Kicking heroin is no easy feat
Getting heroin is easy. Getting off of it is not.
Javier H. would know. The 27-year-old from Santa Cruz has been hooked for 10 years. Having failed a slew of treatment programs, he's hoping his current stint at the Si Se Puede residential facility will change his life for the better, and change it for good.
"I hope this will be it, man," he said during an interview last month at the Watsonville complex, the name of which means "Yes You Can."
To protect the confidentiality of the residents' families, the Sentinel agreed to use only the first initial of residents' last names.
"I've had my wild side and it's time to move on. I know if I keep going back, it's prison or death," he said.
Heroin addicts tell of the deep physical pain and mental anguish involved in detoxifying and recovering from the highly addictive opiate. Withdrawal symptoms are so immediate, sometimes within hours of the last hit, that the cycle of highs and lows is often too tough to break.
Last year, heroin use reclaimed its spot as the top addiction treated by county programs. Nearly 29 percent of the 2,287 clients of residential and outpatient programs in the 2009 were heroin addicts, up from 24 percent in 2008 and 21 percent in 2007.
During the past three years, 59 out of Si Se Puede's 251 residents, or 24 percent, were treated primarily for heroin addiction. Thirty-six percent of those treated for heroin completed the program. As oflast week, the three Si Se Puede clients interviewed for this article were still enrolled.
Rates of heroin treatment and completion are similar at Si Se Puede's co-ed counterpart, Santa Cruz Residential Recovery. Since 2006, the two-month program has treated 110 of 557 total residents, or 20 percent, primarily for heroin. Thirty-five percent of heroin addicts completed the program.
Besides residential treatment services, the county offers counseling in two outpatient programs and serves people from a variety of ethnic, economic and educational backgrounds. Alto, which runs court programs for substance abuse and drunken driving, has services in North and South County in English and Spanish. The Fenix program in Watsonville offers drug and alcohol treatment for individuals and families. Heroin addicts also can get treatment and counseling at a methadone clinic operated by Janus near the county health campus on Emeline Avenue.
It's been five years since heroin was the county's top drug. Methamphetamine and alcohol treatment numbers have been higher in recent years, but experts say heroin's relatively low cost and the county's long-standing reputation as a heroin highway have kept the drug's presence strong.
Authorities say a gram of heroin costs about $80. In Pogonip, a Santa Cruz park, one-tenth of a gram -- or about one hit -- costs $10.
"Santa Cruz has always had this baseline of heroin addicts, and that continues to be true," said Will O'Sullivan, director of the recovery services division at the Santa Cruz Community Counseling Center, which oversees Si Se Puede.
"We had a meth scourge, and it was and is a huge problem," O'Sullivan said. "But throughout, heroin was always there. It's been over time a really steady population."
O'Sullivan said people who seek recovery have often been addicted for years. Those he's counseled have described the euphoric "Superman effect" of the drug that gets harder and harder to attain the longer they use.
"The euphoric feeling subsides and the addiction and craving begins -- it's all about feeding the flames," O'Sullivan said. "They're finally getting treatment either because their hand is being forced or they finally run out of all other options and decided they have to."
Some have to overcome long-term denial that they even have a problem, he said.
"You've been rationalizing for all these years that it's not as bad as you thought, that it's something you've got under control and it's not ruining your life," O'Sullivan said. "Ultimately, you have to face the fact that it is and you've been deluding yourself, and have to come to grips with that."
YES YOU CAN'
Treatment experts say heroin users come from all types of backgrounds, professionals to young people, poor to wealthy. Besides the Pogonip and Highway 9 corridor in Santa Cruz, the river levee in Watsonville as well as South County's agricultural fields have historically been hot spots for buying and using the drug.
That's where Si Se Puede's director, Jorge Sanchez, started using the opiate when he was 15. Now 23 years clean, Sanchez, who immigrated with his parents from Mexico, remembers shooting up to soothe aches that stemmed from picking lettuce and packing it onto trucks. Heroin also gave him the energy to pack faster, which meant more income for fieldworkers who were then paid by the piece.
"It would kill all the pain," said Sanchez. "Later, it just became a way of life."
But as he has seen all too many times, it's also a way of death. Several of Sanchez's relatives died from heroin overdoses, and men currently enrolled in his program have overdosed or know someone who has.
