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A Report From The Front Lines Of Heroin Addiction Treatment


We're going to hear the perspective now of someone on the front lines of treating addicts. John Venza is vice president with Outreach; that's a substance abuse treatment agency in New York and Long Island.

Mr. Venza, welcome to the program.

JOHN VENZA: Hi, thank you for having me.

BLOCK: And we just heard in Laura Sullivan's report that heroin is cheaper than buying prescription painkillers on the black market. How much cheaper?

VENZA: Significantly cheaper. I think, you know, depending upon the pills that somebody was using, they may have seen pills ranging upwards of $20, $25 for a single pill whereby they could find a stamp bag for maybe, you know, $7, $8, $10, depending upon the quantity that they're buying it in.

BLOCK: And those would provide about the same effect for the user?

VENZA: Yeah, I think so. And I think, you know, basically, where in the progression the person is in their use.

BLOCK: Mm-hmm.

VENZA: You know, I often that - folks often say it's cheaper. I tell folks it's cheaper in the beginning. But when the person begins to use more and more, and the progression of the addiction marches on, then suddenly the couple of bags becomes 10 bags or maybe even upwards of 20 bags a day. And then it gets pretty costly.

BLOCK: When you talk with addicts, do they describe the same pattern that we were hearing about; of a progression from opioid prescription painkillers to heroin, over time?

VENZA: There's a financial, sometimes - I don't want to say motivation - but necessity. I think that was one of the unintended consequences we saw with the appropriate crackdown on the prescription painkillers and the accessibility. But the unintended consequence being that now, you know, people who are addicted to opiates, they're still going to go through drug-specific withdrawal. So suddenly out of necessity, they're going to cross over to the heroin.

And a lot of folks enter the heroin by sniffing, not by shooting. And, you know, the needle has always been an interesting piece because that needle, I think, is that psychological barrier that, you know, historically kept folks away from heroin. But now that the strength of the heroin is pretty strong and pretty pure that, you know, you no longer need the needle.

BLOCK: I've read that in New York City, that heroin-related overdose deaths jumped 84 percent from 2010 to 2012. And I wonder if that squares with what you've been seeing and hearing from the folks who are in treatment.

VENZA: Yup, I think it's pretty consistent. We're seeing a lot of folks with overdoses. And I think that's sometimes a misnomer among folks, that folks often think of overdose and fatality. But there are plenty of folks who have overdosed on a few occasions, but they were of the nonfatal nature. So it's clearly consistent with what we're seeing.

BLOCK: And does that correlate with a rise in purity of the heroin? Or what accounts for that?

VENZA: I think that the purity and the strength is certainly a factor in that. I think that there's also, you know, when folks are trying maybe to stop or not use on their own, they may pull away from it. They may not use or several days. But unfortunately, without any treatment behind them, it's usually the same story; that they pick up their use, and they quickly get back to the level they were using in a much, much, much shorter time than the progression that got them there in the first place. That is part of what puts the body into some kind of a traumatic, you know, episode.

BLOCK: How young are the youngest clients or patients that you've been seeing at your treatment center?

VENZA: What I can tell you is, we have recently began treating a person as young as 13 in one of our residential facilities.

BLOCK: For heroin addiction?

VENZA: For heroin. But clearly, you know, 13 - by 12, beginning using substances; by 13, having tried heroin on a few occasions, and the parents swiftly intervening and getting them into treatment with us.

BLOCK: What do you think the biggest misconception is about treatment for heroin addiction, and what that means?

VENZA: Well, I think one of the misconceptions about treatment for heroin addiction is that that somehow that folks are going to be able to do it in such a short amount of time. You know, it's a chronically (unintelligible) condition. And I think that, you know, the idea that either somebody goes for detoxification and then goes to outpatient, or somebody who gets maybe 12 or 15 days of in-patient treatment is enough.

What folks are starting to realize, it's clearly not enough. This was a progressed disease that got to a very, very unmanageable state of addiction. And it takes a while. There's no way to get around that. It takes an extended period of time and treatment, with the proper supports and the proper foundations for recovery.

BLOCK: Well, Mr. Venza, thanks for talking with us today. We appreciate it.

VENZA: Oh sure, Melissa. Thanks for having me.

BLOCK: John Venza is vice president with Outreach. That's a substance abuse treatment agency in New York City and Long Island.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.