Welcome to Heroin City
"Jimmy," a drug dealer in his mid twenties, injects himself with heroin in the bathroom of a West Burnside Street tavern.
On my first attempt at buying heroin in Portland I was told to come back in an hour.
I'm a reasonably clean cut, 34-year-old white man with one wrist tattoo, no drug contacts; a photographer, not an addict.
Within five minutes at O'Bryant Square downtown, I had sidled up to a gaunt middle-aged man, and asked if he knew where I could find some "black" -- a street name for black tar heroin. "The natives might be back in an hour," he said. I'd come back in an hour.
Ten minutes later, I approached a young man on the sidewalk across the street from Pioneer Courthouse Square who told me he had just been ripped off to the tune of $15. I asked him for black. He said I should follow him around the corner. But then his girlfriend came up behind me, asking to see my track marks, accusing me of being a cop.
• Editor’s note: First-person narration by Christopher Onstott, story by Peter Korn
I had the impression that if she hadn't come by I would have had my black tar heroin, or at least a number.
That's the goal. Little pieces of paper with suppliers' phone numbers are treated like currency on the street. A dedicated addict will pay up to $100 to secure one, and always keeps two or three on hand.
Back to O'Bryant Square, where casually standing around with a group of street kids brought in offers of meth, crack cocaine and pot, but no heroin. Odd, since heroin use in Portland has skyrocketed in the last year.
There were 84 heroin overdose deaths in Multnomah County last year, up from 57 in 2009. A growing body of federal data show that in the span of a few years, Portland has become one of the nation's top cities for heroin use.
Portland is awash in heroin, and it's killing us. That's what the numbers say.
Criminal justice officials and addiction treatment providers say that the numbers only tell half the story. Heroin, they say, has moved from a drug used mainly by the poor to one increasingly used by the middle class.
More specifically, it is being used by young men and women younger than 35 who are looking to move beyond the highs they've experienced from prescription painkillers, such as OxyContin. All this is made possible, experts say, because heroin is incredibly cheap and easy to obtain here.
Still, I'd been out on the street for close to two hours and I hadn't scored.
Weary of role-playing with street kids, I headed home, stopping first for a drink at the Plaid Pantry on Southeast Burnside Street. Sipping my Gatorade in the parking lot, I hardly noticed the young white man who walked up and asked, "How's it going?"
"Not bad," I answered with a shrug. He countered with, "Wanna buy some bud, bro?" "No thanks," I answered. Then I asked, "Got any black?"
That's how easy it was to buy heroin on a Wednesday afternoon in Portland. My new friend told me he lived downtown, but his dealer on 82nd Avenue "gets the best (stuff)."
I explained to him that I was on my way to a tattoo appointment, which was true, and couldn't come with him now. I offered $20 for his dealer's number. The number would lead to a call, a meeting place -- often a MAX station -- and the buy.
Cell phone numbers were exchanged, with the promise of an extra $5 for the contact number. After my tattoo appointment, an exchange of text messages, then a series of very fast phone calls setting up a meeting at a quick market on Southeast Foster Road, where I met my new friend and a scruffy companion, maybe in his late 30s, who I took to be his supplier.
My friend tried to hand me a small bag of black tar heroin. I say I need to use the cash machine inside. Somehow, I've got to tell this guy I'm not a heroin user.
He follows me, basically breathing down my neck, no personal space. The machine spits out $20 and I hand him the money. He starts to hand me the bag, but I deflect him.
He gives me a look somewhere between confused and surprised. But thankfully, he doesn't give me a look that says I'm a cop who has tricked him.
He heads back outside to talk to his companion. I explain that I'm a journalist, not a user. Would he talk to me?
He looks at me and says, "Oh my God, that's so f....ing cool."
Ten minutes later, we're in my car, as Jimmy (not his real name) explains how he went from being a University of Oregon athlete so afraid of needles that he had to turn away from movie screens whenever a scene showed a needle going into someone's arm, to a daily heroin user who gets by dealing and occasionally panhandling.
I agree to drop Jimmy at his home in Northwest Portland. But first, a stop at a pub on Northwest 21st Avenue where he uses the bathroom to inject $10 worth of heroin into his arm.
Along the I-5 corridor
People who deal with the local drug scene --from law enforcement officers to drug counselors -- continually use the phrase "perfect storm" to explain Portland's skyrocketing rates of heroin use and overdose.
