The Spike: What Lies Behind the New Heroin Epidemic?

[ed. One city. Millions of syringes.]

Heroin use, which had been relatively stable through most of the decade, began to spike in the late 2000s throughout the United States. Cheap and plentiful, the drug is a staple commodity in an underground market that is as big as the globe and as intimate as your arm. And while heroin has enjoyed widespread popularity since the end of World War II, demand has soared in the past five years as jonesing prescription opioid addicts like Lance have migrated to the street. (...)

Researchers trace the rise in heroin use, in part, to the doctor’s office. In the late 1990s, there was a shift in health-care philosophy that emphasized treating patients’ pain rather than just the underlying ailments causing it. Opioids that had previously been restricted to ailments like cancer or physical trauma suddenly became widely available for more broadly defined problems like chronic pain. At the same time, Purdue Pharma introduced and aggressively marketed OxyContin (the brand name for oxycodone), a painkiller designed to gradually release opioids into the body.

As the sheer amount of opioids prescribed to Americans suddenly jumped, the drugs naturally found their way onto the street.

Users quickly figured out how to circumvent the drug’s time-delay feature, making oxy the vehicle of choice for people who wanted to get high on prescription drugs. “The Gucci, the drug that people wanted,”—people like Lance—“was OxyContin,” says Banta-Green. (...)

Withdrawal from opioids isn’t lethal, as it can be with alcohol or benzodiazepines (Valium), but it is deeply unpleasant, particularly for people with the kind of trauma or poverty that might drive them to drug abuse in the first place. Medication-assisted detox can ease the withdrawal by manipulating the brain receptors that trigger cravings. But without meds, a seasoned opioid addict can expect perhaps a week of snot, sweating, vomiting, nausea, and hot- and cold-flashes, plus—and often more importantly—the resurfacing of painful emotions that had previously been repressed by their drug use. Some addicts do manage to white-knuckle their way out of opioid addiction, but many—separated from friends and resources—are overwhelmed by the painful emptiness of their sober lives. Others, recognizing themselves as “addicts” who are a scourge on their friends and family, fall into a cycle of despair that heroin is particularly good at feeding.

For those on the frontlines of the new heroin epidemic, it’s that loss of hope that is nearly as dangerous as the drug itself. (...)

The holy grail of Murphy’s work, he says, is to reverse that exclusion—to welcome drug users back into the human community. “Our job ... is to convince them that they’re worth something,” he says, because “then you will make different choices” than someone who revels in self-destruction. So the Alliance tries to meet users where they’re at instead of telling them where they should be. Sometimes this looks like the abstinence that Lance tried and failed to achieve; other times, it’s finding a way to stabilize their drug use.

Murphy’s motto, he says, is “Be the best damn drug user that you can be.”

He shows me the Alliance’s supply room. Brown cardboard boxes are piled up to the ceiling, packed so deep there’s barely room for us to shimmy between them. Boxes of syringes are stacked in towering brown columns.

The Alliance gives out a lot of syringes—about 3.2 million per year to King County residents, says Murphy, and collects back as many as 5 million used ones. About a million of the former go to suburban users, he says—a demographic that he saw rapidly grow starting around 2010. That would have been around the same time that Lance, and thousands of others, began their migration from Big Pharma to black tar.

“For me, it was a really sad and stressful time,” says Murphy. For a couple of months, the phone at the Alliance was ringing off the hook from prescription users asking for help. “We were getting multiple calls every week,” says Murphy, from frightened suburbanites trying to figure out how to buy heroin. Callers would say “I’m so scared” and “You gotta help me.” But Murphy couldn’t: The Alliance doesn’t hook people up with drugs. “It was hard to hear all these young folks in this really chaotic and traumatic experience,” he says. “We saw these folks quickly change into injection drug users, sometimes on the streets, sometimes in the suburbs.” Stable drug use, says Murphy, was transforming into unstable drug use, and quality-controlled drugs were being replaced by heroin off the street. “Our delivery service really skyrocketed, to where in the Eastside and North King County, we do over a million syringes a year just delivering to the suburbs. The suburbs have just as much injection drug use as the city.

“The average drug user,” he says, “was much younger, and much more, let’s say, lack of city smarts or street smarts. It was really sad, that whole story and that generation. There wasn’t really a lot of older drug users to help teach them. They were left on their own.”

None of this seems fair to Murphy. “We give people OxyContin,” he says, referring to society at large, “which is essentially legal heroin, and then we tell them that they can’t have it anymore and the only way they can get it is street heroin. We also let drug cartels be our FDA on what’s quality control. We allow people to ingest horrible cuts of drugs, with people getting horrible allergic reactions to stuff it’s [mixed] with.” Criminalization, he says, only drives people further into addiction, cutting them off from the social bonds that can help addicts to cope with undiluted reality.

“It’s not that hard to figure out that beating a human being up isn’t helpful,” says Murphy. “It’s not that hard to figure out that stripping someone of their rights and dignities by taking them to jail is a detriment to society.”

by Casey Jaywork, Seattle Weekly | Read more:
Image: Barry Blankenship