Series: Wasted Youth (Day 3 -- 3 Of 3)

RECOVERING ADDICTS AND THEIR FAMILIES LIVE IN CONSTANT FEAR OF RELAPSE

Heroin's Strong Addictive Qualities Make Quitting An Often Losing Proposition

Dennis walked out of a Brockton detox center after four days.

The first thing he did was buy heroin.

I can't get away from it," the 25-year-old Stoughton man said as he
walked down Brockton's North Main Street. "I like it still. It is still good."

He began drinking at age 12, began using drugs at age 17 and, by age
20, was a heroin addict.

He overdosed once in a Brockton park and was rushed to Brockton Hospital.

Just as soon as I got out of the hospital, I started right up again," he said.

He said he knows he should stop using, that he should get clean, that
heroin could -- and likely will -- kill him.

His story is one of many on the streets and highlights the difficulty
in getting addicts to stop using heroin.

About two-thirds of heroin addicts relapse after getting treatment
the first time, with some going through up to a dozen detoxification
and rehabilitation programs before getting "clean." Studies have
found that the average heroin addict will stop and start a treatment
program including detox -- up to 10 to 25 times.

Relapse is part of the disease," Carol Kowalski, site director of the
Brockton Addiction Center run by High Point, said. "We had one man
who had been to treatment 19 times. He became clean and sober after
that. What was it about the 19th time? Why did it take that long? You
don't know. It is a very difficult disease."

It's one a growing number of teens and young adults -- as well as
their families -- will be facing for years.

It is like getting in a spider's web. They can't get out of it," Avon
Police Chief Warren Phillips said.

An examination by The Enterprise of death certificates filed in 28
city and town clerk offices found 74 people -- 16 percent under age
25 died of opiate overdoses between Jan. 1, 2004 and Aug. 31, 2006.
There have been at least a dozen more suspected fatal overdoses in
the region since, some still awaiting toxicology test results.

What is the draw of heroin and why is it so hard to stop using it?

The answer lies in the brain.

Heroin mimics endorphins -- the body's natural pain killer produced
in emergency moments of shock or injury -- and binds quickly with
receptors in the brain. The drug magnifies the natural effect of
endorphins, producing a surge -- or "rush" -- of pleasure and sense
of well-being.

Researchers suspect heroin may "rewire" the brain, creating more
receptors or "targets" for the drug and making it harder to break the habit.

One study followed 1,339 intravenous drug users for 12 years and
found fewer than 20 percent were able to kick the habit. The first
relapse is usually in the first 10 to 18 months of sobriety, the study found.

But the good news is younger addicts -- those under 30 -- who get
help quickly have a better chance of getting off the drug, a study by
Johns Hopkins University Bloomberg School of Public Health and the
Ben-Gurion University of the Negev in Beer-Sheva, Israel, found.

Those recovery numbers, however, are still low.

Addicts talk about always "chasing" that first "high" from the drug,
and always falling short. They talk about using enough to stave off
the painful withdrawal symptoms -- vomiting, diarrhea, severe
cramping. They talk about using to just "get straight."

And it will go on for years. Addicts overdose and die or keep using
until they die of AIDS or other diseases linked to sharing needles.
Some die in their mid-50s, after decades of use.

I'll never forget the nurse telling us, 'This is a chronic relapsing
disease,'" Mary D'Eramo of Abington, whose daughter is a recovering
addict, said.

For many heroin addicts, the emergency room is the first stop in
trying to get help, experts say.

Nationally, heroin was involved in 162,137 emergency room visits in
2004, the most recent figures available through the Drug Abuse
Warning Network (DAWN). Of that number, 53,088 visits were by people
seeking detoxification from heroin in 2004, the most recent figures
available through DAWN. The majority of all people seeking detox for
all types of substances were white -- 62 percent.

The type of treatment that work for heroin addicts varies. For some,
a detoxification program followed by a lengthy treatment program is
best. For others, the drugs methadone and Suboxone, which reduce the
heroin cravings and block the high, can work.

There is no one fix for all," Phillips said.

Nicholas Tenaglia, clinical director at the Brockton Addiction Center
run by High Point, said the addicts now in treatment are younger,
more from intact families and hailing from suburbia.

It is an epidemic right now," he said. "It is very accessible
everywhere. It is more prevalent in the suburbs than it is in the inner city."

Theresa Cairo's daughter, Jill, went through several programs and was
clean throughout her pregnancy before relapsing in 2005.

She was at a halfway house in Lynn when she met an addict, used
heroin again and died of an overdose.

It became a vicious cycle," said Mrs. Cairo of Hanover. "In the end,
she hated it. She absolutely hated using. It just wouldn't let her
go. It just had a hold on her."

Christine D'Eramo went to 24 treatment programs and halfway houses
before finally getting clean last year.

It is all a blur," she said. "Any place I was in, I was able to find
drugs if I wanted to. It was like a radar."

[Accompanying article on website]

Note: This portion appears to be web-only and accompanies the relapse article

"I Know This Drug Is A Monster, But I Need That Monster"

By Maureen Boyle

TAUNTON -- Each day, he rubs Vitamin E on his arm to help the skin
heal. It is a trick he learned years ago to hide needle marks, the
tell-tale signs of heroin use.

"I've learned a few things over the years," he said.

One of those things is that the grip of heroin addiction is not easy to break.

After more than 20 years using heroin, the 45-year-old former
Middleboro man once stayed clean for nearly two years -- then started
up again.

"This drug is a monster," he said. "I know this drug is a monster,
but I need that monster."

James, who didn't want his name used, fearing arrest because he is
still using heroin, is what experts call a "functioning" addict: he
works by day and uses enough heroin to avoid withdrawal symptoms. He
works as a roofer and in the construction business, using his wages
to buy drugs.

"I don't steal," he said. "I don't do that. ... I work, Monday
through Friday."

James buys his heroin daily on the streets of Taunton -- he won't say
from whom or where -- and spends about $50 for half a gram daily.
When he started using heroin in his early 20s, he did it to get high.
Now, he does it to "get straight," the term used by addicts to stave
off the nausea, the cramping, the diarrhea, the bone pain -- just
some of the symptoms of heroin withdrawal. He has a son he rarely
sees. He says his mother and siblings say he is welcome in their
homes -- but not while he's using drugs. He doesn't see them very often.

James said he is seeing a new breed of heroin addicts on the street.
And it is frightening.

The newest addicts got hooked on OxyContin then moved to the cheaper
heroin, he said.

And he knows what the future will hold for the young addicts, he
said. He has seen it on the streets for more than 20 years. He has
lived part of it. They will lose their families. They will lose their
homes. They will overdose and recover. They will overdose and die.
They will contract HIV from sharing needles. They will develop AIDS.
They will die. The grip of heroin will never leave, he said.

Once you're hooked, you're hooked," he said. "It's going to grab you
by the ass and you're done." He said he knows he should stop using heroin.

But not yet. He's not ready, he said. "It still has a hold on me," he said.