DOPE-SICK: YOUTHS MIGRATE TO HEROIN AS DEATHS SPIKE

The suburban youth drug culture is graduating.

Marijuana, alcohol and the occasional acid trip are being replaced by
powerful painkillers and the drug blamed for more local overdose
deaths: heroin.

"It's in your backyard. You just don't know it," Chad Sabora
said.

Sabora is a recovering heroin and painkiller addict who lives in south
St. Louis County and lived, rehabilitated, relapsed and rehabilitated
again in the metro-east. He grew up and became a drug addict in
Chicago -- while serving as a prosecutor for Cook County.

The 35-year-old knows the youth drug culture. He lived it as a teen in
the 1990s, doing everything from crack to heroin. He took a hiatus
from recreational drugs in his college years, but became addicted to
sleeping pills after a prescription for insomnia in law school. He
fell back into addiction around age 30 after his father and mother
each died within a year.

Heroin addiction was his living hell.

"You wake up every morning dope-sick if you are out of
dope."

Being dope-sick means diarrhea, hot and cold flashes, vomiting and
insomnia, said Brian Muller, a recovering 24-year-old drug addict from
O'Fallon.

"It's not that they're getting high. They're getting well," Muller
said.

Muller and Sabora escaped.

Muller said he has been to at least 10 funerals this year for friends
who died of drug overdoses. Since the beginning of 2008 there has been
a spike in local heroin deaths.

Many of these overdose victims were youths, a couple as young as 17.
Roughly a third of all drug overdose victims between 2006 and 2010 in
Madison and St. Clair counties were 35 or younger, according to
coroners' files. Almost 70 percent of their deaths were caused by
drugs known as opioids, which include heroin and prescription
painkillers such as oxycodone, morphine, methadone and
hydrocodone.

Amy Warren, the clinical supervisor at Gateway Foundation Alcohol and
Drug Treatment in Belleville, where Muller was treated for substance
abuse, has seen the abuse of heroin and painkillers increase the past
seven years.

"There is just a tremendous increase in heroin use and opiate use
overall," Warren said.

Gateway's heroin patients tend to be middle class, white and 25 years
old and younger.

"It's our next-door neighbor," she said.

Muller is that next-door neighbor. He is confident and articulate and
has the sturdy body of someone who has been working in manual labor,
even through his addiction, since he was 13.

Muller grew up and lives in O'Fallon, where his divorced parents
provided what he described as a stable home life. His drug friends
were from all parts of the local suburbs, including Belleville,
Edwardsville, Shiloh and across the river in south St. Louis County.

Muller started with marijuana and progressed to hallucinogens. By his
sophomore year, he was taking prescription pills.

Muller and his school friends would trade drugs. One person would have
a pocketful of Vicodin, someone else a pocketful of Xanax. "We weren't
dealers," he said.

Muller didn't get into heroin until after high school.

"I wasn't getting high to get away from (stuff)," he said. "I was
getting high because opioids felt good. Once you get that high, you're
hooked. That's it."

But that high became harder and harder to maintain and turned into
something less desirable: a never-ending quest not to be dope-sick.

He paid $5 a pill for Percocet, a drug that is a combination of
acetaminophen and oxycodone. As his tolerance increased, so did the
cost of his habit. He needed $50 worth of pills when before $10 would
do it.

So when his normal dealer in East St. Louis wasn't there one day and
another dealer offered him a line of heroin to snort for $10, he did
the math and some reasoning.

"An opiate's an opiate," he said.

The painkillers were similar to heroin, except for one thing:
"(Heroin) was the same high times 10. It was so much better," Muller
said.

Heroin market

Muller's rationales are what is driving up heroin use and overdoses in
the area, according to law enforcement officials.

It's not just in the metro-east; the city of St. Louis has recorded at
least 63 heroin fatalities each of the past two years after not
topping 38 in the previous eight years, according to the St. Louis
Office of the Medical Examiner.

Since 2008, Mexican drug gangs have marketed a purer form of heroin in
the United States, according to Harry Sommers, the special agent in
charge of the Drug Enforcement Administration's St. Louis Division.
The consequence has been that a drug, which since the 1970s had been
used by a stagnant minority of addicts who injected it, has grown in
popularity.

"Now the heroin is very usable without injection," Sommers said. Not
to say addicts won't eventually get around to injecting heroin. Muller
said he got to the point he was injecting heroin in between his toes
so people couldn't see the needle marks.

Shooting up provides a faster and more intense feeling than snorting
or smoking the drug. Heroin users feel the effects within seconds if
they inject it into a vein, a minute if injected into a muscle and
about 15 minutes if they ingest the drug orally, said Illinois State
Police Master Sgt. Joe Beliveau, who oversees the Metropolitan
Enforcement Group of Southwestern Illinois.

