HEROIN DEATHS RISE DRAMATICALLY IN MASS.

Report Says Lure Growing In Suburbs

Deaths from heroin and related narcotics in Massachusetts soared close to
fourfold during the 1990s, an increase the state's public health
commissioner described yesterday as an emerging health care crisis.

A report issued by the state Department of Public Health also found that
heroin now ranks as the illegal drug of choice for patients checking into
rehab clinics, with 42 percent of patients who received substance abuse
treatment this year reporting that they had used the drug recently. That
compares with just 19 percent a decade earlier.

The heroin surge, specialists say, is a classic case of market-driven
economics: The drug is both purer and cheaper today, with a hit of heroin
selling in some neighborhoods for less than a six-pack of beer. And, unlike
a decade ago, when heroin was rejected by middle-class users as the province
of street junkies, today the drug is snorted and smoked, burnishing its
appeal in the suburbs.

''Heroin is suffocating our society,'' said Dr. Howard K. Koh, the
Massachusetts commissioner of public health. ''It has invaded every corner
of our Commonwealth.''

The effects of heroin addiction are evident across New England. All six New
England states have seen heroin use rise in the past decade; Portland,
Maine, alone recorded 27 overdose deaths during the first 10 months of this
year. Health officials also report increasing rates of AIDS and hepatitis C
related to injection-drug use. For addicts seeking help, the outlook is
clouded by budget cuts to a range of agencies that help fund drug treatment
clinics.

The new study, compiled by reviewing government, hospital, and drug
assistance records, found that in 2000, the most recent year for which
numbers are available, there were 363 overdose deaths from heroin or another
narcotic, such as OxyContin, in Massachusetts. In 1990, there were just 94.

Although the study does not break down that figure into heroin and other
drugs, the counselors who provide treatment to substance abusers believe
that the overwhelming majority of those narcotic-related deaths can be
attributed to heroin.

''There's no question that it's an ever-growing problem that is getting to
parts of the population that would have never considered doing heroin
before,'' said Tom Magaraci, CEO of Habit Management, the largest provider
of narcotic treatment in the state. ''There's a lot of heroin on the street
- - on streets everywhere.

''We're talking to suburban kids who tell us they go to parties, and there
are drugs all around, including heroin, and it's just an accepted thing.''

The report on heroin was issued two months after another state study showed
that cocaine use tripled among Massachusetts middle school students and
doubled among high school students in the past three years.

Across New England, heroin in the past five years has begun claiming more
lives than homicides.

For example, there were twice as many overdose deaths (40) in New Hampshire
in 1999 as homicides (21), according to the New England High Intensity Drug
Trafficking Area, a consortium of representatives from law enforcement and
health agencies.

At $5 to $20 for a small bag, heroin represents a cheap and potent high. In
fact, an analysis performed by a Massachusetts state lab concluded that in
2002, the purity of heroin samples ranged as high as 66.9 percent, far
higher than a decade earlier.

That increase in purity means two things: Users can buy less heroin and get
the same high, and the risk of overdosing rises substantially.

In just one city, Lynn, heroin has claimed more than 50 lives in the past
six years, police chief John Suslak said. It has also spawned crime - armed
robberies, for instance - by users trying to support their habits.

Increasingly, those users no longer fit the profile of a heroin junkie. A
decade ago, drug counselors said, the typical addict was a middle-aged man.
Today, the junkie is increasingly likely to be young and, more than ever,
female.

The Department of Public Health report found that from 1996 to 2001, there
was a 230 percent increase in 15- to 24-year-olds who received hospital
treatment because of their addiction to heroin and other narcotics.

''If people picture an addict in the alley injecting themselves, they'd
better get that picture out of their head,'' said George C. Festa, executive
director of the New England consortium.

For heroin abusers, gaining access to treatment programs could prove more
difficult in the coming year.

Bay Cove Human Services, which provides drug treatment services in Boston,
has 286 patients in its long-term methadone program, but 50 more are waiting
to get in, said Stan Connors, the agency's president.

Because of federal and state budget cuts, agencies such as Bay Cove expect
that dozens of patients will lose benefits that help provide methadone to
wean them off heroin. Bay Cove executives estimate that 35 of the patients
in the methadone program will stop receiving care when they lose government
benefits next year.

''Just recently, we had two 19-year-olds come in who both had five-year
histories of using heroin,'' Connors said. ''Where are they going to go if
we have even more cuts?''