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Illustrations by Shawn Murenbeeld
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Lexie reached for the perfume tray. It was rimmed in gold filigree just like the one she had when she was a little girl, but with a small pile of white powder on its mirrored surface. The cute guy holding the tray shook his head and passed it to the next person. “You’re on psych meds,” he reminded Lexie.*
The tray passed in front of her a second time.
The third time it came around, the guy, call him Joe, let her inhale a tiny line. He said the drug was called China White.
“If you do this drug for three days consecutively, you will be hooked, and if you use a great amount, you will die,” he warned her, shifting into the stilted, emotionless delivery that ends pharmaceutical commercials. She nodded and bent over the tray. Afterward she felt good, weird, foggy. When she got home, she took a shower and almost fell. She braced herself against the cool tile and felt absurdly, unaccountably happy.
Six months later, in June 2010, Lexie saw Joe again. She snorted for the second time, and the heroin was far more potent. She woke up surrounded by hard, chilled porcelain, water sloshing at her arms. Joe leaned close to her face. “We almost called an ambulance,” he told her, and he looked really worried. She smiled and slid back into peace.
After that evening, Lexie started dating Joe. She’d watch him shoot up, see the bliss instantly soften his face. She begged him to inject her. She was 23 and miserable, her diagnosis bipolar disorder, her mood a wild mix of restless and sad, bored and angry and why bother? Her mother, who worked at a university, kept telling her she had potential—for what? Finally, one night when Joe was out of money and desperate, he told her that if she bought the buttons ($10 capsules, a twentieth of a gram each), he’d shoot her up.
The rush came over her like a tide, washing away every worry she’d ever had. What followed was a sweet, soaring joy, the kind she’d always guessed was possible but she’d never, ever felt.
Hours passed, but she wasn’t bored. No angry thoughts slammed around inside her skull. She tested her thoughts tentatively—no anxiety came. Even the sadness deep in her gut was gone.
For the next two weeks, Lexie let Joe’s brother shoot her up whenever Joe couldn’t. Once every couple of days…every other day…every day. Her mother had always told her she was a born entrepreneur—when their new neighbor was waiting for his water to be turned on, she put up a stand in the yard and sold him gallon jugs. Now, she needed a lot of money. She advertised on the Internet as an “escort” (“‘Prostituting’ is a better word,” she’d say dryly), and her clients, mostly doctors and lawyers, posted stellar reviews. After a session, she’d go straight to Joe’s workplace so he could shoot her up in his workstation or the women’s bathroom.
When he complained that shooting her up was ruining his high, she learned to use the needle herself. When he lost his job, in February 2011, she slept with two or three men a day to buy heroin for both of them. Sometimes he even drove her to her “appointments.” He didn’t seem to mind, and she hated him for it.
“You lose all self-esteem,” she told me, months later. “You lose…clarity.”
Heroin used to be a subculture with its own wan, vacant, anorexic heroin-chic aesthetic. Now it’s so mainstream, it has no aesthetic at all. Lexie’s dealer “carried himself really well,” she says. “He went to Frontenac, had his clothes tailored, and just the way he talked…”
The current epidemic has a longer reach than the heroin upsurges in the 1970s and the early 1990s. Two reasons are purity (you can start out by snorting, so there’s none of the inner-city-junkie stigma that comes with the needle) and availability. Many dealers give the first button away, a diabolically brilliant marketing strategy. And today’s heroin hasn’t been “stepped on” so many times, buffered with fillers. “We are seeing, at the street level, 30 to 60 and sometimes 80 percent purity,” says James Shroba, acting special agent in charge of the Drug Enforcement Administration’s St. Louis Division. “When I started this work, a 3 percent level was a home run.”
Local law-enforcement authorities blame heroin for upticks in shoplifting, residential robberies, copper theft, prostitution, and homicide. Police in St. Louis city and county made more than 825 heroin-related arrests in 2011, and in September, the DEA collaborated with 32 other agencies on the largest single strike against heroin in St. Louis history, arresting 53 dealers and distributors.
