FRESNO, NATION'S NEEDLE-DRUG CAPITAL

Poverty and Cartels a Potent Mix in Central Valley

FRESNO - The nation's capital of intravenous drug use is not New York or
Miami, not Chicago or Detroit -- but Fresno.

It is an unlikely distinction for a city of fewer than 500,000 people in
the heart of one of the nation's richest agricultural regions.

The percentage of people shooting up heroin and other drugs in Fresno is
nearly three times the national average, fueled by a boom in
methamphetamine use, according to a study issued last month.

"This town is so full of meth," said Amy Wilson, 28, who was ordered into
rehab after her daughter, now 3 1/2 months old, tested positive for
methamphetamine at birth.

"My grasp on reality was gone," she said. She described drug use in the
Central Valley as "a cancer."

Law enforcement agencies and treatment counselors say they are overwhelmed
by the scope of the problem, which is compounded by HIV and hepatitis C
infections that come from sharing needles.

The Fresno area has become home to Mexican drug cartels that operate in its
rural expanses, where the farm chemicals used to make meth are readily
available and the noxious fumes are less easily detected. According to a
2001 estimate by the Drug Enforcement Administration, 80 percent of the
country's meth comes from the cartels.

Part of the problem in the Fresno area is also poverty, said Samuel
Friedman, a research fellow at the National Development and Research
Institutes in New York and primary author of the study in last month's
Journal of Urban Health.

Fresno County, where farmworkers get paid low seasonal wages, is one of the
poorest counties in the nation. More than 20 percent of its residents -- an
estimated 165,000 people -- live in poverty, according to census estimates,
and the per capita income is just $15,495 a year.

In the study, Fresno was found to have 173 intravenous drug users for every
10,000 people; the national average is 60 per 10,000 people. Three other
urban areas within 200 miles also made it into the top 10: San Francisco,
Stockton-Lodi and Bakersfield.

It is a problem that has been costly for the government. Fresno County
spends $20 million a year on drug-treatment programs that served more than
9,000 people in 2002, and the programs are straining to meet demand.

"Now at least we have a waiting list," said Dennis Koch, administrator of
Fresno County's Alcohol and Drug Program. "Before, we used to not have
these programs. There was nothing to wait for."

Meanwhile, the number of addicts who shoot up with dirty needles has placed
a heavy burden on public health. A recent Fresno County study found that 75
percent of the area's injection-drug users had hepatitis C, compared with 2
percent of the general population. The county had 251 new HIV infections
last year, a 17 percent increase from the previous year.