YOUTH THE FIRST HOPE IN FIGHT AGAINST HEROIN, OTHER DRUGS

The battles are waged on streets, in classrooms, and in political
circles, hospitals and at the dinner table.

The fight against heroin relies on a network of people:

Police officers. Educators. Elected officials. Medical professionals.
Moms and dads.

The mission has multiple goals: reducing the amount of drugs coming
into Berkshire County; changing the nonchalant attitudes about abuse;
helping the one person who previously might have been unreachable;
and eliminating the stigma that drugs only affect society's downtrodden.

And most importantly, it's remembering that the fight isn't just
about heroin and other opioids, including the prescription painkiller
OxyContin. The battle starts with discussions about alcohol and
focuses on getting young people to think about substance abuse as an
unacceptable choice for the body.

"If we really want to make a significant dent in drug use in our
communities, we have to start with the young children," said Michael
Botticelli, assistant commissioner for substance abuse services at
the Massachusetts Department of Public Health. "There's a culture in
society that has sanctioned underage drinking and, in some instances,
even drug use. We have to change community norms."

That sentiment has been echoed locally of late, and it serves as the
motto for the year-old Pittsfield Prevention Partnership (PPP), a
group of local leaders and civilians determined to fight alcohol and
drug abuse. The organization was formed in the model of a similar and
successful group in North County, the Northern Berkshire Community Coalition.

Berkshire County District Attorney David F. Capeless, a PPP member,
said that in some homes, parents tolerate underage drinking. For
instance, a mother allows her teenager to drink at a friend's house,
condoning it because she knows her child won't be driving for the night.

Or a father finds his son's marijuana cigarette, but brushes it off
because he smoked pot at his child's age.

"We call it the trickle-down effect," Capeless said. "The attitudes
that we convey to our children will influence their actions. If we're
going to take things lightly, so are they. When they're drunk,
they're more likely to try marijuana. And if they've smoked
marijuana, they're more likely to take an opioid pill."

The PPP is trying to open the lines of communication between parents
and drug counselors. Francesca Speicher-Cote, a counselor from
Pittsfield, said parents need to get over the stigma that sending a
child to counseling "looks bad."

'No parenting'

"The results can be worse," she said. "I had a pair of 14-year-old
girls say to me, 'Mrs. Cote, if you just tried opioids, you'd love
them.' There was no parenting there."

Cote said that even though the girls went through a Drug Abuse
Resistance Education (DARE) program in middle school, they had little
dialogue with their parents about drug abuse.

Josh Weeks, the Pittsfield Public Schools' coordinator of health and
physical education, said adolescents who talk about alcohol and drugs
with their parents are less likely to abuse substances. He said
organizations such as the PPP have been established because school
districts have joined detox and rehab centers in absorbing reduced
funding for drug and alcohol programs.

Weeks said students take DARE classes in grade school and progress to
more in-depth, science-based health programs. In addition to
following state guidelines, Pittsfield schools augment the curriculum
with the Michigan Model, "which places the emphasis on student
skill-building," Weeks said.

He said students are presented with real-life situations. In one
scenario, they're asked what they would do if a friend offered them a pill.

"It opens up good dialogue," Weeks said. "It all comes back to
decision-making. It's the behavior. Kids are going to experiment. But
we need to stop the addiction."

No fear

Frankie, 22, a recovering addict from North Adams who asked that his
real name not be used, said he went through the DARE program, yet
still got addicted to heroin and cocaine. He said there will always
be a segment of society that will experiment with chemicals.

"Some will get addicted," he said. "But some of my friends tried
heroin a bunch of times and didn't become addicted. I think a lot of
it has to do with your chemistry. I was never scared of trying things."

A 2004 survey by the state Department of Public Health found that 16
percent of eighth-graders said heroin is easy to obtain. And the
Partnership for a Drug-Free America estimates that 1.7 percent of
teenagers have tried heroin.

The South Berkshire Youth Coalition and the Great Barrington-based
Railroad Street Youth Project (RSYP) are teaming with schools,
counselors and police officers to help educate adults and teens about
drug trends and effects.