The Barnes-Jewish Hospital emergency department saw 150 heroin overdoses in 2010 and nearly as many in 2011; its records show a fivefold increase in the past five years. Deaths have shot up, too: More than once, St. Louis County medical examiner Dr. Mary Case has walked into the morgue and found three or four heroin overdoses. This is worse than crack cocaine, she says, because “kids go off to college and get hooked. They’ll be out partying, and the price of heroin is like the price of a six-pack of beer. You don’t have that exposure to crack at a frat party.”
Crack-cocaine deaths peaked in St. Louis County in 2006, with a high of 54. Heroin deaths reached 90 in 2011. Heroin’s demographics are different, too; while those who died from crack cocaine are a mix of races and largely middle-aged, heroin’s victims skew younger, more white, and more male.
Dan Duncan, director of community services for the National Council on Alcoholism & Drug Abuse in St. Louis, says its help line first noticed an increase in heroin-related calls about four years ago, “and last year it went through the roof.”
In heroin’s patchwork geography, most of those calls came from West County and South County, yet an inordinate number of recent fatal overdoses have been in South City—and most street deals take place near Interstate 70, in North St. Louis neighborhoods littered with syringes. Nice SUVs with Illinois plates are parked along the curbs, and kids from West County and Jefferson County and Franklin County are pouring in, navigating the unfamiliar terrain with their phones and GPSes.
Paul slid off his mail carrier’s bag. He was sweaty and tired, but instead of heading home for a cool shower and dinner, he drove downtown to an ATM where he wouldn’t have to pay a fee, then got on I-70 north and veered right back off again at the Madison Street exit. He pulled out his phone and dialed his dealer, counted the rings, flipped his phone shut and waited, scanning the street: Was there a school nearby? That meant extra charges, if he got caught. He checked his rearview mirror—where the hell was his dealer?—and saw a couple of guys heading toward him. “Here I am showin’ up in a mailman outfit, this white guy in a black neighborhood,” he thought, and touched his handgun for reassurance. “And that’s bad, too,” he reminded himself, “because now I’m a mailman with a gun in a bad neighborhood with drugs on me.”
He couldn’t buy more than a day’s supply at a time, or he’d use it up too fast. Sometimes the cravings got so bad, he’d wake up in the middle of the night and have to use to get back to sleep. But he always had to make sure he had heroin for the next morning, because he wasn’t going to be able to work if he didn’t. And so far, he hadn’t missed work once.
This was a lot of trouble. But heroin—it was better than your best dream. Better than love. He couldn’t believe how good it felt, like a fairyland. Some days the word just played through his head a million times, and all he could think was “I want to do it I want to do it I want to do it.”
At first, he’d thought everybody in the world should use heroin, so they’d be mellow and loving. But now, he could feel himself changing. He lied all the time, had attitude with his mom and dad, fought over stupid stuff, couldn’t keep a girlfriend. He dreaded that drive every night. He’d start thinking about it while he walked his route. But by afternoon, he’d feel sweaty and sick and know he had to go.
He first tried heroin in the grunge ’90s, after Colombia introduced a higher grade that could be snorted. He never switched to shooting up, couldn’t imagine having to find clean syringes all the time. He could sprinkle his dope on a CD and snort it while he was driving down the highway.
He watched friends smoke heroin, putting it on a piece of foil, taking a Bic pen apart, holding the little tube an inch above the heroin and lighting a flame under the foil. The heroin sent up billowy, fantastical clouds of smoke that they followed with the pen tube, breathing it in. Chasing the dragon.
Shooting up was supposed to be the real high, though. People laughed at Paul for snorting, told him he was just wasting his time. He heard of people shooting straight into the jugular, or between their toes to hide the needle marks, or into hemorrhoids because their veins had collapsed…
No thanks. He’d snort. He bought his heroin raw when he could, mixing it with Dormin, an over-the-counter sleeping aid he could only find “in ghetto gas stations and Arab stores.” He’d seen the ends of capsules crunched because somebody had taken out a bit of heroin and replaced it with filler.
