OxyContin & Heroin Abuse

That first hit of heroin didn't feel like a turning point to him. The all-American-looking Lynn teen, a prescription drug abuser since junior high, didn't feel like he was slipping into a pit as he snorted heroin for the first time on a Friday evening last spring. Most of his buddies already had switched to smack to save money. ``I couldn't afford OxyContin anymore. A couple of friends had heroin. I did it with their father and them,'' recalled the 19-year-old recovering
addict, who's been clean for three months, but didn't want his name used for fear of inflicting more pain on his family.
Thanks to a chillingly sophisticated marketing strategy devised by South American drug lords, heroin has moved from back alley shooting galleries to suburban schools - from junkies to jocks. Fatal opiate overdoses among teens and young adults have tripled in Massachusetts over a four-year period. Hospitalizations have doubled. Today's heroin is dirt cheap, pure enough to snort and it's hooking kids barely into their teens across the state. ``It can happen to anyone's kids. Don't for one minute think I'm not worried about my kids getting hooked up on heroin,'' said Lowell police Capt. Robert DeMoura. Every day of the week, Project Rebound gets about 10 calls from parents
and social workers trying to get a child a bed at the Boston rehab program for teens. ``We get a lot of calls for kids 15 to 17. We get some younger than that. The youngest was 13,'' said Director Earl Dandy. ``A drug dealer don't
ask their age.'' In 2002, Massachusetts emergency rooms treated more than 2,000 people between the ages of 15 and 24 for opiate overdoses and withdrawal, state figures show. DeMoura, the Lowell cop, once caught red-handed a young man breaking into a minivan for drug money. The veteran cop was shocked to recognize the strung-out thief as a former member of a youth wrestling team he coached. ``Talk about breaking your heart,'' DeMoura said. ``He started crying. He said, `Coach, I was using heroin in high school. I can't stop. It's killing me.' ''Death toll  Across the state, in affluent suburbs and hardscrabble cities, teens still in puberty are addicted to cheap, super-pure Colombian heroin. The
body count is rising at a staggering rate. Fatal opiate overdoses among Massachusetts residents 15 to 24 years of
age tripled between 1998 and 2001, skyrocketing from 17 to 54 in just three years. Opiate-related hospitalizations, mostly from heroin and OxyContin, have more than doubled from 1,174 to 2,532 in the same age range, according
to figures compiled by the state Department of Public Health. The department closely monitors rehab admissions, emergency-room visits, overdoses and hospital discharge data. ``In all of those indicators we are seeing significant increased use of heroin and OxyContin, particularly among younger kids,'' said Michael Botticelli, assistant commissioner for substance abuse. ``We're hearing that kids are moving very quickly from OxyContin to heroin.''
Botticelli suspects the available statistics actually low-ball the problem because family and some emergency room doctors are reluctant to report heroin overdoses among kids. It's not at all unusual for Lowell police Sgt. James Trudel to deal with heroin abusers as young as 14 and 15, many of them from middle-class families living outside the city, he said. Dr. Punyamurtula Kishore, an addiction medicine specialist and founder of the National Library of Addictions in Brookline, has treated half a dozen heroin addicts in their early teens over the last year. ``I'm very sad to report we've had a couple of incidents of young people who tried heroin for one and only one time and it was lethal,'' said Essex District Attorney Jonathan Blodgett, who recently attended the funeral of a 19-year-old overdose victim from Peabody.
Kids who get hooked on opiates by experimenting with trendy OxyContin - a prescription painkiller that sells illicitly for as much as $80 for an 80 milligram tablet - often have to switch to $4-a-dose heroin when the opiate addiction gets its claws in them. ``We're seeing a tremendous amount of people outside the city in suburban high schools starting to use OxyContin and heroin,'' said Trudel, the Lowell narcotics officer. He figures roughly four in 10 drug arrests in
Lowell are of young people coming in from the suburbs looking to buy heroin. `It was horrible' The recovering teen addict from Lynn said he started experimenting with pot and booze at 10 years old. In eighth grade, he scored a pill he thought was just another prescription painkiller, like the Percocets he liked to pop. ``I thought I was in heaven. I felt great,'' he recalled. He had chewed up an 80 milligram OxyContin pill, a synthetic opiate often prescribed for seriously ill patients. ``From there, I basically just started rolling downhill. It started getting bad, doing them every single day,'' he said. ``I was selling them at first, then when I fell off that I had to start stealing and robbing. It was horrible, you know.''
He was hospitalized for several months at 15, but went right back to drugs when he got out. By the time he was 18, he had switched from OxyContin to heroin because he could no longer afford the ``OC 80s'' he needed all the time to keep from getting unbearably sick. When he couldn't get any smack, he laid in bed writhing in agony. ``When I did have it, I'd do it the first thing before I even got out of bed,'' he said. Before turning to heroin, he had to snort two crushed up OxyContin tablets as soon as he woke up. ``One in each nostril. Just to get myself out of bed and take a shower.
Like someone drinks coffee,'' he recalled, sounding astonished at himself. ``I had to lean over to do it, and it hurt just to lean over.'' Last fall, he lost his big sister to a fatal heroin overdose. Two months later he went to his parents for help and got into rehab. He estimates he spent six figures on drugs, most of it money he made dealing. Some of it stolen from his family. ``Most of my friends are in jail right now,'' he said. ``Some of them are dead. It sucks. I have to fight every day to stay clean.''

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Would Hydrocodone be a good maintenance medication such as Methadone (Dolophine) for long term addicted adults? Although hydrocodone is a short acting opiate it has been reported that many chronic opiate and alcohol addicts are maintaining very well on relatively low doses of  hydrocodone (up to 60mg/day) sometimes combined with anti-anxiety agents such as Diazepam (Valium), Alprazolam (Xanax) or Oxazepam (Serax); in medical studies hydrocodone has proven to cause less physical dependence than Heroin, Oxycontin, Methadone or Dilauded. It is recommended that the treatment of chronic opiate and alcohol addicts with hydrocodone is done under supervision as there is a fairly high possibility that the patient will start self medicating.