OVERCOMING HEROIN

Local methadone clinic would brighten future with son, couple says.

He awakes each day at 7 a.m. and faces the same choice: 80 miles or a
hypodermic needle. His name is Dominick. He's a recovering heroin addict.

The needle, he knows, once put him in jail for two years. He knows it hurt
his family. He knows it destroyed part of his heart, and nearly killed him
with overdoses twice.

And he knows he'd probably shoot up again - if not for that 80-mile drive
to the clinic in New Jersey.

That's where he obtains methadone. It's a drug he and his 24-year-old
girlfriend, Kara, also a recovering addict, said blocks their cravings.

But each day is a struggle, the Wilkes-Barre-area couple said, as they
fight their addictions and the obstacles they face in obtaining help.

Despite nearly four years of planning, Luzerne County does not have a
methadone clinic, forcing dozens of local addicts to travel to surrounding
areas for treatment.

At least 25 Luzerne County residents remain on a 120-person waiting list at
the primary methadone provider for this area, the New Directions clinic in
Allentown, said the center's director, Glen Cooper.

In the meantime, drug addicts continue to die at an alarming rate in the
county. The number of suspected or confirmed drug deaths since January was
at 21 as of Saturday, according to the county coroners office. That
compares to 43 last year.

At least two of those 21 people were on the New Directions waiting list,
Cooper said.

"To die while waiting in line for treatment is an obscene thing that should
not happen in a civilized society," Cooper said. "We can't accommodate
everyone. You need a treatment facility in the Northeast."

New Directions tried to open a center in Old Forge several years ago, but
public opposition scuttled the project. That opposition remains strong today.

Opponents, many in law enforcement, say a facility will attract out-
of-town drug addicts and dealers and increase crime. They also criticize
the concept of methadone as simply substituting one drug for another.

Kara and Dominick have heard all of the arguments. They know the public
views them as derelicts. That's why they agreed to speak only if their last
names were not used.

They decided to tell their story, they said, because they want the public
to see the other side of the methadone story - the good that effective
methadone management can do.

They want you to see their bouncing, 14-month-old son, Michael. They want
you to see their comfortable, toy-filled apartment.

And they want you to see they are not bad people. They made a mistake by
trying heroin as teenagers and getting hooked. They are fighting to get
their lives back.

They would not have made it this far without methadone, they said.

"We would be dead," Kara said.

They came close to that more than once.

It was Father's Day, 2000. The return trip from Philadelphia where they
bought drugs ended abruptly at a rest stop off the Pennsylvania Turnpike.

"I was in the rest stop and I passed out. Dominick found me with my head
behind the toilet," Kara said.

A mixture of pain killers and heroin had turned lethal. Rushed to Temple
University Hospital, a semi-conscious Kara phoned her parents.

"I said, 'I want to say goodbye to you.' "

Heavy doses of adrenaline injected into her heart brought her back. She
stayed in the hospital several days.

"As soon as I got out, I did it again."

Dominick nearly died from overdoses twice. His heroin use caused other
serious problems.

"It ate a whole in my heart," he said, describing a condition known as
endocarditis.

He had a mechanical heart valve implanted in 1997 to repair the damage.

"I still used after that."

Sitting in Kara's apartment, the couple struggled to explain why heroin had
so much power over them.

"I knew I could die. I knew I could go to jail. I knew I was breaking my
parents' heart. But I always went back to it," Kara said.

"It takes all the problems you have in your life away temporarily,"
Dominick said. "It's like euphoria at first, but then it becomes ... "

"Hell," Kara said, finishing his sentence.

Medical researchers have shed some light on why addiction to heroin and
other opiates is so hard to kick. They've found that prolonged use causes a
chemical change in the brain that permanently affects its functioning, said
Cooper, of New Directions.

"It damages the brain in a way that it cannot repair itself," Cooper said.

The craving for the drug "is on a level that is almost animalistic," said
Ed Pane, director of Serento Gardens, a drug treatment center in Hazleton.
"It's almost like you trying to will yourself to stop breathing."

For Kara and Dominick, their addictions followed a common path. Both
started snorting the drug at around age 16 after graduating from other
drugs, including marijuana and cocaine. Both swore they would never inject it.

"People who shot it were scummy scumbags, and I would never do it," Kara
said. "This one girl told me in rehab, 'Never say never. You'll shoot it.'
Sure enough ... "

The turning point for Kara came in June 2000.

