NARCOTICS-RELATED FATALITIES RISE IN MASSACHUSETTS

A decade-long epidemic of heroin-related deaths reached a new high in
2003, according to a state report released yesterday that offers the
newest evidence of the toll exacted by the continued influx of cheap,
pure drugs into New England. The study, issued by the Department of
Public Health, found that drugs were deadlier than motor vehicles:
Narcotics caused 574 deaths, compared with 521 fatalities attributed
to traffic accidents. In the last 13 years, drug overdoses have
soared six-fold.

Substance-abuse specialists said that in many respects, the continued
spread of heroin represents a classic example of market-driven
economics. Today, a small bag of heroin can be purchased for as
little as $4, cheaper than a six-pack of beer. And to entice young
users, dealers sometimes offer free samples. The result: Deaths from
opiates have climbed markedly since 1990, when 94 people succumbed.
The report released yesterday was the latest in a series of recent
studies documenting the scope of addiction problems in the region.
"We have a major crisis," said Elizabeth Funk, president of Mental
Health and Substance Abuse Corporations of Massachusetts, a trade
group. "One would assume that society sooner, rather than later,
would be attentive to the situation. We don't put these people on
barges and ship them off to the middle of the ocean. They're not going away."

The increase in deaths in 2003 happened as state government cut
spending for substance-abuse treatment significantly. Between 2001
and 2004, the Department of Public Health cut nearly $11 million
from what it devoted to treating drug users and to preventing
narcotic and alcohol abuse. The impact of those cuts was intensified
by reductions in other state programs, particularly the MassHealth
Basic insurance plan for the poor. The number of treatment beds for
substance users needing urgent detoxification fell from nearly 1,000
statewide to 420, meaning patients waited weeks or months for a slot.
Lieutenant Governor Kerry Healey was put in charge of a commission to
review the state of substance-abuse treatment in Massachusetts, and a
May report from that commission called for better coordination of
services among government agencies. It also championed prevention efforts.

In the wake of that report, the administration of Governor Mitt
Romney increased by $9.1 million what it had committed for the
current budget year for the Bureau of Substance Abuse Services. But
drug-treatment specialists said that money only restored the bureau's
finances to the 2004 level. In an interview yesterday, Healey said
her commission is trying to make sense of the bewildering web of
treatment services.

"We want to make sure we have the right amount of funding in the
right place," Healey said. "This is an opportunity to build the
system back and build it back in a more rational way than it existed
previously." The task force Healey presided over concluded that
substance-abuse services were divided among too many agencies and
that recovering addicts too often did not get the sustained help that
would prevent them from returning to their drug of choice.

Executives with substance-abuse agencies estimate that the state
needs to spend $50 million more for adequately addressing the medical
needs of addicts and for prevention campaigns.

Nancy Paull has seen the face of heroin addiction in Massachusetts,
and it is increasingly suburban, middle-class, and young. There was,
for instance, the teenager who celebrated his 16th birthday in a
detox bed at Stanley Street Treatment & Resources, the Fall River
agency where Paull is chief executive officer. That teenager's story,
Paull said, was emblematic. He was hooked on the painkiller
OxyContin, a potent prescription drug that has gained widespread illicit use.

"Kids are buying OxyContin on the street," she said. "But it's quite
expensive, and they quickly move to snorting heroin, and that moves
to quickly injecting heroin."

As suburban parents began to recognize that the users of heroin and
OxyContin looked a lot like their own children -- and that,
sometimes, they were their own children -- that changed the
political dynamics of substance-abuse treatment, Healey acknowledged.

"In the past in America, when there have been drug-abuse problems, it
has been the government vainly trying to draw attention to why this
is a problem for society," Healey said. "Parents are extremely
concerned that this is now a middle-class, upper-class issue."