Pubdate: Sat, 19 May 2001 Source: Age, The (Australia) Copyright: 2001 The Age Company Ltd Contact: http://www.theage.com.au/ Details: http://www.mapinc.org/media/5 Author: Julie-Anne Davies HEROIN SHORTAGE LEADS TO RISKY SUBSTITUTES Jessica and Fiona have nothing in common except their heroin addiction. Yesterday their paths may have crossed as they trudged a city block looking to score. They both "got on", each paying $50 for a "cap" of heroin and but said later that their deals were "crap"; too small and too weak. Both women were ripped off by street dealers they didn't know, and, worse, they could have been selling them a drug that was stronger than the heroin they have become accustomed to during the longest heroin drought in memory. Since Melbourne's heroin supply dried up before Christmas, there is no doubt that lives have been saved. The Metropolitan Ambulance Service is attending only half as many overdoses now as at the same time last year, and the death rate has fallen spectacularly. Raw data provided to The Age by the Victorian Institute of Forensic Medicine shows that in the first four months of last year there were 126 heroin-related deaths. For the same period this year there have been 17. Amid all this good news it is easy to lose sight of the live victims, the drug users who have been forced into "non-voluntary" withdrawal, or those who have turned to potentially more dangerous and addictive substances like benzodiazepine and amphetamines. It's the street's equivalent to Russian roulette; buy a cap of heroin and just hope it isn't loaded with A-grade smack. For an addict whose tolerance to the drug has plummeted in the six months since the drought began, overdose and death are very real risks although few seem prepared to face that reality. "I know it's foolish but I just don't think it will happen to me," Fiona says, looking embarrassed. A professional woman working in the finance sector and studying welfare part-time, she doesn't look like the stereotypical drug user. She lives with two friends who have no idea about her "problem". "I've thrown away my dealer's mobile phone number because I wanted to stop but then I had a bad trot and now I have to buy off the street and because of the drought, you get ripped off ... it's just a desperate situation," she says, her eyes filling with tears. At 16, Jessica has more street smarts. A ward of the state since she was 10, she lives in a state-run residential unit where she was introduced to heroin. The drought has forced her to scale down what was a $1000-a-day habit. "I've had to clean up a bit because there's only so much stuff you can pinch to pay for it," she says. Her routine is to steal expensive perfumes from Myer and sell them to another store. But, like so many addicts, Jessica has been forced to find alternatives to supplement low-grade and expensive heroin. The most popular at present is a commonly prescribed sleeping pill called Normison that is selling on the streets for between $50 and $100 for a bottle of 25. A benzodiazepine, Normison is not a benign drug, especially when it is injected into veins or, worse, arteries. Drug and Alcohol outreach worker Helena Jedjud, of the Youth Substance Abuse Service, is based on the streets of inner Melbourne. She has seen the terrible damage this and other drugs like speed, Valium or Serapax are doing to users like Jessica. Two of her "punters" have lost testicles this year after developing septicaemia through injecting Normison into their groins. Another, a 14-year-old boy, died. "People are losing limbs, boys are losing testes. That's the stuff people don't hear about or see but it is happening because these kids are desperate and will try anything," Ms Jedjud says. Jessica had a close call a couple of nights ago. "I injected some Normison into my arm and almost instantly it turned bright red and my hand swelled up and I couldn't move my fingers and I wound up in hospital. It did scare me a bit so last night I just swallowed them instead, but everyone else was shooting up and I was kind of jealous," she explains. Since the drought began, Ms Jedjud says street violence between users has escalated, as has crime and, perhaps worst of all, the number of girls and boys prostituting themselves to pay the inflated heroin prices. "I've seen older boys standing over young kids, six of them surrounding one and pulling a knife and demanding the kid's heroin," she says. The heroin drought is just another unfair, out-of-control obstacle that has been thrown up at drug users, Ms Jedjud believes. "You know, I think this drought is manufactured by the suppliers, it's cynical, and one day they'll decide to release the stuff again and then the deaths will follow. It's crazy, we should be regulating heroin so people aren't subjected to this kind of manipulation. "Every time one of my kids dies in a toilet block I get angry. There's no dignity for drug users, just denigration." In the past month media reports have suggested that the drought is over. But the prediction is premature, according to the ambulance service, the police and drug workers. "There is absolutely no evidence the heroin drought has lifted," says Paul Holman, of the ambulance service. "We'll be the first to know when it does. The addicts' tolerance will be zero and they'll take a hit and fall down. "A month ago we had five overdoses in one night and word got out about that and people jumped to conclusions, but in fact it was one batch of heroin and one group of friends, so it indicated nothing." Chris Hardy manages the Inner Melbourne Needle Exchange in Smith Street, Collingwood. A year ago she was seeing at least 80 people a day, but since Christmas the number has dropped to less than half. "The evidence is on the street," she says. "It's never been quieter. In 15 years working in this area, I've never seen anything like it." Her "punters", she says, have done it tough through the drought, forced into "non-voluntary detox" and usually at home, alone. "They haven't been able to get into a withdrawal facility until too late or they've done it with the help of some benzos (benzodiazepine) but it was not a choice thing; it was a supply thing." Although more than 50 per cent of heroin-related deaths also involve benzodiazepine, the drought has further increased the numbers of addicts who have turned to these drugs. Hardy says that before the drought most of her clients were not using benzo, which many say is a dangerous and more difficult drug habit to kick. After 25 years working in the drug field, Peter Wearne, special projects manager at the Youth Substance Abuse Service, thought he had seen and heard it all. Yet this heroin drought is the most vicious in his experience. He says it has been especially hard on young users because they have no experience of a drug shortage. "They're just freaking out, some of these kids," Mr Wearne says. "They've been living in a drug paradise, paying between $10 and $20 a cap and now suddenly they have to fork out 50 bucks for stuff that's no good, and that's if they find it at all." The result, he says, has been a lot of chaotic, psychotic and desperate behavior among addicts. "We've had really young kids talking to us about suicide because they are so desperate, and you can't get any worse than that." Margaret Hamilton, director of the Turning Point Drug and Alcohol Service, has been part of both David Penington drug committees. The State Government has won praise from the field for its recent initiative aimed at reducing the risk of heroin overdoses when the drought breaks. Radio advertisements and posters targeted at drug hot spots warn about the increased risk when stronger heroin returns. It is a big departure from the previous zero tolerance or "just say no" campaigns, instead adopting what drug workers say is a realistic approach to heroin use. "In the past heroin users were either good if they weren't using or bad if they were," Professor Hamilton says. "This campaign is much more humane and, let's face it, much more practical." Reasons put forward for the drought and the drop in deaths vary, with many pointing out that the two are not necessarily as closely linked as some might like to think. Some believe drug seizures and failing crops in Asia's Golden Triangle are the cause. Others point to the falling Australian dollar, arguing that suppliers are taking their product elsewhere. Many believe it is a cynical attempt by the suppliers to push the price of heroin up after two years of record low prices. And some believe that the recent State Government injection of an extra $77 million into prevention, treatment and education programs has also contributed to the falling death rate. One clue can be found in the soaring number of drug users receiving treatment in Victoria. In 1996 almost 3000 people over 21 received treatment. Last year the figure was close to 18,000. Andrew Dent, director of the Accident and Emergency Department at St Vincent's Hospital, has no doubt that the heroin drought has saved lives. "Long may the drought last as far as I'm concerned," Dr Dent says. "Sure, we're seeing a lot of addicts with needle-stick injuries. We had one chap recently whose arm we had to amputate, but at least they're alive." - --- MAP posted-by: Andrew