BY CHRIS LYDGATE
In 1898, German pharmaceutical giant Bayer launched a new cough suppressant, diacetyl-morphine, under the trade name Heroin. The drug was touted as a cure for morphine addiction.
There are approximately 600,000 heroin addicts in America, according to the U.S. Department of Justice.
In July 1998, two young heroin addicts, Michael Douglas and Mora McGowan, hanged themselves from the Steel Bridge. Their bodies dangled above the Willamette River, in view of rush-hour traffic, for more than an hour.
In April 1999, Portland sociologist Marcia Hood-Brown died of a heroin overdose in New York City. She had dedicated her career to the study and treatment of troubled women (see cover story, WW, May 26, 1999).
There are currently 3,592 people enrolled in methadone programs in Multnomah County, a jump of 26 percent from last year.
Recovery Association Project: (503) 294-1681. 2 NW 2nd Ave., Portland OR 97209.
Alcohol & Drug Helpline (503) 244-1312 or (800) 923-HELP
Alcohol & Drug Youth Line (503) 244-1611
Narcotics Anonymous (503) 284-1787
Narcotics Abuse 24-Hour Helpline (800) 234-0420
Most heroin addicts interviewed for this article say that 12-step groups such as AA and NA are the cornerstone of their recovery. However, the traditions of such groups prohibit their members from publicly identifying themselves.
RAP is headquartered in the building that used to house WW'’s offices.
Alan Levine took his first shot of heroin by accident.
It was 1966 and he was 19 years old, a high-school dropout working on a New Jersey construction site. One day he asked two Spanish-speaking co-workers if they had any marijuana. Except he didn't say marijuana, he said "dope."
After work, they drove into New York City to score. It wasn't until Levine watched one of his friends empty a bag of white powder into a spoon, light a match, and draw it into a syringe that he realized he was out of his depth. But he was too proud to back out. His buddy injected the needle into Levine's vein, and a few seconds later, he felt the first rush of the drug blast into his consciousness. "I remember riding back in the car and saying to myself, 'This is the way I want to feel for the rest of my life,'" he says.
Levine's pride proved costly. Over the next three decades, Levine sank into the quicksand bog of addiction: heroin, cocaine, alcohol, amphetamines. The most degrading experience, he says, was not the time he robbed a bank, nor the numerous occasions when he stole cars, nor even his seven prison sentences. It was the night he camped beneath an overpass in Salt Lake City, when an unopened bottle of beer slipped out of his hand and rolled down the embankment. "It was like watching your child get hit by a truck," he says.
He climbed back down the slope, and as he neared the shards of glass, he could see a swallow of liquid glinting in the bottle's broken neck. And he thought to himself: "I'm going to have to do this right, or I'll lose a drop or two."
Levine bears many scars from his addiction. His right forearm is a twisted cacophony of muscle and sinew. His face is scuffed like an old baseball. Most notable, however, are his feet, which he keeps in his closet. Levine suffered severe frostbite in January 1987, after falling into a drug-induced stupor underneath a bridge near Joliet, Ill. Surgeons were forced to amputate.
Listening to Levine recount his story in his fast-paced Brooklyn accent, it's hard to believe the guy is still alive. But today, at the age of 54, Levine has been clean and sober for four years. He lives with his wife and dog in a Milwaukie apartment. He is an honor student at PSU, with a GPA of 3.93. He even has a new pair of feet--anatomically correct prostheses that allow him to walk, climb stairs and ride a bicycle.
It's not news that drug addicts can and do become productive members of society. But Alan Levine is more than that. He is also one of the leading members of an innovative organization known as the Recovery Association Project (RAP)--a bunch of ex-cons, former prostitutes and erstwhile junkies who may turn out to be Portland's most powerful weapon in its ongoing battle with the needle. The truth is, we need him.
One year ago, the Multnomah County medical examiner released a grim statistic: Among men aged 25-44, heroin had become a leading cause of death--surpassing homicide and suicide combined. Approximately 90 junkies succumbed to the needle in the first nine months of 1999, a jump of 41 percent over the previous year.
"If [the same number of] people were dying in Portland from salmonella poisoning, the federal government and the CDC would be parachuting in here with spacesuits," Ed Blackburn, the director of Hooper Detox, said at the time. "This problem can be solved if we have the political will to do it."
In some ways, Blackburn's optimism bordered on the delusional. Heroin addiction has proven to be one of the most intractable social problems of the past 40 years, seducing lit majors, lawyers, musicians and dock workers with equal nonchalance. While its users come from all walks of life, the vast majority arrive at the same destination: abject dependence.
"This drug fixes pain, fear, anxiety--everything," says Dr. Jim Thayer, the medical director at Hooper Detox. "That's an experience most people never have."
