ANNAPOLIS – Heroin use has found a hospitable home in Maryland for decades, and the latest national substance abuse data shows the addiction is unlikely to go away soon.
Statewide, heroin treatment grew 44 percent between 1998 and 2002, according to the U.S. Department of Health, Substance Abuse and Mental Health Services Administration. And Maryland health officials say they are seeing the drug spill out into the suburbs, particularly attracting users in their late teens and early 20s, who risk developing long-term addictions.
“It’s definitely a tremendous concern. Heroin is definitely the No. 1 substance abuse after alcohol in Maryland,” said Bill Rusinko, research director for the Maryland Department of Health and Mental Hygiene, Alcohol and Drug Abuse Administration.
In Maryland, heroin addicts undergoing first-time treatment report they have used the drug for 12.6 years on average, said Rusinko.
Baltimore, which “has always been a heroin town,” according to the City Health Commissioner Peter Beilenson, is Maryland’s primary heroin supplier. The city and Baltimore County account for about three-quarters of the state’s heroin, he said.
In the late 1990s, heroin use started to move out of Baltimore and into Harford and Carroll and then into other counties, said Erin Artigiani, a researcher at the University of Maryland Center for Substance Abuse Research.
In Harford County, that’s meant a rapid increase in heroin abuse and overdose deaths since 1998, when seven people died from heroin problems.
“In 2002, that’s when we explode — 25 heroin deaths,” said Joe Ryan, manager for Harford County Office of Drug Control Policy. Last year, the number climbed to 32, he said.
Heroin use has especially increased among youth, health officials said.
“The main age group is 18 to 25 and the drug of choice is heroin,” said Thomas Morrisey, clinical supervisor of Harford County Addiction Services. “We are seeing 18-year-olds who have four-year habits. And we’re talking about rural kids who live out amongst the trees and the rocks. I think it’s a major problem.”
Denial is common among parents and other community members, said Doe Ladd, president of Addiction Connections Resource, a Harford support group for drug addicts and their families.
“You are in an upper-middle-class, suburban community and the parents don’t want to admit,” what’s happening, said Ladd. “Heroin is the hot one for these kids.”
But despite health officials noticing an increase in heroin use among those in their late teens and early 20s, the age group undergoing the most heroin treatments continues to be those aged 35 to 39, according to the substance abuse administration.
For those in their mid- to late-30s, the number of treatments where heroin was the primary drug abused, grew by about 50 percent, from 2,995 in 1998 to 4,511 in 2002, according to the substance abuse administration.
Heroin treatments among those aged 18 to 24 have also increased, but only by about 36 percent.
Health officials warn that treatment records do not necessarily indicate current substance abuse trends.
It’s “totally irrelevant,” said Leah Young, a spokeswoman for the substance abuse administration.
When it comes to heroin users, Rusinko said “there is usually a lag time, so many of them in treatment in their 30s began to use in their mid-20s.”
The drug’s popularity has increased with its purity, substance abuse experts said. Heroin now available in Maryland is about 80 percent pure, as opposed to the 7 to 10 percent purity of the 1970s.
“Given the purity, no needles are needed. Kids can just snort it and they are — in part because we taught them needles are bad,” said Morrisey.
New users who take fairly large amounts of heroin every day can develop an addiction within two weeks, said Morrisey. “Within three to four months they will be deep into their addiction.”
And chances of recovery “are slim,” Ryan said.
“The need to use more (heroin) overwhelms their entire lifestyle, so they lose their jobs, start to commit crimes and become sloppier in appearance,” Morrisey said.
As the body builds tolerance to heroin, more of the drug is needed to make the receptor sites in the brain feel the effects. Health officials say recovery from heroin addiction is a long-term process because the brain’s memory has to be retrained to feel normal without heroin.
Troy Rowe, a Harford County recovering drug addict sober for two years, said using heroin gives the user “an unbelievable feeling. You’re high and you’re low . . . It’s an escape from reality.”
At one point, Rowe said he was spending about $1,500 per day to feed his heroin and cocaine addiction.
When Rowe began treatment to avoid a likely three-year prison term for violating probation by doing drugs, he said he was at a point “where I had lost everything, my house, my cars . . . all self-respect. . . . I was digging myself a hole and that hole was six-feet-under.”
The key to turning around the trend, substance abuse experts say, is education.
A massive education campaign begun after teens first began dying from heroin in Carroll County in 1996, has significantly reduced the number of 18-and-under heroin treatments there, said Mark Yount, a substance abuse prevention coordinator at Junction Inc., in Carroll County.
Heroin treatments for 18-and-younger clients in Carroll fell from 115 in 1999 to 35 in 2004, Yount said.
Besides education, finding more treatment funding is a universal quest.
“We could definitely use more treatment in Maryland,” said Carlos Hardy, chosen by Gov. Robert Ehrlich for the Maryland State Drug and Alcohol Abuse Council. The council will coordinate prevention and treatment statewide and help determine funding needs.
Maryland now spends about $127 million in state and federal funds for substance abuse treatment, said the Alcohol and Drug Abuse Administration.
Due to varying treatment costs, which range from free to several tens of thousands of dollars per month, and limited availability, particularly for in-patient treatment, it can be difficult for addicts to enroll, said Rowe who has helped between 40 and 50 addicts find programs.
“If there isn’t any bed space available right when somebody is ready to go and they are forced to wait, they might not ever make it,” he said.
Rowe said he will always be an addict, but today he is addicted to helping other addicts find treatment. He recommends the sometimes hard-to-come-by in-patient programs.
“It’s still a challenge at times. I know people who have had 11, 12 years clean and then relapse. It tells me that that never leaves; it is a disease and I’ll always have it.”
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