Alan Levine took his first shot of heroin by accident.
It was 1966 and he was 19 years old, a high-school dropout
working on a New Jersey construction site. One day he
asked two Spanish-speaking co-workers if they had any
marijuana. Except he didn't say marijuana, he said "dope."
After work, they drove into New York City to score. It
wasn't until Levine watched one of his friends empty a
bag of white powder into a spoon,
light a match, and draw it into a syringe that he realized
he was out of his depth. But he was too proud to back
out. His buddy injected the needle into Levine's vein,
and a few seconds later, he felt the first rush of the
drug blast into his consciousness. "I remember riding
back in the car and saying to myself, 'This is the way
I want to feel for the rest of my life,'" he says.
Levine's pride proved costly. Over the next three decades,
Levine sank into the quicksand bog of addiction: heroin,
cocaine, alcohol, amphetamines. The most degrading experience,
he says, was not the time he robbed a bank, nor the numerous
occasions when he stole cars, nor even his seven prison
sentences. It was the night he camped beneath an overpass
in Salt Lake City, when an unopened bottle of beer slipped
out of his hand and rolled down the embankment. "It was
like watching your child get hit by a truck," he says.
He climbed back down the slope, and as he neared the
shards of glass, he could see a swallow of liquid glinting
in the bottle's broken neck. And he thought to himself:
"I'm going to have to do this right, or I'll lose a drop
or two."
Levine bears many scars from his addiction. His right
forearm is a twisted cacophony of muscle and sinew. His
face is scuffed like an old baseball. Most notable, however,
are his feet, which he keeps in his closet. Levine suffered
severe frostbite in January 1987, after falling into a
drug-induced stupor underneath a bridge near Joliet, Ill.
Surgeons were forced to amputate.
Listening to Levine recount his story in his fast-paced
Brooklyn accent, it's hard to believe the guy is still
alive. But today, at the age of 54, Levine has been clean
and sober for four years. He lives with his wife and dog
in a Milwaukie apartment. He is an honor student at PSU,
with a GPA of 3.93. He even has a new pair of feet--anatomically
correct prostheses that allow him to walk, climb stairs
and ride a bicycle.
It's not news that drug addicts can and do become productive
members of society. But Alan Levine is more than that.
He is also one of the leading members of an innovative
organization known as the Recovery Association Project
(RAP)--a bunch of ex-cons, former prostitutes and erstwhile
junkies who may turn out to be Portland's most powerful
weapon in its ongoing battle with the needle. The truth
is, we need him.
One year ago, the Multnomah County medical examiner released
a grim statistic: Among men aged 25-44, heroin had become
a leading cause of death--surpassing homicide and suicide
combined. Approximately 90 junkies succumbed to the needle
in the first nine months of 1999, a jump of 41 percent
over the previous year.
"If [the same number of] people were dying in Portland
from salmonella poisoning, the federal government and
the CDC would be parachuting in here with spacesuits,"
Ed Blackburn, the director of Hooper Detox, said at the
time. "This problem can be solved if we have the political
will to do it."
In some ways, Blackburn's optimism bordered on the delusional.
Heroin addiction has proven to be one of the most intractable
social problems of the past 40 years, seducing lit majors,
lawyers, musicians and dock workers with equal nonchalance.
While its users come from all walks of life, the vast
majority arrive at the same destination: abject dependence.
"This drug fixes pain, fear, anxiety--everything," says
Dr. Jim Thayer, the medical director at Hooper Detox.
"That's an experience most people never have."
"Heroin is very seductive," says Dr. Dale Walker, director
of the Division of Addictions at OHSU, who has worked
with heroin addicts for 26 years. "It's like flipping
a switch in the brain."
"When you have a habit, there are no holidays," says
Jill Kahnert, 43, a former bartender who survived an addiction
for nine years. "There are no days off. It's like being
in a pit you don't know how you're going to claw your
way out of."
Even if they manage to break the drug's grip and kick
the habit for a few days, most heroin addicts quickly
slide back to the drug: In Multnomah County, only half
of them even make it through detox, and a mere 17 percent
finish outpatient treatment, according to figures from
the state Office of Alcohol and Drug Abuse Programs.
In addition to the insidious nature of the disease, heroin
addiction just doesn't generate the same level of sympathy
that issues like poverty or illiteracy do. Junkies are,
by definition, criminals. In the final analysis, heroin
is a self-inflicted wound, and overdose is the ultimate
I-told-you-so for foolhardy thrill-seekers who think statistics
happen to someone else.
At a WW staff meeting where this article was discussed,
one writer summarized that view with disturbing candor:
"So a bunch of junkies are dying. Who cares?"
These elements--the wretched seductiveness of the drug,
the high rates of recidivism and a certain degree of public
indifference--have bred a sort of collective resignation,
a willingness to shrug off the sinister increase in drug
fatalities so long as the victims are poor and criminals.
But one year after Blackburn's defiant challenge, the
impossible has happened. Fatal heroin overdoses in Multnomah
County are falling. In the first nine months of this year,
58 junkies died of an overdose--a decline of 36 percent
from 1999.
"That's a remarkable drop," says Dr. Gary Oxman, the
county's top public-health official. "Something positive
is happening out there."
