KICKING THE HABIT

Nausea. Diarrhea. Chills And Sweats, Aches And Pains.

Health care professionals say quitting opiates takes a toll on addicts.
"It can be pretty intense," said Dr. Lawrence Fuhrman, a substance abuse
counselor at Riverside Outpatient Center in Wakefield. Riverside, which
treats patients from Wakefield, Stoneham, Reading, Melrose and other
communities, provides non-residential treatment for various types of
substance abuse. Larry Berkowitz, Riverside's executive director, said in
the last few years there has been a marked increase in OxyContin and heroin
abuse - while OxyContin is a prescription painkiller, both drugs are
classified as opiates. Berkowitz said high school students and people in
their 20s are suffering from opiate abuse throughout Riverside's coverage
area, and that "absolutely" includes Wakefield.

OxyContin tablets are prescribed to people suffering from severe pain, and
are covered with a time release coating.

When abusers remove the coating, the drug gives an intense high. Many
users crush the tablets and sniff or swallow the powder, providing a
quicker and more intense high. Getting clean Riverside isn't the only
place to see an increase in opiate abuse, especially among young people.

Local police, Essex and Middlesex district attorneys and state and federal
lawmakers have encountered the same problem and are taking steps
to prevent abuse and reduce its prevalence. There are several approaches
to treating opiate addiction, Furhman said. Many addicts attend one-on-one
substance abuse counseling, sometimes in conjunction with group therapy
meetings, similar to Alcoholics Anonymous. Some abusers start by entering
detoxification, a live-in program that lasts from one week to 30 days, but
experts recommend continuing with outpatient treatment - because opiate
dependency is often tough to kick. "Most heroin addicts have an incredibly
hard time staying abstinent; they have a lot of relapses," said Fuhrman,
adding that OxyContin habits are just as tough to kick.

Patients are sometimes prescribed an interim drug, either methadone or
Suboxone tablets, to help them quit. The drugs help an addict function as
a normal person without escalating dependency, while counseling continues.

Only a doctor who is certified can prescribe methadone or Suboxone - most
abuse counselors cannot.

Both drugs ease the symptoms of withdrawal and reduce cravings, relieving
some patients who otherwise relapse repeatedly. Methadone clinics have
historically been controversial, while Suboxone hit the market only a few
years ago. Suboxone treatment has proved effective for some patients and
isn't as difficult or uncomfortable to quit, Fuhrman said. It is helpful
for some addicts who want to avoid the "stigma" of visiting a clinic or
detox program - a certified physician can prescribe it at a private
practice. State Sen. Richard R. Tisei, R-Wakefield, said the healing
process can be long and costly for families.

He serves on the Joint Committee on Mental Health and Substance Abuse, and
one of the committee's recommendations is to increase the accessibility of
both private and public-funded treatment. Getting 'jammed' Tisei
also favors voluntary drug testing at schools, which would require a
parent's permission.

"I think would be great deterrent," he said. Fuhrman said his young
patients, who have included Wakefield residents, "think they're using
(opiates) recreationally," and then get hooked. Woburn's Center for Health
Resources devotes a regular therapy group to opiate recovery, and it is
open to people of all ages. As a counselor at Riverside, Fuhrman tries to
show his patients the "skills and lifestyle changes they need in order to
stay clean." It isn't uncommon for young people to make the leap from
OxyContin to heroin, which delivers a similar high at a cheaper price.

OCs, Oxys or jams, as they are sometimes called on the black market, cost
about $80 per pill, and addicts often need one or two a day to get
"jammed." Heroin, in comparison, is cheap these days, according to
Wakefield Police Chief Rick Smith - $3 to $5 per bag.

Heroin can be snorted, like OxyContin pills, and Fuhrman said he doesn't
see many young people using needles to inject drugs these days. "That's
one area where public education has made a difference," Fuhrman said.
Chewing or sniffing an opiate instead of injecting it may be better in
some ways, but it "doesn't help with the addiction," he said. Smith
said OxyContin and heroin have both caused overdoses in the suburbs north
of Boston, and young people add additional risk when they drink alcohol
while high on opiates.

Heroin's powder form is especially dangerous because it is difficult
to gauge the amount being consumed.

Middlesex District Attorney Martha Coakley recently told a task force of
lawmakers that 76 people overdosed on prescription drugs in her county
last year - and that doesn't include heroin overdoses or incidents that go
unreported.