"Heroin is very seductive," says Dr. Dale Walker, director of the Division of Addictions at OHSU, who has worked with heroin addicts for 26 years. "It's like flipping a switch in the brain."
"When you have a habit, there are no holidays," says Jill Kahnert, 43, a former bartender who survived an addiction for nine years. "There are no days off. It's like being in a pit you don't know how you're going to claw your way out of."
Even if they manage to break the drug's grip and kick the habit for a few days, most heroin addicts quickly slide back to the drug: In Multnomah County, only half of them even make it through detox, and a mere 17 percent finish outpatient treatment, according to figures from the state Office of Alcohol and Drug Abuse Programs.
In addition to the insidious nature of the disease, heroin addiction just doesn't generate the same level of sympathy that issues like poverty or illiteracy do. Junkies are, by definition, criminals. In the final analysis, heroin is a self-inflicted wound, and overdose is the ultimate I-told-you-so for foolhardy thrill-seekers who think statistics happen to someone else.
At a WW staff meeting where this article was discussed, one writer summarized that view with disturbing candor: "So a bunch of junkies are dying. Who cares?"
These elements--the wretched seductiveness of the drug, the high rates of recidivism and a certain degree of public indifference--have bred a sort of collective resignation, a willingness to shrug off the sinister increase in drug fatalities so long as the victims are poor and criminals.
But one year after Blackburn's defiant challenge, the impossible has happened. Fatal heroin overdoses in Multnomah County are falling. In the first nine months of this year, 58 junkies died of an overdose--a decline of 36 percent from 1999.
"That's a remarkable drop," says Dr. Gary Oxman, the county's top public-health official. "Something positive is happening out there."
That something is not the result of cutting-edge technology, massive capital expenditures or armies of bureaucrats. Instead, heroin deaths have dropped, experts believe, because of the efforts of 20 former dope fiends like Alan Levine, who decided to do for junkies what the AARP has done for retirees--organize, agitate and generally raise hell.
The intersection of Northwest 2nd Avenue and Burnside Street has long been the epicenter of Portland's heroin trade, a zone where every greeting is ambiguous, every encounter freighted with double meaning. On a recent evening, a Latino man, shivering against the cold, stared at a passerby, his eyebrows cocked in silent solicitation. As the traffic barreled across the Burnside Bridge, two white kids slipped a couple of folded bills to a young woman. Her companion passed back a tiny balloon. The buyers scurried down a stairway littered with cigarette butts and decaying leaves. "Let's get out of here, man," said one, clutching a shopping bag from Meier & Frank. "I've had enough of this."
This neighborhood is also where Levine and the other members of RAP base their operations. Here, in a cramped room in the offices of Central City Concern, a social-service agency, the RAPsters first met in February 1999 to map out their strategy to reduce the death toll. "Everyone in the room knew someone who had died of an overdose," Levine says. "We had to do something."
Over the course of several months, RAP persuaded Multnomah County Chair Bev Stein to attack the problem on multiple levels. The county printed up posters warning inmates about the risk of heroin overdose (19 percent of overdose victims got out of jail less than 60 days before they died). Medical authorities instructed doctors to be wary of prescribing benzodiazepines to patients with a history of drug abuse (mixing heroin and benzos raises the risk of overdose). And outreach workers at detox centers and needle exchange sites launched a campaign to reassure junkies that it's safe to call 911 if a friend ODs, after a study showed that many addicts were afraid to call for fear of getting busted (in fact, Portland Police almost never make arrests on an overdose call).
"RAP was highly successful in getting the attention of elected officials, the bureaucracy and the public," says Oxman. "They really lit a fire."
At the same time, RAP was also attacking a more fundamental issue--junkies' distressing tendency to run back to the needle even after they get the monkey off their back. In particular, the group lobbied the county for an innovative mentoring program, run by Central City Concern, that pairs recovering junkies who have found the secret to staying clean with struggling addicts like Brian Young.
Young's career as a junkie began eight years ago, when he surprised a burglar in his house. During the ensuing scuffle, the intruder grabbed a flat-bladed screwdriver and stabbed it through Young's throat. He was in a coma for 48 hours, and spent the next week hooked up to a morphine pump. Every 15 minutes, he felt a delicious wave of euphoria flood through his body--and all he had to do was press a button.
The night he got out of the hospital, he took his first shot of heroin. "It's a compulsion," says Young, 41, whose rugged features, spiky mullet and hoop earrings make him look like a roadie for Creedence Clearwater Revival. "You do something that you know you shouldn't do, when you know you shouldn't do it, but you can't help yourself from doing it."
