Pubdate: Tue, 11 Jan 2005
Source: Daily Reflector (Greenville, NC)
Copyright: 2005 Daily Reflector
Contact:  http://www.reflector.com/
Details: http://www.mapinc.org/media/1456
Author: Paul Dunn, The Daily Reflector

THE LESSER OF EVILS: ADDICTS FIND HEROIN CURE' HARD TO KICK

This is the second part of a report on heroin abuse in Greenville. It 
focuses on Pitt County's methadone program, which helps addicts kick the 
habit. One name has been changed to protect the person's identity.

Lea Cormay peeks at the world through the crescent moon beneath her 
drooping eyelids.

This morning, the view is especially ill-defined.

The 39-year-old stands in the street adjacent to a church in west 
Greenville. A low-slung autumn sun splashes shadows out of the pock marks 
in the asphalt. The rays bounce off the ground and like laser cutters 
pinpoint Cormay's now watering eyes, turning her gaze from crisp to 
expressionistic.

"Oh boy, I'm having a hard time today," she says.

Cormay is fighting drug withdrawal, an unrelenting ogre made especially 
fierce by the blazing beauty of the day and her heightened sensitivity to 
light.

Cormay's no junkie, though.

The heroin that threatened to ruin her life has been out of her system for 
quite some time.

Now, she's hooked on methadone.

Cormay is one of the 250 recovering heroin addicts in and around Pitt 
County who have chosen to fight their opiate cravings with methadone, a 
synthetic opiate that can be legally obtained from clinics around the 
country. Most recovering heroin addicts no longer feel methadone's initial 
mild euphoria, but relish its analgesic effects and its ability to help 
them repulse an expensive, illegal lifestyle.

Because they find the substitute as difficult to kick as the original, 
however, it can still leave many addicts chemically dependent for years. As 
Pitt County Methadone Clinic coordinator Lloyd Gajadhar says: "Methadone, 
like heroin, is a hard drug to get off of, but it's the best of bad choices."

Cormay, who began snorting heroin at age 18 and didn't stop until she was 
37, had been clean for 18 months before entering the methadone treatment 
center. Four months in jail, for "being in the wrong place at the wrong 
time," forced her in 2000 to go "cold turkey," a term used to describe 
unassisted drug withdrawal.

Soon, however, she was aching for another heroin fix.

"Even though I'd kicked the heroin, I was really afraid I'd head back that 
way," Cormay says. "I could almost taste it in my mouth."

Gajadhar and his colleagues administer methadone treatments to Cormay and 
others every day. Of the 250 patients, about 75 percent are white, 25 
percent black, and two are Hispanic. Most weeks, another 15-20 newcomers 
knock on the clinic's doors. They are among the 500-750 heroin addicts who 
live in Pitt County, says Gajadhar, who also is the adult clinical 
supervisor for Port Human Services.

Heroin users typically receive 30 millimeters of methadone at the onset of 
their treatment. The dose usually climbs to 40 millimeters the next day, 
depending on the patient's reaction to the lower amount. Over the next few 
months, dose levels may continue to rise, sometimes as high as 150 
millimeters a day. Most patients receive about 120 millimeters a day, 
Gajadhar explains.

Methadone is manufactured in pill and liquid form. Local clinic patients 
drink their dose from a small plastic cup, which holds a pale pink, 
translucent mixture that smells and tastes like mild cherry cough syrup. 
Methadone's cotton candy appearance, though, belies the drug's ferocity.

Says one veteran methadone user: "If you were to give a 30-millimeter dose 
to someone who'd never used drugs before, it would knock him flat on his 
ass. He'd be nodding out for hours."

German scientists developed the synthetic opiate initially named Polamidon 
as a pain medicine during World War II. At war's end, Americans took 
control of the factory where methadone was invented and began clinical 
trials of the drug in 1947.