Dahlia Bousaid, executive director at RSYP, said her group combines
with drug counselors and recovering addicts to offer substance-abuse
forums for at-risk youths. The forums breed an environment for open
conversations.

"When they've spoken with individuals who have dealt with addiction,
who are honest and open with them rather than preaching at them,
Francesca Speicher-Cote, a drug counselor from Pittsfield, says
parents need to be more involved in helping kids fight addiction.

that's when we've seen the best results," she said.

Positive relationships between Berkshire County students and police
also are fostered to encourage students to speak freely with their
school's resource officer or a school adjustment counselor about
drugs, knowing there won't be negative consequences.

As school officials talk with parents and children about drugs, the
police are working to keep drugs out of the county.

The Berkshire County Drug Task Force plays an important role in the
fight. The task force is composed of local police officers who
operate countywide investigations with the help of state police.

Often, you can spot police cars in strategic positions around Exit 2
in Lee. They're waiting for the latest shipment of heroin to enter
the county, tipped off by an informant that drugs were being bought
by a Berkshire resident and brought home to any number of towns or
cities in the county.

"We don't have a lack of informants," said Sgt. Joseph McDyer, a
state trooper who leads the task force. "Sometimes they're addicts
who want to (bust) their dealer, or maybe they're a relative of an
addict and they want to get the guy whose been feeding them drugs."

McDyer has worked the drug scene for more than 24 years and said
Great Barrington became one of the first hot spots for heroin in the
county more than a decade ago.

And in Pittsfield and North Adams, opioid-related hospitalizations
doubled from 2000 to 2005, according to the Massachusetts Inpatient
Hospital Discharge Database.

McDyer blames Berkshire County's heroin problems on the proximity to
heroin-saturated areas such as Holyoke and Springfield.

Police said they don't see as many large-scale heroin dealers come
into Berkshire County and set up shop like they do for crack. Rather,
a number of "mid-level dealers" and users make daily trips to the
middle of the state, making it more difficult for police to bust.

Arrests in Pittsfield

The Pittsfield police have made 30 heroin arrests this year.
Statewide, federal charges increased from 340 in 2002 to 451 in 2005,
and federal seizures of heroin in the state during that period jumped
from 1.1 kilograms to 25 kilograms.

"Our goal is to try and combat the drug dealing, and we lock up a lot
of people," McDyer said. "You're not going to stop drug use
completely, but let's stop our kids from trying it."

Part of the blame for an increase in addiction is placed on the
media, which some say breed a nonchalant attitude toward teenage
drinking and marijuana use. Beer placards are pasted all over
sporting events, movies promote marijuana use, and commercials for
alcohol show drinkers attracting mates.

And now television is inundated Josh Weeks, the Pittsfield Public
Schools' coordinator of health and physical education, says DARE
classes and health programs in schools are meant to encourage smart
decisions by youngsters.

with commercials pushing a pill for every ailment imaginable,
breeding a "take a pill to make yourself better" type of attitude.

The Drug Enforcement Administration estimates there are 3 million
heroin users in the United States, with 1 million addicts. Those
trying heroin for the first time rose from 314,000 in 2003 to 398,000
in 2004. More than 11 million people in the United States have used
OxyContin, a prescription painkiller, for non-medical purposes.

Purdue Pharma L.P., the manufacturer of OxyContin, runs Communities
That Care, a prevention-planning process designed to help communities
support the healthy development of youth by reducing problem
behaviors, including the abuse of prescription drugs.

The initiative has been established in more than 500 communities
worldwide, and in 2004, two New England cities -- Calais, Maine, and
Lynn, Mass. -- received grants to start the program.

James Heins, a spokesman for Purdue Pharma, said his company's drug
provides a legitimate remedy for those suffering debilitating pain.

"There's a widespread perception that these drugs are highly
addictive, but very little acknowledgment that when used under a
physician, patients see an improvement in quality of life, in
working, and living a normal life."

Heins said the company is working on technology to make opioids less
addictive by developing agents that, when crushed and snorted,
produce "no euphoric effects or mildly unpleasant effects."