The list of substances that have been used to bulk up heroin is endless, from sugar to talc to fentanyl, lidocaine, laundry detergent, powdered milk, starch, brick dust, or Ajax cleaner. In toxicology reports, Case sees a lot of Benadryl, which, like Dormin, is diphenhydramine and makes people sleepy—so maybe they’ll think they’re getting more heroin than they are.
Some heroin comes as a fluffy white powder; other times it’s a tan or “Mexican brown” powder; sticky, sweet-smelling “black tar”; or “crete,” a chunky powder as gray as concrete mix. People used hand-held coffee grinders to mix it, and Paul often saw them so desperate for a few grains, they’d tear the whole grinder apart and scrape it out with a razor blade.
He quit—six times. He had a long clean stretch, but last spring, his friend John died of an overdose, and afterward, every time a car like his passed, Paul kept thinking it was John. Then he’d remember, the pain as sharp as new. Heroin was the only thing he knew that could take it away.
John’s mother had been addicted to prescription drugs, and John had hated feeling like he was following in her steps. “I’m not using to get high,” he’d promised his sister. “I’m just using to feel normal.” He lost his job as a social worker and started delivering pizzas. Then he lost that job, too. To get cash, he’d sometimes buy a thousand Dormin capsules and sell them to his dealer. (Other heroin users “smurf,” buying over-the-counter decongestants to sell to methamphetamine cooks.)
Finally, John got into a methadone program that seemed to be working. It was expensive, and the clinic was far away, but he was doing great.
Until he vanished for four days and was found in Florissant, miles from his South County home, dead of an overdose. Paul’s convinced a friend injected John with too strong of a dose and didn’t stick around to help. But nobody’s got time to investigate all the deaths like John’s.
Recently, another friend overdosed, and her dealer’s now wildly popular. “Three or four people have OD’d from this guy’s stuff,” Paul says. “People are droppin’ like flies. So there will be every car you can imagine over at that person’s house, because they know the stuff is good, and they figure the person just took too much.”
He falls silent. “For 15 years, you didn’t hear about it,” he says. “Now it’s on every corner.”
Natlie Burke started using just before her 17th birthday. Her mother, Stacey Burke, noticed her erratic behavior—she was willful, combative if she didn’t get her way, sleeping all the time, screaming even at her friends—but wrote it off as her being a teenager. Natalie was beautiful, had a lot of friends, made honor roll…
Two years went by before the truth surfaced, starting with an odd burst of temper when Stacey asked a friend of Natalie’s to drive with her to drop off Natalie’s car for repair. A few days later, Stacey read about a shooting, probably drug-related, in North City. Then she opened a red-light ticket for Natalie that photographed her at Goodfellow Boulevard and I-70. That afternoon, she turned on the TV and saw Oprah interviewing an entire family on heroin.
“I vomited and collapsed,” she says. “Then I called her father.”
Natalie’s father said, “No way.” Natalie’s friend’s father admitted that his son was on heroin but had promised him Natalie wasn’t. Natalie admitted the truth. (It turned out, she’d been upset about the car repair because her friend was supposed to go get her drugs, and she needed them right away.)
Stacey put Natalie into the hospital for a medicated detox. “She said she’d rather be dead than on heroin,” Stacey recalls. “She said she’d gone to a party, and she and her friend were looking for some ecstasy, and this guy told her he had something else she’d like.”
Natalie used again after the detox, then tried to detox herself using Benadryl, then went to a rehab center in Tennessee. “Mom, I’m in the same room Johnny Cash had,” she exclaimed, thrilled. Fifteen days later, she was kicked out for belligerent behavior. Two more years went by, two more rehab centers, a methadone clinic, a sober-living house. “She didn’t like living there because the people seemed more messed up than she was,” Stacey says. “In all reality, she was just as messed up as they were. She was just younger and prettier.”
