[Hpn] An Old Nemesis Makes an Encore

chance martin streetsheet@sf-homeless-coalition.org
Wed, 10 Jan 2001 10:59:23 -0700

I'm a big fan of Evelyn Nieves. She enjoys a lot of freedom to report
objectively on issues like homelessness and addiction for the New York Times
because she's in their SF office. Now, if she were writing a story about
homeless heroin addicts in Rudy's city, you could safely rely on the fact
that her editors would screw the story into an anti-homeless slant.

Kinda like how our media will give tons of coverage to poverty, homelessness
and hunger in ANY country besides this one.

Junkies are real people, just like anyone. They lead real lives that mostly
aren't too pretty. So, does addiction make a person BAD, or FLAWED, or SICK?

Please, don't answer the question. Just share your thoughts.



Heroin, an Old Nemesis, Makes an Encore

January 9, 2001


SAN FRANCISCO, Jan. 8   At 5 a.m. in San Francisco's seedy Tenderloin
area, the drug addicts are just about the only ones out.

 A young woman with matted blond hair stumbles down the street with
her eyes closed; a man in a red spandex dress and silver pumps nods
out against the door of a single-room- occupancy hotel; small
clusters of hollow-eyed men and women hover on corners. It is no
wonder the police call this strip of the Tenderloin the heroin
corridor. Everyone on the street looks either high or hung over.

 Later in the day, Matt Dodman, a blond, angelic-looking
26-year-old, is sitting in a cafe in another, hipper neighborhood,
the Mission. A heroin user for three years, he avoids the
Tenderloin drug scene. "I'm not part of a hard- core drug clique,"
he said, taking a sip of mineral water. But down the block, a dozen
of his friends and acquaintances   all heroin addicts in their
teens and 20's, and all disheveled and homeless, as he is   sit on
the sidewalk outside a community center and wait to be tested for
hepatitis C. More than half will test positive, as do the larger
population of San Francisco heroin users who have been taking the
drug at least five years.

 Heroin was supposed to be over, yesterday's drug. But almost 20
years after AIDS made injecting it deadlier than it had ever been,
it is as common in some neighborhoods here as Starbucks. A draw for
drug experimenters since the heyday of Haight-Ashbury, the city
remains a place where "old" heroin addicts   those who have been
using the narcotic for 20 or 25 years   feed their habit. But more
and more young people as well are using it.

 And not just here. Hospitals and treatment centers in other large
cities, especially in the West, are seeing record numbers of heroin
cases. Chicago officials attribute a surge in life- threatening
cases of asthma to increased use of heroin among the young. And
while H.I.V. and AIDS are down among users, needles used to inject
heroin are responsible for an increase in hepatitis C, which can
cause liver failure. In fact, hepatitis C is growing across the
United States and in Vancouver, British Columbia, a major
trafficking point for a drug pipeline that extends from Canada to

 The estimated number of heroin users in the United States has
risen to 980,000 from 600,000 at the beginning of the 1990's, while
cocaine use has decreased 70 percent, according to the White House
Office of National Drug Control Policy. The agency attributes the
resurgence in heroin use to new forms of the drug, smokable and
snortable alike; to a prevailing myth among the young that heroin
is safer when not injected; and to the "heroin chic" look of models
in the early 90's.

 Washington State, Oregon and California have the highest incidence
of heroin abuse in the West. Elsewhere, New York, New Jersey,
Michigan, Massachusetts and Delaware also have big problems with
it, according to the Substance Abuse and Mental Health Services
Administration, an agency of the Department of Health and Human
Services. Dr. H. Westley Clark, the agency's director, says its
household surveys show that from 1996 to 1998, an estimated 471,000
people used heroin for the first time, with a quarter of the new
users under 18 and 47 percent age 18 to 25.

 Heroin is not only cheaper than it once was, "it's cleaner,
purer," said Joseph A. Califano Jr., who was secretary of health,
education and welfare in the Carter administration and now directs
the Center for Addiction and Substance Abuse at Columbia
University. "And too many young people think they can snort it and
they won't get hooked." Eventually, Mr. Califano added, they do get
hooked, and turn to needles to achieve a more potent high.

