‘Once you’re addicted to heroin, you have to have it every day.’

     — BARBARA FIELDING

     addiction counselor

     

     THE RISE IS fueled by users who snort and smoke heroin — proof, experts say, that these methods can be just as addictive as injecting the drug with needles.

      The number of treatment center admissions for heroin and other opiates rose by 29 percent — up from 180,000 to 232,000 — between 1992 and 1997, the report found.

      Cocaine, meanwhile, offered some good news: In that same five-year period, cocaine admissions declined by 17 percent from 267,000 to 222,000, the report said.

      Alcohol abuse remains the most common reason people seek help, although it is not as dominant as it once was, according to the annual report of treatment trends by the Substance Abuse and Mental Health Services Administration, a branch of the Department of Health and Human Services.

      While other surveys indicate marijuana is by far the most popular illegal drug, it accounted for just 13 percent of admissions to treatment centers in 1997, the most recent year for which data are available.

      The report, which includes data from about two-thirds of the nation’s drug and alcohol admissions, also details demographic and geographic trends.

     It finds heroin treatments were concentrated in the Far West and Northeast.

     Methamphetamine, meanwhile, has spread from the West into the nation’s heartland.

      About 16 percent of the 1.5 million treatment admissions in 1997 were for heroin and other opiates, compared with 15 percent for cocaine, marking the first time since 1992 that heroin has surpassed cocaine.

     

     HEROIN CHIC NOT SO SEXY

      “People who are using heroin are discovering it is, in fact, a dangerous drug,” said Dr. H. Westley Clark, director of the Center for Substance Abuse Treatment at HHS. Fashion magazines have been accused of glamorizing heroin through use of strung-out-looking models. “Heroin chic — there’s a down side to it,” he said.

      The perception on the street has been that heroin is only dangerous when it’s injected, Clark said, and injecting drugs does add the risk of contracting the HIV virus or hepatitis.

      “Snorting and smoking was something that people could accept as less dangerous — ‘You can’t get as hooked, it’s not as bad,”’ he said. “A number of individuals are realizing that is not the case.”

      Barbara Fielding, counseling manager at a treatment center in Rockville, Md., said heroin can be more devastating because people generally “binge” on cocaine, using it only periodically but in great quantities.

      “Once you’re addicted to heroin, you have to have it every day,” Fielding explained. “Every day, they have to figure out how they’re going to get the money for that heroin.”

      The survey only includes programs that receive some HHS or state funding. Privately funded centers such as Fielding’s are not included, nor are some funded by other federal agencies.

      Still, experts believe the report provides a good look at changing patterns of treatment, and it is the most complete study on the subject available.

      The report provides a striking look at the geographic distribution of drug use, particularly methamphetamine, also known as “speed,” “crank,” “crystal” and “ice.” Nationally, it accounted for 5 percent of treatment admissions in 1997, up from 2 percent in 1992. During the same years, it showed a distinct movement from the West Coast into the Midwest.

      In 1992, only California and Nevada had more than 50 admissions. By 1997, there were that many across the Northwest and into Iowa, Missouri, Arkansas, Kansas, Nebraska and Utah.

      “We call it the methamphetamine plague,” said Alan Leshner, director of the National Institute on Drug Abuse. “It’s spreading like an infectious disease across the country.”