Locally, a pain conference was held at Berkshire Medical Center in
May 2005 to address opioid abuse, and hospital officials said they
are changing the ways they deal with pain and the prescriptions used
to combat it.

"We need to address the pain without pills, and we are doing that,"
said Dr. Donald Scherling, head of the McGee Unit, a detox clinic at
Berkshire Medical Center. "Opioids need to be the last measure."

BMC has implemented a surveillance program to ensure that those who
are at risk for addiction are not prescribed opioids such as
OxyContin or Percocet, but rather non-addictive pain medications such
as Darvocet.

Different strategies

Now, those who need the powerful drugs receive smaller amounts.
Long-term prescriptions have been eliminated, and studies have shown
that people who undergo short opioid treatments for pain face a
minimal risk of addiction.

"The DA's office is collaborating with Berkshire Health Systems to
make sure we're not prescribing medicine to people who are inclined
to abuse it, or sell it to others, to make sure (the pills) are used
for the purpose that they were intended," Capeless said.

Doctors describe the prevention of opioid addiction as "a continuum
of care," from more frequent visits with patients, to testing for
addiction before prescribing, to doctor intervention in the early
signs of abuse.

Prevention and intervention are the two words you hear most often.
But changing the community's attitudes toward addiction is the
ultimate goal of drug education. This was heard in 2001, when former
Berkshire County District Attorney Gerard D. Downing blamed part of
the lack of public awareness of the rising heroin problem on
decades-old stereotypes.

"The fear I have is that the public still tends to think of the
heroin junkies with the needles in the back alleys, but the profile
of the user has changed," Downing said then. "That profile is getting younger."

Berkshire County Sheriff Carmen C. Massimiano Jr. said he's often
approached on the street by parents asking for help.

"It's filtering into groups where you normally wouldn't think it
would be, the good kids from the good families," he said. "I was a
chief probation officer in the 1970s, and I saw this thing peaking,
and now it's back again. It's not just an urban thing."

Lisa, the mother of a Lee heroin addict, said her son hid his
addiction from her for more than two years. It wasn't until he was
arrested in Springfield three years ago that his secret came out.

"I realize there are parents who are going through what I went
through, who never believed their child could be doing this," she
said. "But they will. Kids are going to try drugs. I saw him go
through withdrawals, crawling on the floor, vomiting, sweating,
begging me to get him more heroin.

"We need to get the parents aware that this is going on."

In the 1970s, Capeless said, the typical heroin addict was a
30-something, blue-collar worker. Today, it's a white, middle-class
20-something. Of the 47 opioid-overdose deaths in Berkshire County
since 2000, the majority were males and ranged in age from 20 to 51.
All were white.

A national survey taken by the United Way in 2003 and 2004 determined
that alcohol and drug abuse among teenagers has damaged the quality
of life in the city and has hurt the health care system, leading to
an increase in crime and addiction.

New survey coming

A new countywide survey of 4,500 students is due out by the end of
the summer, and all three county prevention groups -- the Pittsfield
Prevention Partnership, the Southern Berkshire Youth Coalition, and
the Railroad Street Youth Project -- will use it as a basis for strategy.

The survey is intended to determine the frequency and causes of drug
abuse, including the role that poverty and depression play.

Jim Cieslar, president of Berkshire United Way and a PPP member, said
he believes that, to lower addiction rates, a community-wide effort
will need to take place.

"We can prevent these things from happening. Look at what we've done
with smoking cigarettes and how people view that today," he said.
"Fewer kids than ever are smoking today. We want to do that same
thing with drugs and alcohol. It's about advocacy and awareness, and
getting the information out on what they do to a body."

Capeless said people should prepare for the long fight. Talk with
your children, he said.

"We're not to the point of giving up; we're trying to fight it,"
Capeless said. "But we have to realize that the Berkshires have
changed. Pittsfield has changed. It's not accurate to blame our
problem on outside forces. These are the people of Pittsfield and
North Adams and Sheffield and Lee, and everywhere else. Let's focus
our attention on working to prevent a new generation of users.

"Let's work on the ones who aren't thinking about it."