"Heroin is recommended reading for both the general public and addiction treatment professionals. It provides a wealth of information of great value in understanding heroin addiction and treatment." --
Mark Parrino, M.P.A., President, American Methadone Treatment Association"If ever a comprehensive book on heroin were needed it is now, and Humberto Fernandez has filled that need by providing a fully developed history, psychology, physiology, and pharmocology of heroin addiction. Moving on from those basics, Heroin explores the variety of treatment approaches, presents case histories of addicts, and places the drug within a detailed social context that includes public health, organized crime, the criminal justice system, popular culture, and the media." --
David E. Smith, M.D., Founder, Haight Ashbury Free Clinics & Richard B. Seymour, M.A., Managing Editor, Journal of Psychoactive Drugs
I learned about heroin during the summer of 1958, as a child growing up in the South Bronx, when I saw my first overdose victim. Since that day, heroin has both fascinated and terrified me. That was forty years ago. A lot has happened since then, but not much has changed.
My family moved to Elizabeth, New Jersey in 1962. It was a lush, green place where neighborhood parks, manicured lawns, and the smell of backyard barbecues that filled the air most Sunday afternoons. I grew up drinking egg-creams at Beck's candy store, listening to Mrs. Beck extol the importance of education, family, and respect. She was a stickler for cleanliness, making sure her sidewalk was always swept, and if I didn't have enough money for the latest comic book, she'd put me to work sweeping. Mr. and Mrs. Beck sold the store and retired long ago. The store is still there, but you'd never recognize it. Today, a gang of young men dressed in hooded sweatshirts troll that sidewalk, peddling drugs. Exactly when it became an open-air drug market is hard to pin down. I suppose it was never really as idyllic as my childish eyes perceived it, after all, the Dayton Street housing projects on the Newark-Elizabeth border were never more than a bike ride away. Heroin was there in 1968. Today those projects are a ghost town.
For thirty years we have engaged in political posturing. In New Jersey, with the fifth highest rate of HIV in the country, we still struggle, vacillating on important issues because of politics. Governor Whitman, despite recommendations by her own hand-picked AIDS study group, adamantly opposes needle-exchange programs; disregarding research studies by organizations like the National Academy of Science, The National Institute of Health, and the General Accounting Office, who all conclude that needle-exchanges reduce the transmission of HIV and do not promote additional illicit drug use. It is now politically expedient to be perceived as "tough on drugs," and any politician concerned with reelection would rather be caught in a sex scandal, than be seen as "soft on drugs."
Methadone, long thought to be the most viable treatment modality by the medical community, still suffers from stigma and prejudice. Nationally, less than twenty percent of heroin addicts are enrolled in a methadone program. Even some of those who work in the field of treatment, are guilty of the same bias that public perception has mistakenly created. "After all, methadone is just a legal substitute for heroin, and why should my tax dollars go to supporting their habits?"
The whole question of what comprises "effective" treatment for heroin addiction becomes muddied by our collective bias and perception of who uses heroin. Now that more white, suburban teenagers are using heroin, our attention is focused on the problem as if it were something new. We search for root causes, answers, and look for new treatment approaches, like Dr. Lance Gooberman's "Ultra Rapid Opiate Detoxification Under General Anesthesia," as an alternative. We seek simple solutions to a complex social problem.
We have resisted treating heroin as a public health problem, turning it into a criminal justice issue, incarcerating more people than any other country in the world. But then, new prisons equals new jobs. Even in prison, where heroin users are literally a captive audience, we provide treatment for less than ten percent of those who need it.
What price do we pay for our mistakes? Look into the face of the thirteen year old prostitute from Camden, working the stroll, under the Frankford elevated train tracks in Philadelphia.
On Broadway, in South Camden, I stand and watch. A twelve year old child skips over to me. He smiles and says, "Got that good thing, Papi." I study his face and see, the price we pay, is in his eyes. copyright. NY Times 5-3-98
