Bruce never dreamed he’d live in a dingy, roach-infested downtown apartment, let alone be evicted from one.
But the money he scrapes up working at odd jobs and collecting aluminum cans doesn’t go for rent. It fills two needles with heroin - one for Bruce, one for his wife.
“We haven’t fallen into the thieving thing - I can’t do that - but a lot of people do,” he says.
Bruce, who spoke about his addiction on the condition his last name not be printed, says he desperately wants to quit heroin.
In January, he went to the Spokane County Health District building and asked for help.
He’s been on a waiting list for the methadone program for heroin addicts ever since.
Methadone is a controversial synthetic narcotic that serves as a heroin substitute. Its purpose is to wean people from heroin, although in Spokane, no one has tracked methadone users to find out how many successfully have quit.
County health workers point to people like Bruce, 37, when explaining why they want to expand their program, one of the smallest in the state.
“We cannot admit another person until someone leaves,” says John Harris, who supervises the program. “I’m telling (applicants) they should be thinking three, four, maybe even six months.”
Heroin use is at an all-time high in Spokane, and although it is not as prevalent as crack cocaine, it is making its mark on the community, health officials say. Medical costs are higher among heroin users, who also commit more crimes, say health workers.
It also is affecting the methadone pro gram, which is stretched to capacity at 69 men and women, says Harris.
“We would like to be able to meet the needs of the community,” he says. “I’d like to see this program expand to 100 or 125 within one or two years.”
Bruce and his wife are No. 6 and No. 8 on a waiting list of 17 people.
They know what to expect when they get to the top. Six days a week, they’ll join a line of people waiting to swallow doses of the reddish liquid. They’ll get weekly counseling.
Their doses of methadone will be gradually reduced; ideally, they’ll stop altogether someday.
Nearly a third of participants pay fees of about $200 per month, and the remainder pay with Medicaid coupons or get free services, says Harris. Spokane County’s program also gets just under $300,000 in state and federal money every two years.
McIntyre says he hasn’t decided how much more money he’ll request this year, although he wants at least enough to hire another counselor.
Methadone programs have always been controversial, criticized by some as simply switching addictions to a legal drug.
“There are some legislators who don’t like giving drugs to drug addicts, as they put it,” says Ken Stark, director of the state health department’s methadone division.
One lawmaker proposed getting rid of government-run methadone programs altogether this year. The bill by Sen. Jim Hargrove, D-Hoquiam, didn’t make it out of the Senate Human Services and Corrections Committee.
Don McIntyre, director of the Spokane program, says methadone doesn’t deserve a bad reputation.
“It’s non-euphoric,” he says. “It’s a proper medical procedure. As a medicine itself, it stops withdrawal symptoms and blocks effects of other narcotics.”
Stark says getting people off heroin also lowers crime and medical costs.
A recent University of Washington study showed emergency room visits dropped dramatically after methadone treatment, from 130 visits per 1,000 drug addicts during the year before treatment to 6 per 1,000 by the end of treatment.
That study didn’t include people in Spokane’s program, which is one of eight in the state.
A clinic in Yakima treats about 62 people. Those in Pierce and King Counties are much larger, treating up to 350 people.
Spokane County has run its methadone program since 1990, when another 10-year-old clinic closed. The county program started with 35 people and has since nearly doubled.
The average participant, says McIntyre, is 40, but the program includes people in their early 20s and a 58-year-old man.
About half are women. A third are working or in school, a third are raising children on public assistance, and a third are disabled.
Just over half have decreased their doses of methadone. About 34 percent are out of the program within six months; 54 percent leave within a year.
People who don’t take the program seriously are booted, says McIntyre. They’re out if they skip too many counseling sessions or if drugs show up in their urinalyses too often.
No one knows how many people actually quit heroin for good, says Harris. “We haven’t done follow-up studies on our discharges.”
If the program continues growing, Harris says those studies might be done. Nor does anyone know just how much heroin is in Spokane. It’s not as immediate a concern to Spokane police as other more prevalent drugs, such as crack cocaine.
Police statistics show heroin arrests have gone from 15 in 1992 to 35 in 1994, while crack arrests went from 156 to 576, says Lt. Steve Braun.
“Heroin isn’t one of the drugs targeted as a big threat.”
Health officials say people in the methadone program tell them there are more dealers and users than ever in Spokane. “There’s a lot more heroin around than people think,” says Bruce.
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