Heroine - by lawdog

"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 trustee 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 lockdown 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 myself."

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."