Coalition on Homelessness (coh@sfo.com)
Wed, 21 Jul 1999 16:19:48 -0800

Hey folks-

Here's my August STREET SHEET article.  Comments/suggestions?


ch@nce martin


"I started shooting heroin at age 15."  Heather says, describing her 25
year junkie career as a vicious cycle of getting high, homelessness,
methadone programs, and prison.  "I've gone to prison three times... I
had three different CDC numbers... all drug-related."

There's a determined edge in her composure as she as she recalls the
landmarks of her odyssey as a prisoner / hostage of America's drug war:
her first methadone program at age 17, meeting her main connect when he
was a trusty sweeping an office as she waited for an investigator to
interview her, the tattoo on her right shoulder she got from her cellie
during a lock down in the California Rehabilitation Center.   Her
regrets?  "Nine years of my life lost in prison, and all the people I've
hurt.  I was an outcast... I was a junkie.  When I was using and needed
money I did a lot of fucked-up shit."

Heather's story mirrors disturbing trends in the United States today.
After a long decline from the 1960s, America's war on drug users,
coupled with the despair of a generation, has fueled heroin addiction's
re-emergence as an epidemic.  Demand and risk have driven the purity of
the average retail 'bag' of heroin from 5% in 1984 to 59% in 1995,
according to DEA samplings of seized product. The age of a new heroin
user has plummeted from 1988's average of about 27 years of age to
1995's estimate of about 19.   The numbers of regular heroin users have
swelled nationally from adjusted estimates of 144,000 in 1993 to a
conservative projection of 342,000 in 1996, while heroin-related
emergency hospitalizations doubled between 1990 and 1996.

Locally, the impact has been devastating.

San Francisco leads the state, and arguably the entire nation in
drug-related deaths: 20.5 per 100,000 residents.  Sources at SF General
Hospital estimate $73 million spent annually treating wound infections
alone for users of the cheap, plentiful, powerful and incredibly
contaminated 'black tar' heroin that oozes from the corners of our
poorest neighborhoods.  Abscesses are merely the tip of the iceberg --
heroin users gravest risks lie in exposure to blood-borne diseases, and
the longer they use the more certain they will be exposed to HIV and
hepatitis C.  All these factors contribute heavily to the Dept. of
Public Health's estimates that untreated substance abuse cost the City a
staggering $1.7 billion in 1996 alone.

When she was last released from prison, Heather knew her pattern all too
well: "It was the worst possible situation.  In two weeks I had a
habit."  The risks were familiar, too.  She came to a decision.  "I
wanted out of that lifestyle, and to stop the harm I was doing to

Harm reduction for long-term heroin users usually comes in the form of
methadone treatment -- a daily communion ritual of a pink liquid in a
plastic cup proffered from behind a Plexiglas window.  Methadone
suppresses withdrawal symptoms and relieves cravings.  Methadone
patients soon learn that their accustomed 'hit' of heroin no longer
provides the euphoria they seek, so habitual heroin use becomes easier
to subdue.  In 1995, 191,000 persons in the U.S. were admitted to
publicly-funded methadone programs.  Medically indigent addicts must pay
around $ 250 per month out-of-pocket for this life-saving treatment, and
pay they will.

Heather began a four-year long run of methadone maintenance.  It hasn't
been easy, but she's managed to remain free of heroin.  "Once you make
up your mind that you really want to stop, it seems like people come out
of nowhere offering to get you high."   These last nine months she's
been "tapering" -- reducing her daily dose about two milligrams every
seven days -- from her maintenance level of 80 milligrams per day to her
current dose of six milligrams.

"Methadone is a far worse drug [than heroin].  It's more addicting.  And
it goes into your bone marrow, so it takes four times longer than heroin
to kick.  It doesn't get me high, but it numbs my brain... numbs my
senses.  Since I've been detoxing, colors are brighter to me today."

If Heather sticks to her plan, she will be free of methadone, as well as
heroin, in a matter of weeks.  The only other time that's happened in
these last 25 years was behind bars.  Surprised yet again by un-numbed
senses, her voice cracks a little as tears well in her blue-gray eyes.
"All the things I've done, all the things I've been through, and here I
am crying.  After 25 years, I guess I'm scared."

771 words
ch@nce martin 7/21/99