This past fall, Natalie seemed to pull it together. She enrolled at Allied College and got a job selling Lancôme at Macy’s. One day, her mother came home with groceries and asked for help unloading. Natalie picked up a can of peanuts and said dreamily, “What’s this?” Stacey gave her a long look. “What does the box say, Natalie?” Stacey made an excuse and went to her bedroom, thinking, “What do I do? What do I do? What do I do?”
She came back out and said, “I think you’re high.” Natalie denied it, and the next day, she went to live with her father. Two weeks later, he called Stacey in a panic, saying Natalie told him she was going to a baby shower, but she was wearing sweats and hadn’t taken a bath in two days. He went into his bedroom and saw his drawer ajar, his pistol gone.
When Natalie finally answered her cell, she promised her father she wouldn’t pawn the pistol and told him she was just going to get high one more time and then come home. She went to the Lumière Place parking lot, shot up with heroin—her mother says police found three syringes—and shot herself with the pistol. The note next to her read, “I will never get better only worse. I’m sorry. Please forgive me.”
Her funeral was by invitation only. Two of Natalie’s friends had already taken fatal overdoses; others were still using, and Stacey didn’t want them there. “They use before the funeral,” she says, her voice flat, “and they use sometimes in the parking lot before they pull away from the funeral home.”
Heroin is one of the most addictive drugs on earth—but why? For starters, it’s stronger than morphine, and it crosses the blood-brain barrier 100 times faster, notes Ted Cicero, professor of psychiatry at Washington University School of Medicine. Heroin is so fat-soluble, it flows right through the fatty layer that normally protects your brain from foreign substances in the bloodstream. “There’s a sudden rush—they call it a ‘whole-body orgasm,’” Cicero says. Your skin flushes warm, your mouth goes dry, your legs get heavy. Reactions slow, the mind detaches, anxiety dissolves.
The euphoria that follows is a flood of dopamine, released because heroin stimulates the reward center in the brain. Over time, though, the brain’s receptors change in number and sensitivity; they get twitchier, and it takes more heroin to reach the deep relaxation of “the nod.” Once dopamine’s base line has been altered, life without heroin feels flat and joyless, and a once-euphoric dose of heroin only brings you back to normal. Then there are the physical symptoms of withdrawal, which can include a runny nose, insomnia, severe body aches, nausea, vomiting, diarrhea, cold flashes with goosebumps (“cold turkey”), restlessness, and kicking movements (“kicking the habit”).
Because purity’s so variable, and the body’s tolerance changes so quickly, heroin is also one of the easiest drugs to overdose on. “Heroin kills by suppressing respiration,” Case explains. “Death can come so rapidly, people come to us with the tourniquet still on their arm, maybe even the needle in there. Other times, death will take several hours—someone looks like they’re asleep, but they’re actually unconscious.”
Friends think the person’s “snoring,” but it’s really “stertorous respiration, meaning that it’s a struggle to breathe through the mouth,” she adds. “Often there’s white or pink-tinged foam running out of the mouth and nose. That’s because there’s not enough oxygen in their blood, so fluid leaves the capillaries in their lungs and exudes into the airway.”
Such graphic descriptions don’t scare teenagers, who are wired to believe they’re immortal. But even small doses of heroin zap sex drive and potency—why don’t antidrug educators impart that bit of info to teenage boys? “I don’t know,” Cicero admits. “They should.” (I ask Paul if he noticed any…effects. “Oh yeah,” he says. “I probably didn’t—my girlfriend and I probably weren’t together for over a year.”)
First, reproductive ability is destroyed; then come infections of the heart’s lining, pneumonia, damage to kidneys and liver. Other effects can include oozing, abscessed flesh from “skin popping” (injecting right under the skin because the veins have collapsed) and contracting HIV or hepatitis from dirty needles.
