Only 1 in 10 can "make it out and get clean"

IT STARTS on a corner, like Turk and Eddy or 16th and Mission in The
City. Packed into small party balloons and stored in the mouths of
dealers, it's bought for as little as $40 a gram. Smoked, snorted and
shot, it hooks users fast, leaving them "torn up," as they're
described on the streets.

In the Bay Area, where heroin use is four times higher than the
statewide average, the opiate has crossed all lines of race, class
and age.

No amount of money, intervention or love was able to save the life of
Nicholas Traina, romance novelist Danielle Steel's 19yearold son,
who was found dead of an apparent heroin overdose Saturday.

By all accounts, his mother and adoptive father, John Traina
Steel's fourth husband from whom she is now separated did
everything they could to help the troubled teen, who was found in his
Pleasant Hill apartment early Saturday. Next to his slumped body was
drug detritus a hypodermic syringe, a spoon containing burned
residue and a cotton ball.

When Traina, a musician, wasn't checked into a hospital or drug
treatment center, he was under daily medical supervision and had a
covey of people hired exclusively to look after him.

"I don't care if you're rich or poor or what your state of mind is,
when you're addicted to heroin, it's extremely hard to kick," said
Bryan Jackson, senior substance abuse counselor at the HaightAshbury
Free Medical Clinic.

"Of the heroin addicts I deal with they are everyone from
professionals to musicians and artists only one out of 10 are able to
make it out and get clean."

Heroin "hip among young people'

By comparison, Jackson said, half of cocaine addicts kick the habit.

"Heroin has become hip among young people. Kids are smoking it and
snorting it which is more acceptable than shooting it. But, after a
while, they want a better high, so they start shooting. If you do
that for a few weeks, you're hooked. Period. And it's far tougher to
detox off heroin than other drugs."

At San Francisco General Hospital, three or four heroin overdoses
come in every day, and every third day a person dies of heroin
overdose, said Karl Sporer, assistant clinical professor in the
hospital's emergency department.

"It's an epidemic, as common as bread and butter," Sporer said.
"Consider that the most common diagnosis of a person admitted to our
hospital is that of tissue infection related to injection of drugs."

A dubious distinction

San Francisco has the dubious distinction of leading the rest of the
state in rate of heroinrelated hospital admissions and ranks third
in the country behind Baltimore and Newark, N.J., according to Larry
Meredith, director of The City's Department of Public Health
Community Substance Abuse Services.

In 1995, the most recent year studied, The City had 314
heroinrelated admissions per 100,000 people, a figure that is more
than four times the state average. San Francisco ranks second in the
country on cocainerated admissions and first for methamphetamine admissions.

"We live in the drug abuse capital of the country," Meredith said.
"And for youth under 18, heroinrelated admissions to hospitals has
doubled from 1990 to 1995."

Cheap and easy to get

Part of the added popularity of heroin a powdery or sometimes
tarlike opiate derived from opium poppies has to do with price and
availability. "Heroin is really cheap to obtain and there's a glut of
it," said San Francisco narcotics Officer Larry Mack. "You go to the
Tenderloin or the Mission and you'll find it."

Trafficking arrests by the federal Drug Enforcement Administration's
San Francisco field office show a steep increase in recent years. In
the Bay Area, the DEA seized 77.8 kilos of heroin in 1996 and made
207 heroinrelated arrests. In 1995, 19 kilos were seized and 106
arrests were made.

Kids starting younger

Besides the supply increase and price decrease, heroin has slithered
its way into mainstream culture largely through the media. Fashion
photography glamorized the strungout "heroin chic" look at least
until there was a backlash against it. Movies like "Trainspotting,"
"Pulp Fiction" and "Basquiat" portrayed heroin addiction, either in
glossy terms or in jarring cinema verite.

"Heroin is definitely on the rise for kids from all backgrounds," said
Elizabeth Escobar, director of admissions and outreach at Thunder Road
Adolescent Treatment Center in Oakland.

"What's frightening is that kids are starting to try drugs earlier, and
when they start earlier they get bored. So they go from alcohol and weed
to acid and heroin." She added: "When you hear about the tragedy of the
Traina boy, it really hits home. This is not a drug for a certain type
of kid or person. It's one that appeals to and can destroy anyone."