Doctors initially thought it would prove to be a revolutionary new 
painkiller, but by the early 1950s, the drug was rarely used. In 1968, 
doctors found that methadone helped relieve their patients' heroin cravings 
and that tolerance for the drug was slow to develop. Methadone maintenance 
treatment soon became pivotal in the fight against heroin addiction.

Though the two drugs are similar in strength, Gajadhar says, they are 
radically different in other ways. Methadone, for instance, effectively 
relieves pain for 18-36 hours; a typical heroin high lasts about three 
hours. Methadone is legal; heroin is not. Heroin is expensive about $25 a 
bag; methadone costs about $5 per dose.

And foremost, Gajadhar stresses, "Methadone gives patients their lives 
back. After a certain time in treatment, your life is manageable," he adds. 
"You can interact again with your family, in school and in church like you 
might have before your addiction. It gives people the opportunity to avoid 
hanging out on the street corner or other ungodly places, and it gives your 
community a chance to reduce crime."

According to Maj. Kevin Smeltzer, operations bureau commander with the 
Greenville Police Department, drug addicts typically steal to pay for their 
drug habits. Cigarettes and medicines are popular because they can be sold 
quickly. Drug addicts don't have time to worry about what they're stealing, 
Smeltzer says they need a quick fix, now.

Though Smeltzer recognizes Greenville's heroin problem which, he says, 
began in the 1970s he's unable to attribute the rise or fall in crime to 
the city's fluctuating drug use.

Referring to methadone treatment and other intervention, Smeltzer says, 
"I'm sure individual lives have been turned around, but we don't have 
statistics that point to a noticeable impact on the crime rate in the area. 
I'm sure if we could significantly reduce drug use, our crime would also go 
down."

Smeltzer doesn't see that happening.

"I hate to sound pessimistic, but drug use will continue to be a problem," 
he says. "Heroin use (for instance) has gone down in many places, but in 
Greenville, it has remained stable or even risen."

To hear him tell it, Greenville resident Donald "Gator" Taylor was once the 
high priest of Pitt County's heroin empire.

"I was a smooth operator," the now reformed 47-year-old says with a grin.

 From about 1994 to 1999, the 5-foot-9-inch, 220-pounder with a face like a 
smashed anvil, sold and snorted heroin with the skill of a casino blackjack 
dealer. At one time, he says, he had $80,000 in cash stashed in his 
apartment; he'd earned the money in six months.

Taylor, 47, wouldn't even leave his apartment to score his shipment other 
drug dealers would bring the haul to his front door. As many as 5,000 bags 
of heroin changed hands on those occasions, Taylor says. He received 40 
percent of the profits, his suppliers, 60 percent.

At $30 a bag, heroin sales put Taylor in hog heaven in more ways than one.

"Some of my customers were spending $5,000 to 6,000 dollars a pop on 
heroin," Taylor says.

Lesser spenders augmented their minimal finances with other incentives.

"My wife would get jealous of me, because every girl in town was on my 
doorstep," Taylor says. "They would be willing to do anything for the dope."

At one point, Taylor freebased (smoked) $40,000 worth of cocaine in one 
weekend, he says. He was riding so high, in fact, that when he and his wife 
were between permanent residences they were making enough money to reside 
in a hotel room for 2 years.

Taylor's world crumbled in 2000 when narcotics agents arrested him for 
dealing. He spent the next 11 months in jail. When he got out, he headed 
straight for the methadone clinic. He's been clean for the past four years, 
a daily 65-millimeter dose of methadone keeping his heroin urges under wraps.

"Methadone's keeping me normal and straight," Taylor says. "It's a 
psychological thing. If you want it (methadone), it will work. But if 
you're taking it but don't really want to, you're playing with the trigger."

For the moment, Cormay's trigger finger is attempting to open a tiny bottle 
of methadone she's taken out of her medicine cabinet. She's at home sitting 
on a rocking chair in the living room of her Greenville duplex apartment. 
Cormay is allowed to self-administer her methadone at home because she's 
been drug free since she entered treatment.