When St. Louis County Chief of Police Tim Fitch was in Vancouver for a conference, he visited a 24-hour supervised injection site on the city’s East Side, surrounded by old, rough-bricked buildings zigzagged with rusted fire escapes. Junkies slumped in doorways and prostitutes kept a gaunt, overeager vigil, their eyes darting. Inside the center, Fitch walked past a 55-gallon trash can full of clean syringes to a row of 12 occupied booths.
“Why the mirrors?” he asked.
A guard nodded toward booth No. 8, where a man was slowly, shakily injecting heroin into his eyeball.
Tom’s a big guy, a former police officer; his wife, Sally, is tiny and bubbly and practical, June Cleaver with a sense of irony. Last spring, they started worrying about their son, Matt. He’d get a good paycheck and be broke in a few days. He’d stopped coming home as often, stopped shooting the breeze with his dad.
In August, Matt’s sister found him passed out in his truck. “He had a baggie full of six or eight little—now I know they call them capsules,” says Sally, who still doesn’t quite have the slang down, “and they had a powder in them. When he got up to walk, it was like he couldn’t wake up.”
Tom drove to the house of an assistant police chief, dropped a syringe in his hand, and said, “I just want to know what this is.”
“I can give you a pretty good idea,” the man said, “but I’ll get it tested.” It was heroin. Matt told his parents he had been sad since his grandfather died and using made the pain go away, and he’d only shot up once.
“Having been a cop, I know people lie, and you can usually tell,” Tom says, “but it’s your son and you want to give him some benefit of the doubt. So you think, ‘Maybe I’ll believe less than half of what he says’—and then it slowly deteriorates, and I’m finding less and less I can believe, and why is he lying to me?”
He and Sally had cared for their kids, held them close, taught them what to fear and what to honor. OK, they weren’t Ozzie and Harriet—but they were pretty darn close. Was that where they’d gone wrong? Did they make life look too easy?
When Matt finally agreed to seek treatment, Tom started calling around. “Is he living at home?” one rehab staffer asked. “You need to get him out of your house right now, get him a one-way ticket, and get him down here. Does he have a car?” Yes. “A job?” Yes. “Well, that will change.”
Tom called Narcotics Anonymous, too. “I’m guessing he probably stole from you, from other family members, from his grandma,” the counselor said.
“You’re three for three,” Tom replied. “Keep going.”
Matt lasted five days in rehab, then came home, saying he was tired of eating Cheerios and wanted a decent meal. Soon after, his sister had to bail him out of jail, because he got caught on Freedom Drive—famous for its drug deals—in Belleville, Ill. And in late July, Tom found Matt asleep at work, checked his phone, and found text messages. “He was trying to work a pot deal!” he recalls. “I said, ‘You’ve been using!’ ‘No, I haven’t.’ ‘Oh, bull! So you’re gonna broker a deal for guys who are in rehab? Are you out of your mind? Go home. Pack your bags.’”
The next time Matt wound up in jail—for stealing recycled steel and selling it—his parents did not bail him out. “They’re gonna kill me!” he wailed to his father. “You’re just gonna let me sit here?”
“Well, at least we’ll know where you are,” his mother replied crisply.
She hung up and burst into tears.
Matt went through withdrawal in jail. It was pure hell, he told his mother. “I don’t ever want to go back there!”
“You hold the key to that one,” she answered quietly.
Now, she’s starting to see some of the old Matt again, the easygoing and patient young man she knew so well. “A few months ago, the anger was unbelievable,” she says. “So I know he’s coming back.”
“Rebuilding the trust is hard,” Matt says. “I’ve gone through some painful things with that man [his father], and I don’t think anything has hurt him as much as I did.”
At his first Narcotics Anonymous meeting, Matt saw three people he’d known in high school.
He’s found a job, but he’s still casting about for a career choice, trying to figure out where to pin his hopes in this economy.