Sommers said addicts in the metro-east can get heroin from two main
sources: Dealers at an "open air market" in north St. Louis and north
St. Louis County and Mexican gangs from Chicago that sell in the metro-east.

Beliveau has his own evidence supporting an increased prevalence of
heroin. In 2010, MEGSI seized 11 times more heroin than in 2006.

The most commonly found heroin in the metro-east is "Mexican heroin,"
Beliveau said. It is usually brought over from Missouri and sells for
$100 to $150 per gram.

A personal use amount, dubbed a "button," is a tenth of a gram and
costs $10 to $20. Many heroin dealers are also users, making the drug
difficult to find in the area and causing buyers to purchase in small
amounts, Beliveau said.

Muller said he sold heroin himself in the metro-east to pay for his
own habit, which grew to $200 to $300 per day. He also went to the
north St. Louis neighborhoods that Sommers cited. He said 20 to 30
dealers would be on a corner selling the drugs.

From pills to smack

Like Muller, Sabora said he switched to heroin after first abusing
prescription drugs. Nobody starts on heroin, he said. "We all said we
would never do heroin."

Pill users switching to heroin are asking for trouble, he said. They
don't know what they are buying and could easily take too much.

"These kids have no idea what they're putting in their arms," Sabora
said.

Dr. Wilson Compton, director of the Division of Epidemiology, Services
and Prevention Research for the National Institute on Drug Abuse, said
pill users have shifted to heroin because they could not obtain
prescription pills or the pills became too expensive.

"That is a new phenomenon," he said. In the past, heroin addicts would
sometimes seek pills if heroin were not available, he said. Beliveau
has seen the same trend on the streets.

"A lot of the people we run across have been prescribed pain meds,"
Beliveau said. "Then they exceed the prescribed amounts and it's not
working anymore, so they use more and it gets costly."

Beliveau has another theory for the local rise in heroin use. He
believes it is a byproduct of the state's crackdown on
methamphetamine.

Heroin was popular in the metro-east in the late 1990s, but not a huge
issue as far as overdoses because it wasn't as potent, Beliveau said.
By 2002 heroin users had switched to meth, which could be made cheaply
at home. The trend reversed in 2005 when Illinois implemented stiffer
penalties for meth-related offenses and threw more law enforcement
resources at the problem by forming seven meth response teams.

New laws put nasal decongestants made with pseudoephedrine, an
ingredient sought by meth makers, behind the counter at pharmacies and
required customers to show a driver's license and be recorded in a
state database.

"Since 2005, it's been an increase in heroin again," Beliveau said.
"Now meth users have turned to heroin. In the last two years, we've
seen more heroin cases than in the last six years. That's the only
thing I can attribute it to."

The spike in fatal heroin overdoses could be attributed to several
things, Beliveau said. Some have said current strains of heroin are
cut with bad ingredients or are more pure and potent.

Combining heroin, painkillers and other drugs that depress the nervous
system can be deadly, according to Dr. Christopher Long, director of
forensic and environmental toxicology at the St. Louis University
School of Medicine. Alcohol with drugs is a big killer, Long said.

Most fatal overdoses in the metro-east were because of a combination
of drugs.

"Some people are able to do it," said Long, whose lab conducts
toxicology tests for local coroners' offices. "And other people make
mistakes. We see the ones that make mistakes."

Last shot

Just because Sabora, the former prosecutor, isn't dead doesn't mean he
hasn't paid for his addiction.

His law license was suspended in 2010, two years after his arrest for
heroin possession. Addiction also ended his engagement and cost him
friends and family.

He said an opiate addict will lie, steal and cheat. They transform
into somebody they never thought they could be.

"It completely destroyed my soul," Sabora said.

Treatment saved him. Heroin addicts must find a new way to live and
find something spiritual in their lives, he said.

"I hope people start understanding this is a disease, not a moral
deficiency," he said.

Pressure from the justice system and law enforcement led Muller to
stop using heroin.

Three years ago, he was arrested for heroin possession in north St.
Louis after he had just scored the drug. While on probation, he failed
five drug tests after testing positive for drugs he said he was
prescribed for legitimate medical issues. He was told by the judge he
would be sent to prison if he didn't clean up.

He decided to quit, but on the way to rehab shot up heroin one final
time.

"I knew it was my last time," Muller said.

Muller recently completed treatment at the Gateway Foundation and got
off probation.

He hasn't relapsed this time because he is afraid his tolerance is so
low that he will die if he shoots up again.

The only drug he takes now is Xanax for post-traumatic stress
disorder. He gets panic attacks constantly from his drug
experiences.

"I have had friends OD in front of me," Muller said. He has replaced
his addiction.

"I jog a lot," he said. "It's still an addict thing. I'm still jogging
to get that runner's high."