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Heroin: A cheaper and deadlier high:
Recent overdoses point to easier access and more dangerous use
Sunday, July 11, 2004
Peter Reuell Metrowest Daily News
In MetroWest, 10 bucks in your pocket is all it takes to buy a movie ticket, a large pizza, or even a 12-pack of beer.

It'll also buy enough heroin to keep you high for half the day.

Over the last decade, police, social service agencies and drug users say, the price of the drug has tumbled dramatically, selling in some circles for less than the price of a pack of cigarettes.

At the same time, the potency of heroin on the street has increased, in some instances testing at nearly 90 percent pure.

It's a recipe for death.

In the last three weeks, at least four people, in three MetroWest communities, died in what police believe were heroin overdoses.  Two were found dead just hours apart.

"We have heard...that there has been an increase in deaths," Ken Bates, director of behavioral health at Advocates Inc.

The Framingham-based agency runs a handful of drug treatment programs in MetroWest.

"There's really not an easy way for us to tell what's happening," he said.  "But it has caused a stir among the clientele.  We're hearing that people are concerned about it.

"(But) unfortunately, people are driven by their...addiction.  They are looking for the best high they can get.  I think that's what ultimately leads to death."

Though police believe the four recent deaths were heroin-related, they're still awaiting test results.  If all four were found to be using the drug, it would signal a marked increase in the region's fatal overdose rate.

It's unclear, though, if the overdoses are the result of a particularly potent strain of the drug, or if an unknown additive to the drug may be contributing to the rash of deaths.

"It scares me," Angel, a recovering addict from Worcester, said this week, of the deaths.  "It scares me in a way, and it helps me.  It scares me because if I go back to using I could end up like these people, and it helps me...to not pick up."

Heroin has long been available in the Bay State, experts said.  It wasn't until the early '90s, though, that the drug's popularity exploded.  Today it is one of the most abused drugs in the state, surpassing even alcohol in some studies.

In 1992, 16,337 people sought treatment for heroin addiction.  A 2002 study by the state Department of Public Health found that number had grown to 51,715 that year, a three-fold increase.

"We have seen a dramatic increase in heroin use across the commonwealth," Michael Botticelli, assistant commissioner for Substance Abuse Services at the Department of Public Health, said this week.

Perhaps more disturbing, he said, as heroin prices have dropped and purity increased, the state has seen a dramatic increase in younger users.

How easily and cheaply can heroin be bought on the streets?

Earlier this year, Botticelli said, police arrested a dealer at a Cambridge mall with nearly 600 "bags" of heroin, each containing a six- to eight-hour dose.

The going price per bag? Just $3.

"What that means, especially among kids, is there appears to be a shift," he said.  "The stereotype was an older person injecting (the drug).  We're seeing a shift to people who are snorting it, because there's less taboo than sticking a needle in your arm."

But price and purity aren't the only factors contributing to the drug's popularity.

"We've also seen an increase in the use of drugs like OxyContin and Percocet," Middlesex District Attorney Martha Coakley said.  "They get addicted to these drugs, but either they can't afford them or they're not available anymore."

On the street, Coakley said, a single OxyContin can cost $80 or more, making heroin a cheap substitute.

"I think that has become a gateway drug that has increased the pool of users," she said.

Based on his experience, Milford Police Chief Thomas O'Loughlin said he suspects the two apparent overdoses last month can be chalked up to a surprisingly pure supply of the drug.

"Ten, 15, 20 years ago, there would have been a tendency to look at the cut -- what was it cut with?" he said.  "Today...the potency is much stronger, and it's significantly cheaper."

As little as 10 years ago, O'Loughlin said, users could expect to pay between $30 to $35 a bag.  Today, that price has dropped to about $10.

For more hard-core users, though, buying individual bags has fallen to the practice of buying in bulk.

"Traditionally, back in the '60s and '70s, they would buy little, tiny bags," state police Lt. Dennis Brooks said.

Today, Brooks, the head of the special investigations unit at Coakley's office, explained, many users simply buy by the gram.

A gram could be split into as many as 100 individual bags, Brooks said. At $100 a gram -- a price often found in the state -- addicts could be paying as little as $1 per bag.

For the dealers, O'Loughlin suggested, the drop in price is little more than a smart business move.

"Once I gotcha, you know...selling it cheap is an investment for the dealer for the future," he said.

However, the human toll in lives lost and the pain to their families, is immeasurable.

One of the Milford men who died was actually home with his three children when he died, but the children, ages 4, 2 and 1, didn't know.

"They thought he was sleeping," O'Loughlin said of the 27-year-old victim.  "One put a pillow under his head.

"The tendency is to view individuals in these circumstances as down and out individuals," O'Loughlin added.  "The impacts on these families -- it's sad, it's tragic."

Though he hasn't seen a pronounced spike in heroin use in Framingham, Deputy Chief Craig Davis this week said the drug has long been a presence in town.

"I think it's pretty constant," he said. "It's been constant for years."

This week, police were called to the Monticello Motel on Rte. 9 when a 22-year-old man was found dead.  Police found a syringe in the room, Davis said, and are investigating the death as a possible drug overdose.

While police have said none of the overdoses appear to be connected, Coakley said there's little authorities could do if they were.

Though the state does track "unattended deaths" -- the category into which overdoses fall -- it's impossible to say with much accuracy how many overdoses, fatal or not, happen in the state.

To correct the problem, Coakley has backed a bill filed by Lt. Gov. Kerry Healey that would require hospitals to report all overdoses to the state, just as they do with gunshots and stabbings.

"It's not like one problem in Hopkinton or Milford or Framingham," Coakley said.  "We should have the picture countywide. We should have the picture statewide."

But for some users, even the prospect of death isn't enough to put down the needle, said Steve Silvestrino, director of the Common Ground shelter in downtown Framingham.

By the age of 13, Silvestrino, now 41, was using cocaine and alcohol.  By his 20s, he'd moved up to heroin.  Before kicking the habit more than four years ago, he spent about 10 years using heroin through the late '80s and '90s.

A sudden rash of deaths or overdoses, he said, does little to frighten off hard-core users.

"When you hear of a rash of overdoses, people went to that spot, because that was where the good dope was," he said.  "When you're out there, you really don't care if you live or die."

"A lot of people don't even care," agreed Angel.  "The guy has an overdose, ambulance comes, takes him, 20 minutes later the guy's back looking for the same bags again.  It's insane."

"I know people who have OD'd and they want to know where they got that stuff from, so they can go get more," said Jay, 26, who asked that his last name not be used.

After years of addiction, both are working to kick their habits at a residential treatment center run by Spectrum in Westborough.

The recent deaths give Silvestrino a chance to reach out to addicts using his own experience, he said, but for many those moments of clarity are fleeting.

"The lack of detox beds is probably the biggest problem," said Richard Michel, director of behavioral health services at the South Middlesex Opportunity Council.

In 2003, state budget cuts fell hard on detox programs, cutting the number of beds by more than half, from about 1,000 to just 400.  The result, Michel said, is users who want to get help can't get it, and many fall back into their addiction.

"It's an opportunity, yes, but because there's no resources, the opportunity is lost," Michel said.

"I do the best I can to relate, through my experience, and tell them that it can happen to them, too," Silvestrino said.  "It shows them for the moment, but they're still in the fog themselves."  

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