - even though
they weren't using the drug themselves - and it was practically being given
away.

Like most people, Anthony snorted the drug the first time. The next day, he
decided he would inject himself. After seven or eight days of injecting, he
developed his first stomach cramp - the first physical sign of addiction.

But, he says, with heroin, psychological addiction occurs immediately
anyway. At first, it's more want than need, he says, because heroin is such
a likeable drug. Then again, Anthony has a few friends who use heroin
recreationally, maybe once a month or so, and they are not addicted. He
doesn't know why, but he does know that heroin is always on his mind.

Anthony has talked to many users about their addiction. Many say the needle
is part of the draw. "Apart from the addiction, of getting stoned and all
that, it's an addiction of actually putting a piece of steel in your arm
and doing the bizzo, and taking it out, and all that sort of thing."

Anthony was a state ward, in and out of foster homes since he was three.
His parents were alcoholics and his mother abandoned Anthony and his brother.

At school, his friends couldn't understand why Anthony wouldn't go to
nightclubs with them. He seemed too straight for his own good, like a
hermit. He told friends he was busy and had appointments. They didn't
realise he was "running amok", robbing houses to pay for his addiction.

At 19, he ended up in Pentridge for drug-related offences.

Even at the tender age of 13, didn't he realise the danger of using heroin?
"It's just like telling a little baby: 'Don't go over there because you are
going to get yourself hurt'. They're going to try it anyway. You learn
you're going to get burnt by a match if you play with it, but you still go
and play with it."

Anthony has been seriously burnt by his addiction. He has overdosed and
almost lost a leg. Still he continues to use the drug about once or twice a
fortnight.

He says he doesn't know if some people are more vulnerable to addiction
than others. But, he says, everyone is more vulnerable these days because
there's so much heroin around. It's everywhere, he says. "You can't run
from it. Dealers target certain young people and offer them a try. Before
they know it, they're hooked."

Checked-by: Mike Gogulski