Pubdate: Sun, 20 Aug 2000 Source: Worcester Telegram & Gazette (MA) Copyright: 2000 Worcester Telegram & Gazette Contact: P.O. Box 15012, Worcester, MA 01615-0012 Fax: (508) 793-9313 Website: http://www.telegram.com/ Author: George B. Griffin HEROIN ADDICTS GETTING YOUNGER Drug-related Deaths, Illnesses Are On The Rise WORCESTER-- Peter Stefan sees more than his share of the misery caused by heroin addiction. His business, Graham, Putnam and Mahoney Funeral Parlors on Main Street, is the next-to-the-last stop for many who have enjoyed a final dose of what has become the drug of choice for addicts. Among drug abusers in Massachusetts, heroin has surpassed cocaine, crack and marijuana. In fact, its use has increased steadily since 1992, while addicts' use of alcohol, cocaine and marijuana has declined. The rise has been steady despite the dangers of contracting AIDS, hepatitis and other diseases from tainted hypodermic syringes, and the very real danger of dying. "I see a lot of deaths from overdose and lot of young people dead," Mr. Stefan said, adding that he handles funeral arrangements in many such cases. "We do so many, we can't keep track," he said. "It's sad here and difficult to work here seeing some of the things I see. "I don't think any of them overdose intentionally," Mr. Stefan added. "It just happens. Do I prejudge them? No, I don't prejudge anybody." The statistics kept by authorities serve to indicate the scope of the problem. From January 1996 through December 1998, the last year for which figures are available, 292 Worcester County residents died from drug overdoses, many involving illegal narcotics and some involving medications available by prescription. And the actual tally of drug-related deaths may be higher. Physicians and medical examiners who certify the causes of deaths may list the primary one as heart or renal failure resulting from a range of circumstances, which may or may not include drug abuse. Other causes of death sometimes cannot be certified because toxicology reports have not been done, or have been delayed. It is not unusual, state and local health officials say, for a death certificate to include the phrase "pending toxicology results" under the heading of cause of death. Health officials, police and social service workers say there are many reasons why heroin is a preferred drug among addicts, and why it causes so many deaths. It is inexpensive, readily available, and of exceptional purity. "Heroin for the last four to five years at least has been 50 to 60 percent and sometimes 80 to 90 percent pure," said one veteran police officer. "The market is out there." The quality of heroin today makes it a better value for the money than it was years ago, when it often was mixed with other substances. "Everything is cyclical," the officer said. "Heroin is just another drug that has come back around again. There is a whole new flock of young people out there who think they're reinventing the wheel, when, in fact, they're just one of the spokes." The Rev. Charles Carnahan, executive director of AIDS Project Worcester, lauded efforts by law enforcement personnel to take heroin and other illegal drugs off the streets. But those efforts, he said, have not resulted in a reduction in the need for services to addicts and people infected with HIV. "From our agency's standpoint, we have not witnessed any sort of decrease in the number of people seeking services over the last three to five years," Rev. Carnahan said. "Most of our clients present to this agency with intravenous drug use as their primary or secondary mode of transmission. ... Those numbers continue to go up." Charles J. Faris, chief executive officer of Spectrum Health Systems Inc., of Marlboro, said that despite the efforts of law enforcement agents, the sale of heroin is "business as usual" these days. "I think it is increasing," he said. "Heroin has made a big comeback in the last several years and it's being used as extensively now as it ever was. The price has come down quite a bit and the quality has gone up. Availability has gone up." Heroin, he said, is the "primary drug of choice" among those who seek help from Spectrum's treatment centers in Central Massachusetts. "In our two detox centers in Central Massachusetts," he said, "we had about 6,500 admissions last year and about 70 percent of those were using heroin." His agency, he said, has a number of methadone treatment programs targeted at people who use heroin and other opiates. "We have 1,200 people in treatment and the demand continues," Mr. Faris said. "The phone keeps ringing -- and these are not necessarily the same people who have just relapsed and are recirculating through the system." The age of his agency's clients has declined. In past years, heroin users who sought treatment were generally in their late 20s and early 30s. Now, many clients are in their mid-20s. Mr. Faris said he wholeheartedly supports the efforts of federal, state and local drug enforcement agents to interdict shipments and arrest traffickers. But those efforts may have a limited impact on the availability of the drug so long as there is a demand for it. "The profits on this are so high that someone will step in to fill the void," he said. "You may capture stuff with several million dollars in street value. But I think even the people in the federal government will tell you this is probably only a small percentage of the stuff that's getting through. The people who import this stuff recognize that they will have so much loss and build that into their prices. It's a business." But such sterile economic factors do not describe the nonmonetary cost of heroin abuse. For Mr. Stefan, the cost cannot be measured at all in economic terms. "It's extremely bad for the families," Mr. Stefan said. "These are the people I feel bad for. You see the little kids hanging on to the side of the casket looking in at their mother or their father. Or you see the mother and father looking in at their kids. "There are days when I walk out of here just shaking my head. We see the worst of the worst. I take them all; I don't refuse anybody." The single overriding sorrow of it, he said, is that the life that has led to the death is a matter of choice. "It's a matter of choice what people do with their lives," he said. "They get hooked and then it's hard to kick this stuff. ... But it's the kids that suffer; it's the families that suffer." - --- MAP posted-by: Richard Lake