GIRLS FACE TOUGHER PATH TO RECOVERY

It was a familiar scene for Elena. She was used to being on the streets,
with no money, no way to get home, coming down off a heroin high.

She'd beg people for quarters, playing the scared girl routine: lost in
Manhattan and trying to call home. But Elena wasn't scared; she was an
expert liar with a $100-a-day heroin addiction.

She'd started snorting heroin in her sophomore year in high school,
progressed within six months to shooting up and, by the end of her
three-year addiction, had stolen from everybody who trusted her -- even her
addict friends.

Teenage girls may be using heroin as much as boys, but they carry greater
emotional weights into treatment, psychiatrists said. While there's little
research on how heroin affects the teenage female body, experts said girls
need separate treatment from men. Girls are typically dependent on males
for their drugs and once in treatment, they must cope both with their
addiction and possibly with the shame of having traded sex for drugs.

An estimated 25,000 girls between 12 and 17 reported in a federal survey
last year that they had used heroin at least once during the prior month.
In comparison, 17,000 boys reported using heroin. Yet most heroin addicts
in rehabilitation centers treatment are male -- in 1995, males made up 66
percent of heroin addicts getting treatment funded by public money,
according to the National Household Survey on Drug Abuse.

Boys generally get into treatment sooner than girls, experts said, as
parents tend to send their daughters to counselors when odd behavior
surfaces but call the police when their sons begin acting out.

Most treatment centers are geared to help men, so females don't get the
counseling they need, said Dr. Sidney Schnoll, professor of addiction
medicine at the Medical College of Virginia. Girls who have been lured into
heroin use by men, he said, often have a history of being sexually or
physically abused.

In a 1995 survey at Daytop Village, an adolescent treatment center in
Mendham Township, 54 percent of resident girls said they had been victims
of sexual or physical abuse. Adding to the mix for some girls is the shame
of having sold their bodies for drugs, Schnoll said, so they enter therapy
with more psychological problems than males.

With the explosion of heroin use in the suburbs, Daytop has begun expanding
its treatment for girls. Daytop is the only non-correctional center in New
Jersey that has a separate girls program. The inpatient program has 22
female residents, of 70 patients, and eight girls are on a waiting list.

"Never before have 22 female beds been filled," said the Rev. Joseph
Hennen, Daytop's executive director. "The maximum was 10 or 11, and that
would have been a large amount."

This year, Daytop began conducting female-only retreats, seminars and
semiweekly group therapy sessions. In August, Daytop also hired a
psychologist to focus primarily on counseling females.

"To treat adolescent girls, they need a safe environment where boys are not
always around," Hennen said. "These are girls who haven't learned how to
have non-sexual friendships. They also don't know about hygiene or how to
groom themselves."

Elena had been doing drugs since she was 15 while hanging out with mostly
older, male friends. She first smoked pot, then rapidly moved to acid,
cocaine, Ecstasy and finally heroin.

"I felt more at ease with guys," she said. "I didn't have to compete with
other girls. I didn't feel real feminine anymore. I got tough -- sloppy. I
didn't take care of myself."

Adolescent girls often start doing heroin with male friends or boyfriends,
but with time find their own sources. Elena's habit sent her searching
through housing projects in Paterson, Newark and Manhattan. Usually
accompanied by a male friend, Elena was given the task of buying because
she could flirt her way to a better price. She said she never prostituted
herself for drugs, although she knew of girls who did.

"Guys are the dealers, and if you flirt or smile, they'll knock off a few
bucks," she said. "I know they were thinking, `I'll knock her off like
this,' because they assume I'm on drugs and I'll be easy."

To get money for heroin, Elena said, she helped herself to her parents'
wallets and stole clothing and other merchandise from stores. She also
stole money from friends who asked her to buy drugs.

"I'd lie that I got ripped off -- and to the same people over and over,"
Elena said. "Most kids are so out of it, they didn't even remember. And all
I cared about was getting myself high."

The insatiable desire for the safety she found in heroin's highs quickly
led her from snorting to shooting up. She does not remember whether she
ever shared needles.

"I don't think I did," she said. "I guess I was open to it. There were tons
of times I was so high." She stopped abruptly at her uncertainty and
reaffirmed, "No, I don't think I did."

AIDS is the fourth leading cause of death among women ages 15 to 44, and
approximately two-thirds of AIDS cases among women are related to injecting
drugs, according to the National Institute on Drug Abuse.

There's little research on how heroin affects a woman biologically, and
there's even less on adolescent girls, Schnoll said. The biggest mystery,
he said, is that while heroin suppresses a girl's menstrual cycle, girls
still get pregnant.

Heroin inhibits ovulation and can lead to menopausal symptoms such as hot
flashes, insomnia, nervousness, loss of memory and depression, said Dr.
Jack Mendelson, a professor of psychiatry at Harvard Medical School.

The 5-foot-7-inch Elena dropped to 114 pounds and didn't menstruate for a
year while she used heroin. Since entering Daytop in March, she's gained 30
pounds.

"I used to wear a size 5, now I'm up to a 10 or 12," she said. "I'm not
used to worrying about it -- I know I came in looking bad, but I didn't
really care."

Wearing jeans that flared at the ankles and a long shirt that hung well
past her hips, Elena dressed like many other girls at Daytop. They all gain
weight, she said.

"Females are interested in pleasing males," said Dr. Joyce Bailey, Daytop's
resident psychiatrist.

Elena, now 18, relapsed four months into her Daytop stay.

"I wanted to do (heroin) really bad. I got that old feeling, I got edgy and
excited," she said. "I'm still struggling to stay clean."

Checked-by: Mike Gogulski