 "The next drug czar, in the Bush administration, is going to have
to deal with heroin in a big way," he said.

 Public health experts see the big increase in heroin use as
further evidence that the nation's 20-year-old war on drugs, with
its emphasis on punishment rather than addict treatment, needs a
new approach.

 Here in San Francisco, heroin users, like homeless people (many
are both), are part of the landscape. The city draws young people
with troubled backgrounds from all over the country, even as it
tries coping with inveterate users who have lived on the streets
for years. 

 The new people, like Matt Dodman, from Michigan, arrive with no
money and no plans. Often they end up in loose-knit communities of
homeless drug users, scorned by the rest of the city and consumed
with a need to get their fixes. People cross the street to avoid
them. "They look at us like dogs," Mr. Dodman said.

 To support his habit, which costs him $20 to $30 a day, Mr. Dodman
steals. Or he "boosts"   steals an item from a store, then returns
it for cash. He has panhandled, but says he does not "have the
patience for it." 

 Dr. David E. Smith, founder and president of the Haight-Ashbury
Free Clinics, drug treatment centers here, has described the city's
young addict population as people looking for "geographical cheer"
hope that life is going to be better in San Francisco than it was
in Des Moines, say. Instead, they become alienated. The same is
true of neighborhoods that attract young transients in Seattle and
Portland. Officials in both cities consider heroin use at epidemic
levels. In 1999, Portland had the nation's highest rate of death
from heroin overdose.

 "You look back into the early 90's, and the heroin deaths are one
to two dozen per year, and then in 1999 it was 111," said Gary
Oxman, director of the Multnomah County Health Department in
Portland. The department expects the final number for last year to
drop to the low to middle 70's, he said, in part because of
aggressive education programs.

 San Francisco has stepped up efforts in recent years to divert
drug users to treatment. Such programs are making the city a model
for California now that a statewide voter initiative, to take
effect on July 1, makes first-time drug offenders eligible for
treatment rather than jail. But more people keep coming to San
Francisco than the city can help.

 Matt Dodman was one of several addicts, young and old alike, who
said in interviews on the streets that they could not find a
program that would accept them. Another was R. J., who said he had
been using heroin for 40 of his 49 years and could not find a space
in the city's detoxification centers.

 R. J., who would identify himself only by his initials, saying he
wanted to spare his four children, is a walking sign of what heroin
can cost. He has overdosed five times. He has been stabbed and
raped while selling himself to support his habit. He has done time
behind bars, almost nine years in all. And his inner forearms have
so many needle tracks that they look striped.

 By selling his body, R. J. earns enough money to pay for his
heroin, if nothing else. "When I see young people, I tell them,
`Don't end up like me,' " he said. "I tell them, `Look at me.' "

 Gloria Clay, like R. J. a Tenderloin regular, is a little luckier.
At 35, she is in a detoxification program and says she is on her
way to kicking a heroin habit she picked up two years ago, after
being addicted to crack.

 Her scars keep her motivated. While on drugs, she was kicked by
her drug-addicted boyfriend, a beating that cost her an eye and
permanently damaged her spine.

 Although infected sores in heroin addicts are the leading cause of
admissions at San Francisco General Hospital, and while San
Francisco consistently ranks among the worst metropolitan areas for
emergency-room visits related to heroin, health officials here are
more worried about the drug's long-term effects.

 Experts compare heroin users to smokers, in that risk accumulates
over time. Many people infected with the hepatitis C virus, for
example, do not exhibit symptoms for many years, said Dr. Andrew
Moss, professor in residence of epidemiology and biostatistics at
the University of California at San Francisco. But, Dr. Moss said,
a segment of those afflicted will develop liver disease, cancer or
cirrhosis, and hepatitis C is very infectious.

 In San Francisco, where young users as well as old overdose
routinely, the young are very difficult to reach, because their
problems transcend drug use, Dr. Moss said. "They're America's
damaged children," he said.

 Matt Dodman is not worried. He is sure he will not overdose, and
certain he will remain free of disease. Why? "Because," he said, "I
know so." 

The New York Times on the Web


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