“I think he wants to live the American dream,” Tom says slowly, “but I don’t think he knows what that is.”
Americans tend to assume their heroin comes from Afghanistan, whose poppies yield at least 63 percent of the world’s opium, according to the United Nations’ World Drug Report 2011. But according to the DEA, which tests street samples, St. Louis’ heroin is coming mainly from Mexico, where production has quadrupled since 2006. “There are minerals used in the manufacturing process, a certain iron content in water in Monterrey that’s not present in Nuevo Laredo,” explains Shroba. “When the Mexicans ramped up production, our intelligence indicates that they also brought in Colombian chemists and refined their production methods. They elevated the purity and flooded the market, and the reseller didn’t have to dilute it, because he had a constant supply.”
We can also blame the upsurge in heroin on prescription-drug abuse, which hit an all-time high of 5.1 million pain-reliever abusers in 2010, reports the National Institute on Drug Abuse. Those users are switching to heroin because it’s cheaper, with a faster and more euphoric high. And cocaine users are switching, too, because cocaine’s now in short supply: “Mexican cartels are telling the dealers, ‘I’ve only got a little cocaine this week, but I’ll give you some heroin at a great price,’” Shroba says.
The typical Mexican drug cartel operates from a compound in rural Mexico, its guards armed with more firepower than local law enforcement has. “These are exceptionally sophisticated organizations, highly compartmentalized, and they deploy cell heads just inside our border who coordinate the movement of heroin across the border,” Shroba says. “You may have 100 couriers every day, each carrying 5 kilos of heroin, and it’s all going to be put together and parceled out.”
The couriers drive their kilos to smaller cities, and U.S. prison and street gangs handle the next stages of distribution. Although St. Louis County detectives have identified members of La Familia—a powerful Mexican cartel—in Bridgeton, most local dealers are separated from the Mexican cartels by so many layers, they could just as easily be working for somebody in Burma.
Shroba’s agents use every tool they can muster: informants, who are often surprisingly eager to get their dealer arrested because they want to stop using; wiretapping; GPS, so they don’t have to follow too closely; cameras planted in city parks; cameras concealed by shirt buttons; furtive rooting through a suspect’s garbage. The effort often feels futile.
“Nobody in this building thinks we are going to arrest our way out of this problem,” Shroba says, taking in the safe from which agents draw money to make buys, the control-room screens that monitor GPS and video cameras, an all-one-piece stainless-steel toilet where nothing can be concealed or flushed. “The federal government spends as much money on treatment programs as on enforcement.”
And most treatment programs have only a 5 percent success rate.
Lexi and her mom sit in my kitchen, eating coffeecake. It’s mid-January. Lexie’s wearing no makeup, and her skin’s pale against an orange T-shirt emblazoned with a cat, flat on its back, paws rigid. The shirt says “Curiosity + Heroin.”
Lexie tried detox in 2010, but she immediately started using again. In October, she went into the hospital for a six-day medical detox, then spent 21 days in an inpatient program. Now, she’s receiving a monthly shot of Vivitrol; if she uses heroin, Vivitrol will block the high and increase the chance of a fatal overdose.
She’s no longer with her boyfriend, but she still has a drug-possession charge pending; she and Joe were arrested last August in a strip-mall parking lot in broad daylight. “Drug addicts don’t care where they shoot up,” she shrugs. “McDonald’s, alleys, bathrooms in QuikTrips—all you need is a spoon, a needle, water, maybe a tie-off.”
She’s heard about needle-exchange programs aimed at reducing transmission of HIV and hepatitis. “That’s just telling me, ‘OK, I’ve got a needle; I don’t need to go work for my needle,’” she says with a shrug. The capsules to package the heroin? “You can buy ’em. I’ve had every color. My one dealer, he used clear so people could see how much dope there was. Some dealers don’t top off the cap, but he was legit.”
Her mother nearly chokes. “A legitimate dope dealer,” she repeats, measuring out the words. “First time I’ve heard that one.”