Dominick was in jail for burglaries and thefts he committed to support his
habit. She sought admission to Choices drug and alcohol treatment center in
Kingston and learned she was pregnant.

That stop at Choices was the latest in a long list of rehab centers Kara
had tried.

"Every time I was in rehab, I was like, this is it. I'm done. I'm sick and
tired of being like this. I'd stay clean a couple weeks after I got out,
but it never lasted."

Dominick also graduated from multiple rehabs, only to relapse.

Nothing worked for either of them until they started methadone.

"It's like insulin for a diabetic. It's something I need to stay alive to
raise my family," Kara said.

Kara has been on methadone for two years and is being weaned gradually from
the drug. She has remained free of illicit drugs since she began treatment
- - an accomplishment that earned her the right to have three take-home doses
of methadone, reducing her trips to the clinic to three a week.

Dominick is less far along in his recovery. He has been on methadone three
months. He must make daily trips to his clinic, State Line Medical in
Phillipsburg, N.J. He has remained clean, also, and expects to soon earn
one take-home dose per week.

The couple are determined to stay clean, but the trips to the clinics are
taking a toll on them and their son. Both are unemployed because their
travel for treatment makes holding a job difficult. Their son also must
accompany them on the trips on days his grandparents can't watch him.

"It just goes to show how much it sucks that we don't have a methadone
clinic here," Dominick said. "We have to drag a 14-month-old baby in the
car. He starts screaming when you put him in the car seat."

The Luzerne/Wyoming Counties Drug and Alcohol Program is working with
Choices to bring a clinic to the area, but progress has been slow as
officials search for an acceptable location and to fulfill a multitude of
state and federal mandates, said Mary Martin, director of Choices.

Martin said the state Department of Health is in its second review of a
plan for a local clinic. The clinic would be methadone-to- abstinence,
gradually weaning users off the drug. Participants would be required to
undergo counseling, and it would serve only residents of Luzerne and
Wyoming counties. No location has been chosen, she said.

"It's not a fly-by-night thing. It's very well thought out," Martin said.
"If or when a program comes, it is going to be of the highest quality with
all safety and security measures put in place to ensure maximum benefit of
the program."

Kara said she believes much of the opposition to a clinic is based on
misunderstanding.

"Everyone thinks, 'Oh, it's a free high on the taxpayers,' " she said. "I
swear to God, I do not get high on methadone."

Neither she nor any other addict can get a high on methadone because there
is a chemical block that prevents that, Martin said.

Local law enforcement officials have repeatedly expressed concerns that
crime will increase. But police in other communities with methadone
clinics, including West Reading, Pa., and Phillipsburg, N.J., said they've
had few, if any, problems.

"Some people who go to a methadone clinic may trade it for the real thing,
and it might aggravate local drug activity, but I haven't seen it have a
major impact on crime," said John Laky, prosecutor for Warren County, N.J.,
which houses the Phillipsburg methadone clinic. "I'd rather have a person
alive and on methadone than dead on heroin."

Kara said she's also frustrated by comments opposing clinics because of the
cost. There's a direct cost - in mileage reimbursement - taxpayers absorb
now. She gets $46.50 for each of the three trips she makes weekly to New
Directions in Allentown.

"The taxpayers think their money will be saved, but they're paying so much
now," she said. "I'm going to go to school. I'll be a productive citizen.
You won't have to pay to lodge me in jail. You're not going to have to pay
to have my child in foster care. You're not going to have to pay for me to
go in and out of detox."

The couple said they understand it's the fact that they, and many other
addicts, have repeated failures in rehab that frustrates the public.

So what makes them so sure they won't relapse again?

Their son is a big motivator.

"I thank God gave us him, because me and Dominick both would have died. He
saved two lives and two families with one baby," Kara said.

"He is an inspiration. I never had that until he came along," Dominick
said. "I want to be his father, for him to have a good life. I know I can't
do that being on heroin."

But Dominick said he knows he's sworn before he would kick his habit. He
knows he's prone to relapse. But he also knows he has more to lose now.

"My life hasn't been this good since I was 16, before I started using
drugs," he said. "I love my life."

He and Kara said they hope a methadone clinic here will give other addicts
the chance to say the same thing.

"Methadone is to a heroin addict what Alcoholics Anonymous is to an
alcoholic," Kara said. "The only people who should oppose a clinic are
funeral directors and prison guards - for job security."