...With a New Clientele, Same Old Worries

A former heroin addict gazes out the window of a New York City drug rehabilitation center. "Over there, the weather has been good. That is greatly appreciated on these streets." Sunny skies have made for bumper poppy crops in Turkey, Afghanistan and Pakistan over the last three years. The increasing availability of this so-called Golden Crescent heroin has spurred a marked rise in the use of this and other drugs in the united States. Not associated with a general ethos of disillusion or uncertainty, as was the drug movement of the late '60s and early '70s, today's crescendo in drug abuse is a more nebulous, and ultimately more dangerous, problem.

While heroin usage still remains concentrated in the nation's ghettos, officials are seeing evidence of a new breed of "upwardly mobile" addicts. "They are the shooters who think they can beat the game--white collar workers using heroin only occasionally, just enough to keep going, and frequently mixing with other drugs," says Vic Gelineau, head of the Massachusetts Division of Drug Rehabilitation. Rather than taking root in a counter-culture and espousing alienation from the establishment, the modern group of users is effectively indistinguishable from other elements of society. "These are people from the establishment," says Gelineau. "Most of their peers are content to turn and look the other way." Gelineau points out that in most large companies, alcohol reform and other social services are deemed vital, yet, despite the high probabilities of soft and hard drug use, these issues are never confronted.

The Reagan administration, governed by the long-term misconception that drug addiction is a moral failure and not a physiological phenomenon rooted in serious social inequities, is treating drug problems as a low priority item. There are an estimated 12,000 heroin addicts living in Massachusetts, and the number of emergency room heroin-related cases in the state's hospitals is up by 4 or 5 percent. Rehabilitaion officials are finding the Reagan budget curs crippling to an already chronically underfunded social service. The combined effects of the recently passed federal block grants, Massachusetts' Proposition 2 1/2, and budget cuts of up to 30 per cent have endangered many of the state's 18 residential treatment programs, and have drastically curtailed preventive education programs. As Gelineau points out, considering that the average addict commits two and one-half crimes a day in order to get the $100 to $600 needed to support his habit, it is clear that the cost to society of neglecting drug rehabilitation remains far greater than the money saved by budget cuts. Officials are quick to point out that to house an addict in residences, which are clearly productive in their community, costs $4000 less than keeping him a year in prison would.

What has not suffered from Reaganomics is the low-cost, low-effectiveness methadone treatment centers. Seven out-patient facilities in the state dispense the synthetic, which is designed to remove gradually the user's need for heroin. "We have had a good success rate with methadone," drug officials say. Most often measured in terms of a facility's utilization rate, success comes easily for a methodone treatment program. A methodone center tends to create its own demand. "If we were a methadone service," Bill McCue, director of project Third Nail, says, "we'd have lines of people down the block."

An addict speaks of his experience with methodone. "I, like anybody else who uses the stuff, just transferred addictions. The government says we can't do dope, so we line up at the juice center and get methodone instead. Half the junkies out there are addicted to methodone and mixing it with other drugs. When I was on methadone, because it was such a downer, I would get my treatment dose, start to nod, them mix it with a little coke so I could keep tuned in. The withdrawal from methadone is far more severe than from heroin, and it takes months to get it out of your body system." The treatment, partly because of the small amount of time that a therapist has to spend with each client, remains very inexpensive, which accounts for Washington's support of the program. Funds have been collected to accommodate 100 more methadone clients at different centers statewide. As the number of methadone users soars, one cannot help but note the development of an ironically vicious circle--heroin initially came into vogue as a cure for morphine addiction.