Lexie attends support groups whenever she can, learning a lot about triggers. “Resentments will be the first thing to send you out,” she remarks. “‘My mom just pissed me off. F—k that bitch. I’m going to go shoot up.’”
She sighs. “You have all these problems before you do drugs, and then you go do heroin for two years,” she says. “You don’t know how to feel, because for the last two years, you’ve insulated yourself. Everything hits you like a ton of bricks, because you don’t have a suppressant anymore. It comes back to this painful place, and you’d do anything to get rid of it.
“In the end,” Lexie says, “people do heroin because they want to be numb.”
After Lexie and her mother leave, I don’t hear from them for several weeks. Then, in mid-February, an email arrives. It’s from Lexie’s mother: “[Lexie] has relapsed, took a lethal dose of heroin with intent to commit suicide (5 heartbeats away from dying, according to EMT), stent in hospital, on streets for a few days, I convinced her to go to hospital due to suicide threats (I signed her in involuntarily), now back in 30 day rehab—voluntarily… I sound matter of fact without emotion, but that is not so.”
When I call, she tells me, “Lexie was 90 days clean—or so I thought. She said goodnight and told me she loved me. I went downstairs a little while later and looked in on her. She was purple and blue, her eyes rolled back in her head, and she was not breathing.” When the paramedics injected Narcan to reverse the heroin, Lexie was furious: “One more minute, and I would have been fine.”
Packing for her daughter, Lexie’s mother pulled out her favorite shirt, held it a minute, and set it aside. “It’s what she’s going to be buried in,” she tells me, her voice hoarse and remote, “if she doesn’t overcome this.”
Nod, Boy, Buttons, & Beans
A snapshot from the eighth in a series of St. Louis County community forums.
The auditorium at St. John Vianney High School slowly fills with parents—fathers still in their business suits; mothers in headbands and woolly sweaters, toddlers held firmly by the hand; preteens walking a few paces behind. St. Louis County’s first seven town forums on heroin were held at public schools, but Vianney’s principal asked to host the eighth, and it started with a prayer. Then Col. Tim Fitch, chief of the St. Louis County Police Department, took the podium.
“I guarantee you, your students here have heard about the heroin problem, and they have even been offered heroin,” he tells the parents, who watch him intently. Then he asks how many have come because someone close to them has been involved with heroin.
About a third of the adults in the room raise their hands.
Fitch nods, unsurprised. “We found out this week that one of our police officers’ 17-year-old son has been using heroin,” he says.
Fitch introduces Sgt. Mark Whitson, who supervises the county’s Bureau of Drug Enforcement. Whitson starts with a glossary: Heroin is nod or boy, and it comes in buttons or beans. Parents should watch for missing or burnt spoons (used to liquefy the heroin over a flame), missing shoelaces or belts (used as tourniquets), razor blades (to cut up the heroin), glass pipes or straws (to snort it), missing money…
And the signs in their children? Pupils “pinned,” contracted until they look like somebody dotted them on with a Sharpie. Long pants and sleeves to hide needle marks; self-cutting for the same reason. Body unwashed, hair uncombed, appetite gone. Mysterious errands. Mood flipping from an extreme, slowed-down calm to anger and agitation…
The parents were pale by the time Kate Tansey, executive director of the St. Louis County Children’s Service Fund, stepped forward. “Just say no” is a myth and misconception, she told them. “Addiction is a complex, chronic, relapsing brain disease. Heroin affects their memory, their ability to think, their decision-making—all of that gets railroaded. That’s why they can’t ‘just say no.’ It’s a compulsion that comes from the very center of their body, with every cell screaming to use and use more. Eventually, they need to use just to feel normal.
“The longer a person stays in treatment, the better the outcome, but sometimes it takes multiple treatment episodes,” she warned. “That’s not a treatment issue; it’s the tenacity of heroin. It just grabs them, and it robs them of