Heroin supplied by Mexican drug traffickers is taking a toll on New Mexico, leading to high rates of drug overdose deaths and prompting the state to take some controversial approaches to addressing heroin addiction.
When Jennifer Weiss-Burke found out that her son was addicted to heroin, she was shocked. "I had no idea that heroin was a problem," she told InSight Crime. "Last I'd heard heroin was some 1970s drug that some homeless dude would do. I had no idea what heroin addiction looked like."
All she knew was that something was wrong. Her son Cameron was acting strangely, his grades were dropping, and his moods were different. She took him to several different counselors and eventually learned the truth: he had become addicted to prescription painkillers after a wrestling injury and had switched to heroin because it was easier to get.
After she found out about Cameron's addiction, Weiss-Burke met with other concerned parents and grandparents and formed a non-profit organization, called Healing Addiction in our Community (HAC), in her living room. She also sent Cameron to treatment centers, multiple times, but nothing seemed to have a lasting effect. "It's like an insidious disease," Weiss-Burke said of heroin addiction. "It just keeps coming back."
In August 2011, Cameron died from a heroin overdose at the age of 18, before he had had the chance to graduate from high school. Several of Cameron's friends who struggled with heroin addiction have also passed away. One committed suicide, one was killed in a drug bust, and the others overdosed. "There are only a few who got involved in heroin who are still alive and are doing well," Weiss-Burke said.
{module Heroin Use in New Mexico}
Multi-Generational Drug Use
Between 1992 and 2013, New Mexico occupied the top spot for drug overdose deaths nationwide, with the exception of only three years. In 2013, New Mexico had a drug overdose death rate of about 22 per 100,000, behind only West Virginia and Kentucky, according to CDC figures (see map).
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The New Mexico Department of Health told InSight Crime that statewide, 135 people died of heroin overdoses in 2013, which combined with prescription opiate abuse accounted for the vast majority of the state's 458 drug-related overdose deaths.
According to figures from New Mexico's Department of Health, the rate of heroin overdose deaths among state residents was 7 per 100,000 in 2013, over three times the national rate.
Some regions of New Mexico have been harder hit than others. The city of Española, about a 30-minute drive north of state capital Santa Fe, has seen drug-related deaths reach a rate of 42.5 per 100,000 in recent years. When the other towns in the county are added into the equation, that number hits 62 per 100,000.
What makes New Mexico's struggle against heroin addiction particularly difficult is the prevalence of multi-generational heroin use in families. "There seems to be, in parts of New Mexico, kind of a generational acceptance of heroin use," Sean Waite, the DEA Assistant Special Agent in charge of the Albuquerque District Office, told InSight Crime. "You see families who have had generations of family members who are addicted to heroin and it seems to be something that propagates itself."
Weiss-Burke echoed this statement. "I've heard stories of grandparents injecting their grandkids with heroin at 11 or 12 years old," she said. "It's almost like a rite of passage."
Natural Recovery
When Demian Rubalcaba first tried heroin at age 23, a friend told him he was smoking opium, which didn't seem dangerous. "I honestly never would have done heroin," he told InSight Crime. "Heroin was for junkies and bikers and street people and stuff like that. I would have never tried it."
After that, Rubalcaba was hooked. The drug, he said, "trains [your brain] to think that you need heroin like you need water."
"I need to use not to hurt, but the more I use to not hurt, the more I hurt," Rubalcaba said, explaining the mentality. "It's just around and around and around and around and that's why we get stuck in there. Some of us forever. Some of us die from that."
Rubalcaba spent the next five or six years struggling with his addiction, doing whatever he could to get cash, and exchanging guns for drugs when he didn't have the money. He got to the point where he was living in his truck, smoking about a gram or a gram and a half of heroin a day, cycling in and out of jail.
SEE ALSO: Coverage of Heroin
Then, at the beginning of what he estimates was probably his tenth or fifteenth stint in jail, Rubalcaba decided that he'd had enough. "I just got sick of it," he said. "I'd been sick of it for a long time and I finally got to a place where I could just finally put it down."
Getting off heroin meant going through withdrawal in the 6 by 11 foot cell Rubalcaba shared with two other inmates, curled up in a bed, and vomiting. After that, he said, he "never went back."
Now, Rubalcaba is a licensed social worker and helps coordinate the regional Smart Recovery addiction support group, an alternative to the traditional 12-step program. He hasn't touched heroin for at least nine years.
Like Rubalcaba, there are some users who undergo what addiction specialists refer to as a "natural recovery" -- they get so sick of everything heroin use entails that they finally stop. But not everyone is so lucky, which is why, alongside law enforcement efforts to crack down on heroin trafficking, New Mexico has implemented some of the most progressive harm reduction policies in the United States.
