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Craig Mastantuono July 21, 2014

This is the question I've been finding myself asking young people more and more lately. Increasingly, I find myself representing opioid/heroin addicts, usually young, who end up in my office because they have been caught with heroin, the current #1 nasty epidemic drug in our community, or because they've committed a crime to support their heroin addiction. I want to know how they got on the path that led them to inject a needle into their body filled with street-sold heroin. How they got on the path that ultimately led them to our law office.

A common theme winds through their stories: it seems like they all started by using prescription oxycodone. Oxycodone, or "oxy", is a prescription drug typically used for medical purposes to treat pain; it is an opioid, a synthetic narcotic. Unfortunately, oxycodone is also used recreationally because of the euphoric feeling it produces, as well as its ability to numb its user from any physical and emotional pain. Our clients started out this way, grinding up prescription oxy and snorting it. Some of the feelings our clients describe when they did that for the first time are "great", "in the womb", and "the best feeling I ever had in my life." Users of oxy, opiods and heroin want to check out, to feel numb, to not have to deal with life. According to one pharmacist we consulted with recently, 80-milligram oxycontin (oxycodone) pills were widely available in the 90's and 00's, routinely over-prescribed by doctors to manage pain. As a result, they became quite plentiful on the street, selling for a dollar per milligram. Among young people, oxy use exploded; it was out of your parents' medicine cabinet and into the party scene. When "80's" weren't available, 15 and 30-milligram pills were also used. The pharmacist told us that when the Drug Enforcement Administration and the medical community woke up and realized that the Oxycodone over-prescribing practice was leading to rampant abuse, they tightened up prescriptions in response to rising opiod addition. But by then, it was too late, and a lot of people were hooked. When diverted oxy was no longer plentiful on the street, addicts turned to readily available heroin. No longer grinding up and snorting nice neat pain pills, heroin users buy brown powder and snort it, or eventually, cook it, syringe it, and inject it.

It's just astounding how many young people we've spoken to in the last two years who are hooked on heroin. The addiction is particularly strong and pernicious. People addicted to heroin will do things like commit robberies and major theft to keep their habit going. Crisis-shocked parents bring their sons and daughters to our office, addicted to heroin and charged with crimes, looking for help. Our clients tell us of carrying Narcan syringes for fast action when they overdose; time of your life, right? Relapse during recovery is frequent, and overdose deaths are common. Scarce resources are spent in high amounts within the criminal justice system to try to treat and rehabilitate defendants who commit crime as a result of addiction, money for pre-trial service agents, court personnel, drug treatment courts, lawyers, and judges. And even with all of this, lasting success rates are difficult to achieve. Heroin addiction is not limited to any particular geographic area or socioeconomic class. Most of our heroin-addicted clients are white kids from the suburbs.

Some people have noted that the recent spike in attention to the problem is because of that very fact: that the white kids are dying, rather than the central city black or brown children. That may or may not be and is worth further discussion, but here at our law firm, we see this problem as a very real one, that presents its own unique and quite difficult challenges, and that is catching law enforcement and courts without an effective solution. It's common at drug treatment court meetings to hear prosecutors, defense attorneys, the judge, and pre-trial workers talk about how they lost another young client to an overdose death, or how they have to pull the intervention plug and send another person to prison because of continued drug use and criminal behavior. We're not going to imprison our way out of the problem, rehabilitative efforts are costly and have varying success rates, and young people continue to go to jail, or die on the street. No easy answers here either, as our experiences with our own clients have us learning from experience and adjusting as we go. But one thing has become clear to us: how did our clients start using heroin? By graduating to it from legally prescribed pain pills.