According to reports from the U.S. Department of Justice National Drug Intelligence Center and U.S. Drug Enforcement Administration officials interviewed by the Tribune, meth became harder to produce in Mexico, so the cartels and their gangs turned to producing heroin. Needing a distribution route into the western U.S., the Mexican gangs chose the Interstate 5 corridor.
Meanwhile, according to local addiction treatment providers, a different set of circumstances has been creating a growing demand for heroin in Portland. Oregon has always been an easy place to legally obtain prescriptions for painkillers such as OxyContin and Vicodin, many of which ended up on the black market.
In recent years, studies ranked Oregon somewhere in the top half dozen or so states for abuse of prescription drugs. One 2007 federal study by the U.S. Department of Health and Human Services reported that Oregon had more youth painkiller abusers than any other state.
In the past year, state and county health officials, hoping to reduce the number of people becoming addicted to prescription painkillers, changed their guidelines, making it harder for physicians to prescribe painkillers. In addition, drug companies in 2010 changed the composition of OxyContin, making it almost impossible for addicts to crush and inhale it for their preferred jolt.
With prescription painkillers harder to get through local doctors and a favorite painkiller almost worthless to hard-core addicts, the supply of black market prescription painkillers became scarcer, and the price headed up.
Pain sufferers who had been dependent on legal drugs to get through the day, as well as recreational users, needed a new supply. And there was heroin, cheaper than the prescription drugs, plentiful and potent.
As outlined in documents from the U.S. Department of Justice National Drug Intelligence Center, the Mexican cartels were producing an excess supply of heroin and could sell it cheap, so cheap that local distributors didn't need to cut it in order to make a profit. Instead, they could afford to sell it more pure, and potent, potentially hooking more addicts. But some users, not knowing they might have to scale down how much they injected, died of overdoses.
Dr. Gary Oxman, Multnomah County's public health officer, says he's been expecting the current surge in heroin overdoses. In his view, heroin and prescription painkiller use in Portland are inextricably intertwined.
"I think we probably have these two epidemics fueling each other," Oxman says.
The new wave
Portland has been "a heroin city" for decades, according to Oxman, but until recently the cost of the drug has been high. The new set of circumstances -- cheap Mexican heroin available at the same time county physicians have begun cutting patients off from prescription painkillers -- has changed the fundamental dynamic of heroin in Portland, he believes.
"The heroin got cheaper," Oxman says. "I assume that's not an accidental move on the part of the cartels. I think basically they went from a low-volume, high-price distribution model, to a high-volume, low-price distribution model."
Typically, $10 or $15 will buy enough heroin for an injection that will last all day, according to heroin users interviewed by the Tribune. Prescription pills that will get an addict through the day run about $1 a milligram on the street, so a serious user might have to spend $50 or more to stay high all day, the users say.
Oxman's staff has been studying the overdose problem, even interviewing heroin addicts to get a better handle on what is happening on the street. In an annual survey of people using the county's needle exchange service, 43 percent of heroin users said they became hooked on prescription drugs first. And most of those people were younger, rather than middle-aged or older addicts.
Multnomah County Deputy District Attorney Ryan Lufkin says many in the "new wave" of heroin addicts started out stealing painkillers from family medicine cabinets or trading for them in schoolyards, made possible because physicians and dentists for years have been prescribing more than individuals needed.
"There's this huge class of people who probably wouldn't have used heroin in their entire lives if they had not become addicted to prescription pills," says Lufkin, who adds that virtually every heroin addict he's interviewed -- a number in the hundreds -- started on pills.
The county overdose statistics back up what nationwide studies have indicated -- heroin has exploded in Portland during the past two years, while its use has remained stable or risen slightly in most large cities outside Oregon.
But physicians across the country have been over-prescribing pain pills, Oxman and Lufkin acknowledge. And while West Coast heroin arrives almost exclusively from Mexico along the Interstate 5 corridor, Portland is not the only city on I-5. Yet there are more heroin deaths each year in Multnomah County than in Seattle's much more populous King County.
One of the most eye-opening studies in recent years comes out of the federal Office of National Drug Control Policy, which tallied drug use data for inmates entering county jails in 10 cities across the country, including Portland. More than one in five people entering the Multnomah County jail in 2010 tested positive for opiates -- far and away greater than any of the other nine cities, which included New York, Chicago and Atlanta.
In Portland, 18 percent of county jail inmates reported having used heroin within the prior 30 days. Chicago was second, with 12 percent reported use.
