OVERDOSES INCREASE: PURER HEROIN IS KILLING OUR YOUNG

For decades heroin users were stereotyped as poor inner-city people who
lived in ghetto neighborhoods. In today's drug culture that stereotype is
replaced by the reality that heroin use and addiction cross all racial,
social, and economic boundaries. In fact, heroin use is steadily rising
among middle-class youths who live in the suburbs. The heroin-user
population in our cities has been declining for many years because drug
trafficking is a cash business, and in order to make profits the business
serves the customers who have the money.

From the 1960s through the early 1990s most of the heroin used in the
United States was imported from the Middle East and Southwest Asia. Heroin
was sold on the street in a powder form with an average purity per dose of
3 percent to 12 percent. This heroin was mixed with water and heated in a
spoon or bottle cap and then injected into the user's veins to get high.

Drug's Purity Increased

That all changed in the mid-1990s when the Colombian drug cartels began
growing, processing, and distributing South American heroin. The purity of
South American heroin sold on the street ranges from 65 percent to 90
percent. Because of its potency, this heroin can be snorted rather than
injected to obtain a high. Without the perceived danger of contracting AIDS
or hepatitis with needle use, the use of heroin became attractive.

The introduction of this high-purity heroin into the Richmond metropolitan
area has been responsible for the majority of overdose deaths in the region
over the past three years. In 2000, the area recorded 30 heroin overdose
deaths in the combined jurisdictions of Chesterfield, Hanover, Henrico, and
Richmond. Of the 30 deaths reported, 24 occurred in Chesterfield and
Henrico, five in Richmond, and one in Hanover. These statistics are
alarming because prior to 2000 annual heroin overdose deaths in Central
Virginia could be counted on one hand.

The majority of these heroin overdose deaths were young people relatively
new to heroin use, and the deaths were all from injection of heroin into
the body. These young people started using heroin by snorting it to get
high. Over a rather short period of time, they became addicted to the drug
because of its power to induce physical and psychological dependency.

Usually Lethal Dose

Once addicted to snorting heroin, the user quickly becomes dissatisfied
with the onset of the high, its duration, and the lack of the first-time
euphoric feeling. This leads the user to inject the heroin directly into
his or her veins for a fast intense high that lasts several hours. The
problem is that the old 3 percent to 12 percent heroin per dose can be
processed by one's body, but the new 60-percent to 90-percent dose is
usually lethal. The body cannot handle high-purity heroin injected directly
into the bloodstream.

Parents and teachers need to know some basic facts about heroin so they can
detect heroin use early and intervene with treatment. Heroin is
manufactured from a morphine base, which makes it a central nervous system
depressant and strong painkiller. Because heroin is the most physically and
psychologically addictive illegal drug, recreational heroin use is rare.
Parents may notice small items of value or money missing from their
households, because the young user needs to purchase the drug every day.
Once dependent, if the user does not receive his daily dose, he may become
ill and lapse into respiratory failure.

A person high on heroin will appear mellow and at times sleepy and unaware
of his surroundings. He will have tightly constricted pupils that are
unresponsive to light. Because this drug erodes the liver, kidneys, and
immune system, the user's eyes may have a yellow tint. A heroin user will
be chronically constipated and have a diminished appetite. Typically heroin
is used twice a day, with a normal high lasting from six to eight hours.

When he or she is not under the influence of the drug, a heroin user
exhibits a very recognizable pattern of behavior. On the downside of the
high, the user will exhibit agitated or anxious behavior over everyday
issues. The person will be high-strung with rapid body movements, and his
or her behavior will be chaotic with a short attention span. The pupils of
the eyes will be fully dilated. This pattern of up-and-down behavior will
be repeated daily.

Available on Street

Heroin is sold on the streets in small plastic or glassine bags for $25 to
$35 per bag. A street dose of heroin is approximately 1/10th of a gram.
Heroin varies in color; it can be a white, beige, or tan powder. Still a
popular street drug, it is primarily sold in the city of Richmond and other
urban areas of Central Virginia, with users from surrounding counties
traveling to the cities to make their purchases. Heroin dealing is usually
a daytime business because dealers operate in dangerous neighborhoods that
customers would not frequent at night.

Heroin addiction is painful and can be deadly, but there are successful
treatment and rehabilitation programs in the medical community.

Over the past six months, the law-enforcement community in Central Virginia
has seen an increase in heroin overdoses. The pattern of overdoses that was
first detected in 2000 is again on the upswing. The key to helping our
children is for responsible adults to be aware of the symptoms of heroin
use and intervene. Contact your family doctor or organizations such as the
Richmond Drug Alliance to receive guidance in selecting the proper
treatment program. This will provide the young person the best chance for
recovery. Stay involved in the lives of your children, and together we can
prevent the tragedy of heroin overdose death.

Joe Dombroski, a Richmond-area enforcement supervisor for the U.S. Drug
Enforcement Administration, is a 2003 Commentary Columnist.