Though her dose has never exceeded 40 millimeters per day, Cormay is trying 
to ween herself completely from the drug that has made her life tolerable. 
After plateauing at 30 millimeters of methadone per day for most of her 2 
years in treatment, Cormay voluntarily dropped her dosage to 25 millimeters 
seven months ago. She has since cut back to 20 millimeters per day and 
hopes to drop another 5 millimeters in the next several weeks.

Though the gradual decline in dosage has caused relatively mild withdrawal 
symptoms, such as watery eyes, sneezing, numb lips and sluggishness, Cormay 
has yet to experience what she calls "real pain."

And that frightens her.

Another 10 millimeters drop or so, and she figures she'll start reliving 
the hell that was her heroin withdrawal.

Recalls Cormay of those few days in 2000: "One minute I was hot, the next I 
was cold. Every three minutes or so I got up and then sat down again to 
rock and moan. It felt like my bones were going away like I had needles 
sticking into me."

Some patients contend methadone withdrawal is worse, yet.

Said one local methadone patient recently, "If heroin is a monkey on my 
back, then methadone is a gorilla."

Gajadhar disputes the contention.

"I don't believe it's (methadone withdrawal) much more difficult as long as 
we detox the patients slowly," Gajadhar says. "Each patient is individual, 
and there is no set pattern to the detox."

In the six years Gajadhar has been on the job, he's seen patients steadily 
ebb and flow. The methadone program's strict demands might well be the 
"gorilla" patients most frequently refer to.

"Once you start on the methadone program, it's difficult to cope with all 
the demands of the program," says Gajadhar, 53. "You have to stay clean and 
you have to make a commitment. Some people have great intentions, but get 
fed up and leave."

Most conscientious patients are in the program from 18-24 months, Gajadhar 
says.

Methadone patients are required to give frequent urine samples and pay $5 
per office visit. The clinic, which until a few years ago was part of Pitt 
County Mental Health, split off to become a private contractual business 
when the county divested its mental health services. The clinic receives 
$350,000 a year in state and federal funding.

Joy Credle is one of the clinic's most fierce advocates. She entered the 
program in 2000 after decades of drug use. Methadone has successfully 
crushed her cravings for heroin but not the memories of a life scarred like 
few others. She was a student at Rose High School when her life began 
unraveling ... .

Credle thought she had the flu.

How else could the 18-year-old explain her nausea, the knot in her stomach 
and her nightmarish gagging that was ruining the trip to her aunt's farm in 
Louisburg?

She'd been looking forward to accompanying her mother on the weekend road 
trip from their home in Greenville. But now, with her stomach rebelling, 
she couldn't wait to leave.

Turns out, Credle didn't have the flu at all. She figured out the cause of 
her pain the Monday after returning home. The nausea magically stopped a 
few moments after the needle pricked the vein in her arm.

"When I used again on Monday and the sickness went away, I put two and two 
together," recalls Credle, now 48.

In Credle's case two plus two equaled one year the amount of time she'd 
been using heroin without realizing she was addicted.

"I knew I wanted to come home and get high, but I didn't relate the 
sickness to the desire," she says.

By age 16, Credle had experimented with a cornucopia of illegal narcotics, 
but when she was introduced to heroin by a classmate she knew she'd hit 
paydirt.

"When I did heroin, I said, 'Oh, this is what I've been looking for all my 
life.'"

Credle, whose daughter was murdered in 1996 by her ex-boyfriend in a highly 
publicized case, used heroin consistently from 1974 to 1985. Up until her 
daughter's murder she'd been in and out of drug treatment, but never far 
from the drug's reach. In January 2000, the roller coaster ride ended. 
Credle entered the Pitt County Mental Health methadone treatment program 
and has been educating everyone within earshot about the drug ever since. 
Methadone saved her life, Credle says.

"I don't have to worry about getting up in the morning and having to steal 
or sell my body," Credle explains. "It's given me a chance to live and heal 
my relationships.

"I no longer feel guilty about breathing somebody else's air."
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MAP posted-by: Beth