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Roxana Robinson

Stopping heroin use before it’s too late

By Roxana Robinson
July 30, 2009

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HEROIN, with its sordid paraphernalia, grisly procedures, and criminal aura, was always outside the cultural mainstream. The bare arm, the tourniquet, the white powder, the blackened spoon. The needle, the bloody vein. . . we know the images. Dangerous, expensive, lethally addictive, heroin was an inner-city drug that scared off recreational users. It was a killer.

All this has changed. Heroin is now so pure that needles aren’t necessary; it can be snorted. It’s absurdly cheap: a bag costs between $10 and $20. It’s everywhere: at the gas station, behind the supermarket, in school. And it’s sold by friends, not Tony Soprano.

Cheap, user-friendly, apparently benign, diabolically seductive, heroin has reinvented itself and entered the mainstream. And since our mainstream drug users are young, it’s hitting our kids. It’s now in suburbs and small towns. Across the country heroin is reaching middle-class families that never thought they’d have to learn about it.

Opiate-related deaths in Massachusetts rose in 2006 to five times their number in 1997. In Brockton, heroin has been a problem for the last five years. Teenage heroin addiction has also hit Farmingdale, Long Island; Janesville, Wis.; Glastonbury, Conn.; and Orlando. The heroin problem appears throughout the heartland.

If this is an epidemic, it’s one we can’t tolerate. The survival rates for an addict who goes into rehab are slightly lower than 50 percent, according to a study by the National Institute of Drug Abuse. Heroin is one of the deadliest and most addictive drugs known, and it’s reaching our children.

The average age for experimentation is now 13, and 80 percent of high school students see drugs sold and used on school grounds, according to a survey by the National Center on Addiction and Substance Abuse at Columbia University. (One Arlington student reported snorting heroin during class.) Drugs are so cheap and available they seem harmless, and they’re sold by other kids. Out of peer loyalty, teenagers keep quiet.

During high school, kids inhabit two worlds - one legal, one not. Illegal drugs become a part of many teenagers’ experience: swiping pills from a medicine cabinet, getting high on marijuana. After four years, an illegal culture becomes normal. The drugs themselves create neurological change, and the user craves an altered state.

After high school, between the ages of 18 to 25, is the time of greatest risk for heroin addiction. Kids move on to something more exciting. If they’re addicted to prescription opiates, they may switch to heroin, which is cheaper than OxyContin. Once someone has tried heroin, it’s hard to go back. Once someone is addicted, everything changes.

Drug-related crime is on the rise, and we need effective responses. Police departments can arrest the dealer on the street (often a local kid), but they rarely get the big suppliers. Drug laws have darkened the countryside with prisons without solving the problem: incarceration has not been an effective deterrent. Recidivism rates are high, and between 1992 and 2006 the number of illegal drug users nearly doubled, rising from 12 million to 20.4 million, and the number of illegal teen users more than doubled, rising from 1.1 million to 2.5 million, according to Joseph Califano, head of the National Center of Drug Addiction and Abuse.

There are currently 1.2 million nonviolent drug-abusers in our prisons, many of them without access to treatment. We need another way of helping them.

Drug Court offers an alternative to incarceration for nonviolent addicted offenders. Presided over by a judge, the program provides strict supervision and requires long-term treatment programs, supported by sanctions and incentives. It has been shown to lower recidivism rates, treat addiction, and lower the costs of drug crime and its prosecution. Most importantly, it saves lives, enabling graduates to return to responsible and productive lives.

There are about 2,000 drug courts nationwide, but this number serves only about 5 percent of the eligible population, according to the Urban Institute. A bill in Congress would provide $103.8 million, an increase of $40 million from last year. But the Drug Court program needs $250 million annually to serve our communities. Congress should support and expand this program.

Heroin has reached our real heartland - our children - and we must stop it. This is a battle we cannot afford to lose.

Roxana Robinson is an author, most recently of the novel ”Cost.”

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