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Heroin is Surpassing Cocaine As Users' Choice

By Farah Stockman
Source:  Boston Globe

May 26, 2003

The two drugs were once considered twin threats of equal dangerousness, and Steven Richard knew them both.

First, the young car salesman from Sandwich fell for cocaine's expensive, hyperactive high. Then, years later, he was introduced to heroin pure enough to snort. Its euphoria came cheaper than beer.

In 1992, heroin and cocaine each drove about 11,000 addicts into state-funded treatment centers in Massachusetts. But since then, the number of cocaine admissions has steadily fallen while the number of heroin admissions has steadily climbed. By 2001, 4,334 admitted patients in Massachusetts named cocaine as their nemesis, while heroin haunted 37,399, according to a report by the National Drug Intelligence Center. Those numbers solidify the commonwealth's position as one of a handful of states to see a dramatic rise in heroin admissions accompanied by a steep fall in cocaine admissions.

''Heroin has emerged as the greatest drug threat to Massachusetts,'' reads the report, which was released this month. The yearly report, which comes as state lawmakers wrangle over whether to cut funding to methadone clinics that treat heroin addicts, blames the growth of heroin addiction on fallen prices and increased purity that allows the drug to be sniffed or smoked instead of injected.

The House would like to stop paying for the clinics, but the Senate's proposed budget continues their funding.

The rise in heroin use is ominous because the drug is far more likely to create a lifelong addiction than cocaine, according to specialists and users.

''It takes a very long time to conduct heroin treatment, and a lot of providers will tell you the success rate is very low,'' said Jim Dreier, an analyst with the Drug Intelligence Center, an agency within the Department of Justice, based in Johnstown, Pa. ''With cocaine, there are higher success rates for treatment. It is not as lengthy a process. . . . The physiological dependence is not as strong.''

Heroin users make up only a small percentage of all drug treatment admissions in most Southern and Midwestern states. Clinics in California have seen a decline in the number of heroin addicts who are being displaced by amphetamine users, according to a Globe review of statistics compiled by the US Department of Health and Human Services.

In New York, heroin admissions have surpassed cocaine admissions, but the gap between the two numbers is not nearly as wide as it is in Massachusetts.

''It's an East Coast phenomenon,'' said Thomas Clark, Boston's former representative to the Community Epidemiology Work Group, a federal program run by the National Institute on Drug Abuse, which tracks drug-use trends across the country.

The decline in cocaine admissions has puzzled researchers, who say it could reflect everything from supply patterns to regional drug fads to repeat visits by heroin users, who, because of the difficulty of breaking their addiction, may be trumping cocaine abusers at treatment centers.

''The treatment system has a limited number of slots, so as one goes up, the other almost has to come down,'' Clark said. ''The heroin users are coming in and displacing the cocaine users.''

Using data from treatment centers may mask some of the cocaine usage, Clark said, because cocaine addicts, who have no medically treatable symptoms of withdrawal, have a harder time getting insurance companies to pay for treatment.

But, if the decline in cocaine admissions raises questions, the rise of heroin is an all-too familiar tale. In the early 1990s, the same Colombian drug cartels that sell cocaine on the East Coast decided to wrestle the heroin market away from Asian producers. Their strategy: to push down the price and make heroin so pure it could be smoked or snorted, Dreier said.

''It was a marketing decision,'' he said, adding that there was a false belief that snorting the drug or smoking it -- a practice called ''chasing the dragon'' -- would not be addictive.

The price of a thumbnail-size bag of heroin dropped from about $15 in the 1970s to about $5. The average purity of heroin sold to small-scale users rose from 3 percent in 1981 to nearly 30 percent in 2000, according to nationwide statistics compiled for the Office of National Drug Control Policy. The purity of some heroin on Boston's streets has been found to be as high as 70 percent.

Low prices and high potency have fueled a new generation of heroin users in Massachusetts who are, by and large, younger, wealther, and more suburban than the heroin addicts of the past.

''I see people from the upper middle class. I see 18- and 19-year-old kids,'' said Dana Moulton, 52, who once abused heroin and is now a project assistant with the Massachusetts Organization for Addiction Recovery, a nonprofit education group. ''I could see the transition. . . . In the 1980s, you didn't see young people using heroin the way we do now. You had to be in the loop'' to get it.

Unlike in California, where much of the heroin comes from Mexico in forms too impure to inhale, the purer heroin in Massachusetts began to attract a following from people who had never used the drug.

One recovering addict at Phoenix House Springfield Center, a state-funded residential treatment facility in Springfield, recalls the disgust he felt for heroin when he was in high school.

''It was taboo. [I had] the mental image of a guy with hair down his back who never shaves and weighs 100 pounds soaking wet,'' said the man, a 37-year-old drywall finisher. ''I swore I would never put a needle in my arm.''

But, nine years ago, his cousin told him he didn't have to use a needle, so he began sniffing it. He got hooked, and could not believe how many of his co-workers and acquaintances were sniffing heroin, too. He said he started off buying it from teenagers on Blue Hill Avenue, he said, but soon began to buy it from men in suits with offices on Boylston Street.

''You get a business card, beep them, they come see you, and go have a social drink over lunch,'' he said.

At $5 a bag, he said, ''I thought I had discovered gold.''

Steven Richard, now 31 and recovering at Phoenix House from his addictions, said snorting the drug also lured him into becoming a user. ''I was always against needles,'' he said. ''I never, ever thought that I would inject drugs.''

Richard's journey toward hard-core addiction began when he was a teenager who had moved from Cape Cod to Florida to be with a girlfriend.

One day, he was driving down the highway in Florida, and a friend passed him a pipe full of crack. He puffed and nearly veered off the road. The hit was instant. The next three years were sleepless and wired as he broke into homes so he could afford to ''chase'' the high. Going to jail at age 20 was enough to motivate him to stay clean, and he moved back to his family's home on Cape Cod, got a job selling cars, bought a house, and began living with with his girlfriend.

But seven years later, in 1997, a childhood friend asked for a ride to Boston and, somewhere near the Forest Hills T station, handed him a bag of heroin to snort. He didn't resist, and the drug became a full-time addiction he could afford on earnings from a paper route. ''There were nights where I spent almost $1,500 in one night on cocaine,'' said Richard. ''With heroin, $400 could last me close to a week.''

After a few years of sniffing, he graduated to injecting the drug, asking a friend to do it the first time because he was scared of the needle.

Now, five years, $60,000 in credit card debt, and countless court arraignments later, what public health officials call ''an epidemic'' has cost Richard not only his home, but also the seven-year-long relationship that he lost when heroin became his only passion.

''She's got a baby now,'' he said wistfully of the girlfriend who married someone else. ''It's been four years now, and I still think about it.''

This story ran on page A1 of the Boston Globe on 5/26/2003.
Copyright 2003 Globe Newspaper Company.