Young relocated to Eugene, where he immersed himself in the city's thriving heroin scene. His modus operandi was simple: home in on "pigeons," or inexperienced users, who came downtown to score heroin, and provide them dope at exorbitant prices, generating cash for his own fix. His habit eventually ballooned to 6 grams of heroin a day--enough to kill a novice user many times over. He was arrested more than 40 times over the next eight years.
On the morning of Sept. 23, 1999, Young stood in line outside Hooper Detox, clutching a bag of dirty clothes. Over and over again, the same thought kept running through his head. "I feel like shit and my life is fucked."
After eight agonizing nights in Hooper, sweating and moaning through acute withdrawal, Young felt better--physically, at least. But the real challenge was still ahead. Because the truth was, Young had kicked junk on scores of previous occasions. He had been through detox or treatment at least a dozen times. "I never knew what to do when the treatment ends," he says. "It's like I'm the Riddler and my whole life is nothing but a green suit with a question mark. I've got no job skills, no rental history, no income. What do I do?"
But there was something different this time. Young had signed up for a brand-new mentoring program, the one that RAP spent months lobbying for. As he stood in the center's lobby, waiting for a ride, Young wondered what to expect--after all, he had manipulated well-meaning counselors in the past. Young's mentor, however, was not a frazzled social worker or a college student on an internship. She was a 38-year-old ex-junkie named Kim.
Kim Matic has the kind of steel-blue eyes that could pierce the armor of a Sherman tank. An addict from the age of 19, she fed her habit by turning tricks on the Burnside Bridge. One winter's day, she climbed into a pickup truck with a john who took an unusual interest in her feet. As he drove out to Molalla, she agreed to let him tie her up. Then something gave her a creepy feeling, and she persuaded him to let her go. Later she recognized his face from news reports. He was Dayton Leroy Rogers, the notorious killer who murdered and mutilated eight women, including seven prostitutes, near the Molalla River in 1987, and who is now on death row at the Oregon State Penitentiary.
When Matic picked up Young at Hooper Detox, she had his number from the start. "He was so full of shit he couldn't see straight," says Matic, who has been clean for seven years. "I told him, 'You might be fooling yourself, but you're not fooling me.'"
Matic drove Young across the river to the Danmoore Hotel, a 122-bed drug-and-alcohol-free community, where he checked into a room on the third floor. She took him to the Salvation Army for a box of groceries and some pots and pans. She helped him sign up for acupuncture, a bus pass and the Oregon Health Plan. She took him to 12-step meetings. She even took him and her other "mentees" to movies.
These things sound trivial--even absurd. But addiction experts say they are precisely the sort of minor tasks that newly recovering addicts cannot seem to accomplish on their own. "When you're fresh in recovery, everyday things seem like gigantic obstacles," says Randy Sorvisto, another mentor. "It's like a brick wall, and every brick represents a responsibility. I look at that wall and I look at all those problems and I can't figure out how to do it. Getting on food stamps. Getting a counselor. Joining a gym. And you think, 'If I did one hit of dope, I'd feel better, and I could do all this.'"
Today, Brian Young works as a computer support technician and lives in the Shoreline Apartments, next door to RAP's headquarters. He has been clean for 14 months--and credits Matic with playing an integral role in his recovery. "She is an incredibly strong woman," he says. "It was real clear to me it wasn't worth bullshitting her, because she knows the game."
The mentor program, which has so far served almost 200 clients, is no panacea--heroin addiction is, after all, an incurable disease--and is no substitute for 12-step meetings. But when allied with acupuncture, and drug-and-alcohol-free housing, the mentors can make a big difference. According to preliminary figures, the mentoring program has almost tripled the number of junkies who are still clean at six months, from 16 percent to 42 percent. "It's outstanding what they've done," says Hooper's Dr. Thayer.
For all RAP's successes, it still faces extraordinary challenges. Last summer, Greg Forgrave, a recovering heroin addict who had been active in RAP, died of an overdose. He had been clean nine months. Forgrave's death was like a two-by-four across the face for the fledgling organization. "I wanted to scream and nothing came out," says Young, who was one of Forgrave's closest friends. "I wanted to cry and didn't know how."
Forgrave's death underscored the insidious nature of heroin addiction; it also highlights the peculiar paradox facing an organization made up of ex-junkies. On one hand, in order to put a face on the statistics, RAP members have decided to go public with their stories. But there is always the risk that an individual member will relapse. "We're always talking about this," says Levine. "What if we stick our neck in the noose and screw up? We're human beings. We're afraid. But somebody's got to do this. Somebody's got to take the risk. People are dying. It's as simple as that."
[[Orginally published in Willamette Week, December 5, 2000.]]