TREATMENT OPTIONS NARROW

State Has Cut More Than $11m From Drug Programs Since 2001

DEDHAM -- Richard T. Duda says he needed heroin to get "off E," as in
empty.

The 37-year-old, who says he was addicted to heroin for years, is
serving time at the Norfolk County House of Correction in Dedham for
auto theft. He says he stole a car to make it easier to shoplift, so
he could get money to buy heroin. He will be released next month after
spending a year behind bars.

Duda, like others at the jail, has received help for his addiction.
The care was good and he is physically "clean" of drugs, he said, but
the psychological addiction remains and he is depending on counseling
once he is out.

"If I don't face that issue, I'll pick up again," said
Duda.

But the state budget for substance abuse treatment programs has been
cut from $45 million in 2001 to $33.8 million this year. And the state
could lose another $9 million in federal aid to treat drug users
because it has cut its budget three years in a row. Governor Mitt
Romney said last week that he wants to increase the drug-treatment
budget, but he did not provide specific figures.

Duda, from Boston's South End, is one of many heroin addicts in
prison. Officials at the Norfolk facility said they have seen a sharp
upswing in addicted inmates during the past year. The number of those
in need of "detox" is up 40 percent, said Susan M. Clark, assistant
deputy supervisor of health services. The jail's 10-bed detox facility
used to regularly treat about two people at a time for substance abuse
problems; now there are usually five to seven patients, Clark said.
The jail houses about 515 inmates who are either awaiting trial or are
serving sentences that are typically 2 years or shorter. The average
sentence is 9 months.

The Plymouth County Correctional Facility in Plymouth has seen the
number of heroin-addicted inmates increase by about 10 percent, said
spokesman Michael G. Seele.

The increases coincide with a spike in the use of heroin throughout
New England that officials have labeled an epidemic, especially among
younger people, and with a decrease of more than 50 percent in the
number of treatment beds available to addicts statewide, from 997 to
420. Addicts can wait weeks or longer for a spot. Between 1990 and
2001 (the last year for which figures are available), the number of
Massachusetts residents who died from opiate-related overdoses climbed
fivefold, from 94 to 487, according to the state Department of Public
Health.

"We have a heroin epidemic that is hitting at the same time that there
is a greater strain on the system and our ability to respond is less,"
said Kenneth Tarabelli, executive director of Bay State Community
Services of Quincy, a human services agency that deals with abuse issues.

Treating addicts in prison is much more expensive than treating them
in outside facilities, said officials. Norfolk spokesman David J.
Falcone estimated it costs about $40,000 a year to house an inmate. It
costs about $5,000 to $10,000 a year to treat an addict in a
residential program, said Elizabeth Funk, president of Mental Health
and Substance Abuse Corps of Massachusetts.

The crimes that put the drug-addicted inmates into jail tend to be
more "nuisance" or property crimes than physical crimes, said Norfolk
officials.

Two inmates at the Dedham facility, Robert of Weymouth, who was
convicted of possession of heroin and a syringe, and Edward of Quincy,
who is serving time for shoplifting and larceny of $250, bear physical
and mental scars of drug abuse. The men asked that their last names
not be used.

Robert, 30, lost a leg after it became infected while he was using
heroin. Edward has AIDS. Looking back at his life of crime and
addiction, he said, "I'm 50 years old and everything has gone by me."

But for Duda, there may be a future beyond jail that does not include
heroin. After his release, he plans to go directly into a South End
halfway house.