Harm Reduction
At the Casa de Salud clinic in Albuquerque's South Valley neighborhood, Emily Pollock dispenses syringes and small metal containers used to prepare heroin, known as "cookers," to a steady stream of drug users. She estimates that in an average month, Casa de Salud's needle exchange program distributes up to 30,000 syringes, which are kept in boxes stacked at the back of the clinic, in a tiny room cordoned off with a brown curtain.
Pollock also provides heroin users with informational pamphlets that describe the most sanitary ways to inject the drug -- including using urine "in extreme cases" to disinfect the injection site -- and different materials, like belts or elastic underwear bands, that can be utilized as tourniquets in a pinch. Additionally, she teaches users how to administer naloxone, which can prevent heroin overdose deaths. But what Pollock won't do is push users to get clean.
"We don't want any of the clients to feel like they're being judged," she said, seated in a chair facing four bright red biohazard bins. "Telling them something they're not interested in and don't want to hear [?] is not something that's going to make this a safe place for them to keep coming back to."
In an effort to combat the state's opiate abuse problem, New Mexico has taken some controversial approaches to reducing the harm caused by heroin use. In 2007, New Mexico passed the country's first law protecting drug users who call 911, or who take an overdosing friend or family member to the hospital, from being prosecuted for drug possession. That same year, the state also started giving out naloxone in a nasal spray form, which has not been approved by the Food and Drug Administration (FDA) and is therefore not available in most states.
SEE ALSO: Coverage of Drug Policy
New Mexico also has numerous programs to help wean drug users off of heroin using Suboxone and Methadone, opioids that are administered in a clinical setting under medical supervision. Although these drugs can act as milder substitutes for heroin and help users avoid withdrawal symptoms, there are limits on the number of patients to whom doctors can prescribe Suboxone, creating a black market for the medication.
One advantage to using these drugs, when they are available legally, is that they keep heroin users away from the lifestyle that in many cases perpetuates their addiction.
"Methadone lets you have a stable life," Rubalcaba said. "You're not going and getting your drug from a dealer, you're not meeting weird people in weird places, doing this clandestine, outlaw stuff. You're going to a medical environment and you're getting it at a certain time."
Law Enforcement Assisted Diversion
On a snowy January afternoon, about a dozen law enforcement professionals, health care workers, addiction specialists, and representatives from the district attorney's office gathered in the Santa Fe Police Department to discuss a program designed to keep opiate users out of the criminal justice system.
Known as Law Enforcement Assisted Diversion (LEAD), the program is modeled after a similar initiative in Seattle, Washington and offers opiate users who end up in legal trouble, or have been referred to the program, a range of alternative treatment options instead of jail time.
Captain Jerome Sanchez, who helps run LEAD, told InSight Crime that before implementing the program in April 2014, the city calculated that over a three-year period prosecuting and jailing those who commit property crimes like house robberies -- usually in order to pay for their addiction -- cost the city around $4 million. With the LEAD program, however, the city can treat opiate users for between $5,000 and $10,000 a year, compared to about $40,000 a year to keep that person locked up, he said.
"We're not going to arrest our way out of this problem," Sanchez said. "Simply putting people in jail is not the answer. We need to treat the addiction."
At the moment, there are fourteen people in the LEAD program, and the facilitators hope that this number will grow to 25 by the end of February 2015. Andrew Gonzales, one of around 20 police officers who have been trained to participate in LEAD, told InSight Crime that so far, he has referred two opiate users to the program. One of them was caught shoplifting at a retail store, and confessed to Gonzales that he was stealing to pay for his heroin use.
Gonzales spoke positively of the initiative's potential for helping drug users. "If we get them help, chances are they're going to stop doing these crimes," he said. "And we're going to stop having to deal with them again, taking them to jail, they get released, they go through the same thing."
Captain Sanchez said that while it is still too early to measure the initiative's impact on Santa Fe crime rates, none of the participants have reoffended since they entered the program.
Yvette Medina, herself a former crack cocaine user, is a peer support specialist for seven people currently participating in the program. One woman in LEAD has gone from selling heroin and meth to living with her children and attending school, Medina said. "There are cases that don't [get better]," she acknowledged. "But I've seen people from the bottom of heroin addiction and they're totally where I am today."
"I was a crack addict, totally living in my car, went to prison. I've done every single thing that these people are doing, and I'm on the other side now," Medina said, smiling. "It's beautiful. There's hope."
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