Juan H., whose current stay at Si Se Puede started in March, has overdosed twice and nearly lost his brother to an overdose in 2007.
Juan said his brother introduced him to heroin when he was 13. When smoking it didn't get him high enough, the Watsonville native started injecting it.
Ten years after his first hit, the veins in his arm have disappeared from being overtapped, and he's been in and out of jail or treatment, including a previous stint at Si Se Puede, numerous times. He fled his home when authorities responded to his brother's overdose because he was afraid he'd get busted for skipping out of court-ordered treatment.
He said he's broken into homes to steal cash or possessions, whatever he could get his hands on for dope money. His trick was to call numbers in the phone book, and if no one answered, he'd call their neighbors. If no one seemed around, he'd break in.
"The only thing I worried about was just having that drug in the morning," he said.
At Si Se Puede, which turns 20 next year, up to 23 residents live for three to six months in rooms with four to six bunk beds.
The residents, who are monitored 24 hours a day, are responsible for cleaning, cooking and tending to the garden, where they grow cucumbers, jalapenos and cauliflower. Men who are further along in the program can leave for work during the day, and residents are allowed to visit with families occasionally.
The men-only program -- which is designed to address cultural connections that accompany drug use and gang membership in the Latino community -- is strict and heavily structured. Besides getting clients off drugs, the goal of Si Se Puede is to teach the importance of personal accountability.
"I want our clients to look in the mirror and say, I am changing,'" said director Sanchez.
THE COST IS GREAT
But recovery isn't easy or cheap.
Residential treatment programs cost $3,300 a month, which includes shelter, food and services such as mental health and counseling. Clients are asked to pay about 10 percent of that. By comparison, outpatient programs cost $75 per hour with fees applied on a sliding scale.
The cost of both kinds of treatment could go up as the county grapples with the state's failure to fund drug-treatment programs. Other programs have been closed in recent years due to the defunding of Proposition 36 and other initiatives designed to curb drug use.
Si Se Puede clients, 90 percent of whom come from jail, have to be clean for 72 hours before they arrive, which means detoxifying behind bars, at home or on the streets -- a process that means facing deep bone pain and other flu-like symptoms for days. Hot showers and acupuncture help, but Sanchez said the biggest enemy is a user's own mind, which repeatedly sends the message that getting high will erase the pain.
"Once I started, I liked the high, but then, I couldn't let go of it," said Javier, who grew up in Beach Flats and has been in and out of jail since 2002. "It makes you keep using, even if you don't want to. Your body will make you want to use."
Si Se Puede residents told of buying heroin from dealers who would meet them in market parking lots or other public places. They avoided well-known hot spots like Pogonip or the river levees because that's where cops know to look.
"The risk isn't buying from strangers; the risk is encountering the law and not getting your fix," said Javier, his decaying teeth showing the signs of smoking heroin. "Then you have to go to jail and kick."
Ryan G., a 22-year-old from Aptos, started taking pills five years ago before graduating to heroin. The withdrawal symptoms are so bad he couldn't quit. "I have no veins left," he said.
Failed recovery attempts here and out of state have been stressful for loved ones, he said. He's been to The Camp in Scotts Valley twice and is making a second go at Si Se Puede.
Diane Nieto, a former addict from Watsonville and a family friend of Juan H., said failing is part of the process of recovery. Nieto graduated from Hermanas, a women's drug treatment program that closed last year due to state funding cuts. She started using heroin at 14 to ease the pain of low self-esteem.
"It is so easy to get, so easy to fall into it," she said, adding that she smoked heroin for two years before injecting it. "I didn't know how to express myself."
Nieto, 27, who said she once overdosed in Juan's living room, has been clean for more than 18 months. She writes letters of encouragement to Juan at Si Se Puede and offers support to his family.
"I'm trying to convince his mom to still have faith and be patient, that something will work out," she said. "I hope he stays clean."
Javier, who at the time of the interview had been at Si Se Puede for just a week, said he wants to go back to school and get a job if he completes the program.
"I'm not that old; I still have time to make changes," he said. "When you're clean, stuff just happens on its own. You have to work for it, but things kind of start falling into place. The counselors are here to help you. It's up to you. How bad do you want it?"
By J.M. BROWN
Posted: 05/23/2010 01:30:03 AM PDT