HEROIN: 'HUGE, HUGE PROBLEM'

Cheap Price Fuels Alarming Increase In Overdoses Locally

(NORTHAMPTON) Within days of each other in August, two local men were found
dead of what police suspect were heroin overdoses. Two weeks ago, police
shut down a Main Street apartment that had been the scene of a months-long
investigation identifying it as a place known to both buy and use drugs,
including heroin.

Northampton Police Detective Lt. Kenneth Patenaude said the Oct. 10 arrests
of the six people at 184 Main St. shut down what had become "a flophouse
for people to come and use cocaine and heroin."

Two suspected overdoses and one downtown drug house in a big city might not
even raise concern, but in a small community like this one, such reports
certainly do.

Earlier this month, Gov. Mitt Romney to met with other New England
governors to address the growing popularity of heroin in the region.

Over the past decade, heroin use has jumped, its price has dropped and its
purity has doubled, police say. Substance abuse experts, meanwhile, say
overdoses are on the rise.

Within the past five years alone heroin use has doubled, said Maryanne
Frangules, project coordinator for MOAR, or Massachusetts Organization for
Addiction Recovery, based in Boston.

"It's really made a comeback," said Timothy Purington, director of the
needle exchange program in Northampton, said.

"Overdose is a huge, huge problem," he said.

From 1990 to 1998, fatal overdoses increased 156 percent, according to the
state's Department of Public Health. The same agency reports that between
1996 to 2001, hospitalizations for heroin or other related drugs rose 74
percent.

It's a phenomenon that Frangules attributes to increased purity levels of
the drug combined with decreased access to drug treatment.

Most overdoses are caused by combining heroin with other drugs, mainly
alcohol, Purington said.

According to the U.S. Office of Drug Control Policy and the National Drug
Intelligence Center of the U.S. Department of Justice, dependence on heroin
and other illegal drugs in New England has grown to the highest in the
nation. Heroin is readily available throughout Massachusetts, according to
the center, with primary distribution centers in Boston, Fitchburg,
Holyoke, Lawrence, Lowell, Lynn, New Bedford, Springfield and Worcester.

Despite this situation, the state cut Medicaid by $26 million this summer,
shutting down funding for about half of all state-funded detoxification
beds in the state, according to Frangules.

As of July, six of the state's detoxification centers have closed, she said.

That means that Massachusetts has lost about half the state-funded beds it
had last year for detox, from roughly 1,000 to 500. The loss of these
government-funded beds is significant considering that the state estimates
88 percent of heroin addicts are unemployed.

The situation is getting "close to sort of a crisis in treatment,"
according to according to Dr. Amy Fowler, head of Cooley Dickinson
Hospital's outpatient substance abuse center. The recent closings, she
said, "set back the system 30 years."

Without detox, Frangules said, "people seeking help return to the streets
and shelters in our neighborhoods, show up in our local emergency rooms or
in our police stations, courts and jails, at a much greater cost to the
Commonwealth."

In 2001, when the Daily Hampshire Gazette ran a three-part series exploring
heroin use in the city that revealed the drug's popularity increasing and
its price decreasing. Since then, its price has dropped by about half,
state reports show that heroin use has risen further, and treatment options
for heroin addiction have been cut dramatically.

Cuts Alarm Local Officials

State cuts have alarmed police, who warn that overcrowded emergency rooms
and an increase in crime lie ahead.

Northampton Police Chief Russell P. Sienkiewicz believes that society will
pay for these addicts either through funding treatment centers or through
footing the bill to prosecute and punish the crime continued heroin use
causes - and that the cost of the latter will be higher.

Although detox services are covered by many insurance companies, many
heroin abusers are homeless and/or uninsured.

"Deto"x is a term used to refer to the initial medical withdrawal from a
substance. The program takes less than a week, the time it takes for the
body to go through heroin withdrawal, which can begin as soon as a few
hours after the last injection.

Of the roughly 35,000 people who entered detox in Massachusetts in fiscal
year 2002, 88 percent, (or about 31,000) reported heroin as their primary
drug, according to the state's Bureau of Substance Abuse Services.

Of people classified as homeless who were turned away from detox centers
last year, 59 percent were heroin addicts, according to Frangules.

In an article she wrote for MOAR News about the treatment situations,
Frangules said that about three-quarters of all people who need drug or
alcohol treatment do not receive it. By turning addicts away from detox,
Sienkiewicz said, "you're shutting off their last gasp of hope to get help."

It is unknown whether the two city men who may have died from heroin
overdoses this summer - Paul Garrison, 43, and Roger Ulmer, 46 - sought
drug treatment. The state's medical examiner has not confirmed the causes
of their deaths - toxicology reports are still pending.

Age Breakdown, Other Stats

The state health department reports that hospitalization for heroin users
is highest among 25- to 44-year-olds and averaged about 450 of every
100,000 Massachusetts residents in 2001.

Those aged 35 to 44 lead the population in the number of fatal overdoses.
In 2000, there were 14 heroin overdose deaths for every 100,000 state
residents, according to the health department. The rate for 15- to
24-year-olds was 5 per 100,000. The average age of a person seeking
treatment is 33.

But heroin users are getting younger.

According to a federal Substance Abuse and Mental Health Services
Administration study, the proportion of new heroin users admitted to
substance abuse treatment who were younger than 25 years old increased from
30 to 41 percent between 1992 and 2000.

The number of men who die from overdose was nearly twice the number of
women in 2000. About three-quarters of heroin abusers are men, according to
the agency.

Heroin users come from all walks of life but the most visible tend to be
the homeless, Purington said. About a quarter of heroin addicts are
homeless, according to the state figures.

Over a third of heroin users have been diagnosed with mental illness,
Purington said. A quarter of heroin abusers have received treatment for
other mental health issues, according to the state's figures.

The same study states that the majority of adult heroin users in the state
are white (65 percent). Hispanics comprise 22 percent of users and blacks
make up 9 percent.

Sixty-one percent of all users have children under the age of 18.

Speculation On Increase

A number of factors appear to have converged to fuel an increase in the
popularity of heroin.

One is price. Purington said heroin is competitively priced with alcohol
and marijuana. It's about $5 per bag now, he said. "It's as expensive as a
six-pack of beer," Frangules said.

Purity levels tend to vary, Purington said. One batch might be 40 percent
pure while the next is 80 percent.

Another explanation for the increase seems to be a gradual desensitizing of
society toward heroin use. Purington noted movies such as "Trainspotting,"
"Pulp Fiction" and "Requiem for a Dream," that seem to glorify heroin use.
In the fashion world, some models display a look known as "heroin chic,"
marked by a gaunt body, disaffected demeanor.

In the 1970s, Purington said, heroin was in class by itself. Heroin was
taboo and there were clear boundaries between it and other illegal drugs.

Those lines seem to have faded, he said.