But what is most alarming about the Arrestee Drug Abuse Monitoring Program data is how different cities appear to be trending. In all the other cities surveyed, heroin use remained fairly consistent in recent years or grew slightly. In Portland, it has jumped.
As recently as 2009, Chicago's reported per capita heroin user rate almost doubled that of Portland. Four years ago, Portland trailed both Chicago and Washington, D.C. Now, at least as far as testing of people entering the jail, Portland is No. 1 and trending higher.
Low risk, high reward
The National Drug Intelligence Center 2011 Drug Threat Assessment Report says that heroin production in Mexico has risen from nine metric tons a year to more than 50 metric tons. Eric Martin, policy and legislative liaison for the Addiction Counselor Certification Board of Oregon, is convinced that Oregon is getting more than its share.
Martin points to a 2007 map produced by the Intelligence Center which shows Portland/Salem as having the Pacific Northwest's largest Mexican cartel presence.
"Portland/Salem is basically the distribution hub for the entire Northwest region," Martin says.
Deputy DA Lufkin says he's not aware of Portland serving as a hub for the cartels, but logic dictates we might be.
"Everything in this world is connected," he says.
As Lufkin sees it, "Certain things are never going to change about Portland that makes it an attractive city for heroin addicts."
That starts with Oregon's drugs laws, which Lufkin says would make Oregon a logical place to set up a drug distribution network.
Most users or dealers caught selling less than five grams of heroin, according to Lufkin, receive a sentence of probation until their fifth conviction, which can net up to 12 months in jail, but rarely does.
That means prosecutors have little leverage to force most small-time dealers to provide names of people further up the distribution system.
"The cartels have found the place that affords them the least risk in drug seizures and the highest reward in distributing to local users," Lufkin say.
In addition, Lufkin says, Oregon law provides prosecutors little leeway in going after black market dealers of prescription painkillers.
"Even if you were trafficking in thousands of pills of OxyContin, it would still be a probationary sentence," he says.
Heroin addicts regularly tell Lufkin that they moved to Portland because of the availability of cheap heroin.
Part Two of Portland's Heroin Epidemic.
Prosecutor: Treat, don't jail heroin users
As far as Multnomah County Deputy District Attorney Ryan Lufkin is concerned, an addict who has been arrested multiple times for heroin possession is sick.
During February's legislative session, Lufkin unsuccessfully supported a bill that would have allowed prosecutors to treat repeat heroin offenders as they would people who attempt suicide, and civilly commit them to treatment, even against their will.
Lufkin says he's going to return for a second attempt next year.
The 2012 session's House Bill 4022 would have classified people arrested at least three times for heroin possession as mentally ill, and set it up so they could be committed for up to 90 days of inpatient treatment and a year of outpatient treatment.
The county prosecutes about 1,100 heroin users a year, according to Lufkin, and about half have prior convictions for possessing the drug. Between court and jail, prosecuting a heroin addict runs between $3,200 and $28,000, Lufkin says. And the jail time, when they get it, rarely does addicts much good.
"We can spend all the money that's necessary to bring someone to a jury trial on a heroin charge with no results, or we can adopt a system that actually is the right tool to hit this problem," Lufkin says. "This person has a disease. They're an addict. It's a recognized mental health disease, and we can get them access to treatment and the thing saves money."
But that would be targeting the wrong people, says Alex Bassos, training director at Metropolitan Public Defender.
The problem, Bassos says, isn't the users getting arrested for possessing heroin. The problem is those who are overdosing. And those two categories, he says, aren't nearly as overlapping as people might think.
Bassos says the DA needs to make it a policy to use current civil commitment laws for heroin offenders who have repeatedly overdosed. Those laws, he says, which allow prosecutors to civilly commit people who attempt suicide, should work.
"That is exactly what civil commitment is for," Bassos says. "They have a (medically defined) mental disorder, and that's compelling them to do something which is dangerous to themselves and others."
Bassos, who says the D.A.'s plan "should terrify civil libertarians," thinks it also isn't practical because there are already long waiting lists for the best treatment for addicts -- inpatient beds in treatment facilities.
Lufkin says heroin offenders already require addiction treatment as part of their probation, and that with civil commitment it would happen more immediately and with a huge cost savings.
"The savings in time will help addicts stay alive and get faster access to treatment," Lufkin says. "The savings in money can go back into treatment resources to pay for essential treatment services, such as cutting down the waiting time for inpatient beds."
— Peter Korn