That something is not the result of cutting-edge technology,
massive capital expenditures or armies of bureaucrats.
Instead, heroin deaths have dropped, experts believe,
because of the efforts of 20 former dope fiends like Alan
Levine, who decided to do for junkies what the AARP has
done for retirees--organize, agitate and generally raise
hell.
The intersection of Northwest 2nd Avenue and Burnside
Street has long been the epicenter of Portland's heroin
trade, a zone where every greeting is ambiguous, every
encounter freighted with double meaning. On a recent evening,
a Latino man, shivering against the cold, stared at a
passerby, his eyebrows cocked in silent solicitation.
As the traffic barreled across the Burnside Bridge, two
white kids slipped a couple of folded bills to a young
woman. Her companion passed back a tiny balloon. The buyers
scurried down a stairway littered with cigarette butts
and decaying leaves. "Let's get out of here, man," said
one, clutching a shopping bag from Meier & Frank.
"I've had enough of this."
This neighborhood is also where Levine and the other
members of RAP base their operations. Here, in a cramped
room in the offices of Central City Concern, a social-service
agency, the RAPsters first met in February 1999 to map
out their strategy to reduce the death toll. "Everyone
in the room knew someone who had died of an overdose,"
Levine says. "We had to do something."
Over the course of several months, RAP persuaded Multnomah
County Chair Bev Stein to attack the problem on multiple
levels. The county printed up posters warning inmates
about the risk of heroin overdose (19 percent of overdose
victims got out of jail less than 60 days before they
died). Medical authorities instructed doctors to be wary
of prescribing benzodiazepines to patients with a history
of drug abuse (mixing heroin and benzos raises the risk
of overdose). And outreach workers at detox centers and
needle exchange sites launched a campaign to reassure
junkies that it's safe to call 911 if a friend ODs, after
a study showed that many addicts were afraid to call for
fear of getting busted (in fact, Portland Police almost
never make arrests on an overdose call).
"RAP was highly successful in getting the attention of
elected officials, the bureaucracy and the public," says
Oxman. "They really lit a fire."
At the same time, RAP was also attacking a more fundamental
issue--junkies' distressing tendency to run back to the
needle even after they get the monkey off their back.
In particular, the group lobbied the county for an innovative
mentoring program, run by Central City Concern, that pairs
recovering junkies who have found the secret to staying
clean with struggling addicts like Brian Young.
Young's career as a junkie began eight years ago, when
he surprised a burglar in his house. During the ensuing
scuffle, the intruder grabbed a flat-bladed screwdriver
and stabbed it through Young's throat. He was in a coma
for 48 hours, and spent the next week hooked up
to a morphine pump. Every 15 minutes, he felt a delicious
wave of euphoria flood through his body--and all he had
to do was press a button.
The night he got out of the hospital, he took his first
shot of heroin. "It's a compulsion," says Young, 41, whose
rugged features, spiky mullet and hoop earrings make him
look like a roadie for Creedence Clearwater Revival. "You
do something that you know you shouldn't do, when you
know you shouldn't do it, but you can't help yourself
from doing it."
Young relocated to Eugene, where he immersed himself
in the city's thriving heroin scene. His modus operandi
was simple: home in on "pigeons," or inexperienced users,
who came downtown to score heroin, and provide them dope
at exorbitant prices, generating cash for his own fix.
His habit eventually ballooned to 6 grams of heroin a
day--enough to kill a novice user many times over. He
was arrested more than 40 times over the next eight years.
On the morning of Sept. 23, 1999, Young stood in line
outside Hooper Detox, clutching a bag of dirty clothes.
Over and over again, the same thought kept running through
his head. "I feel like shit and my life is fucked."
After eight agonizing nights in Hooper, sweating and
moaning through acute withdrawal, Young felt better--physically,
at least. But the real challenge was still ahead. Because
the truth was, Young had kicked junk on scores of previous
occasions. He had been through detox or treatment at least
a dozen times. "I never knew what to do when the treatment
ends," he says. "It's like I'm the Riddler and my whole
life is nothing but a green suit with a question mark.
I've got no job skills, no rental history, no income.
What do I do?"
But there was something different this time. Young had
signed up for a brand-new mentoring program, the one that
RAP spent months lobbying for. As he stood in the center's
lobby, waiting for a ride, Young wondered what to expect--after
all, he had manipulated well-meaning counselors in the
past. Young's mentor, however, was not a frazzled social
worker or a college student on an internship. She was
a 38-year-old ex-junkie named Kim.
Kim Matic has the kind of steel-blue eyes that could
pierce the armor of a Sherman tank. An addict from the
age of 19, she fed her habit by turning tricks on the
Burnside Bridge. One winter's day, she climbed into a
pickup truck with a john who took an unusual interest
in her feet. As he drove out to Molalla, she agreed to
let him tie her up. Then something gave her a creepy feeling,
and she persuaded him to let her go. Later she recognized
his face from news reports. He was Dayton Leroy Rogers,
the notorious killer who murdered and mutilated eight
women, including seven prostitutes, near the Molalla River
in 1987, and who is now on death row at the Oregon State
Penitentiary.
When Matic picked up Young at Hooper Detox, she had his
number from the start. "He was so full of shit he couldn't
see straight," says Matic, who has been clean for seven
years. "I told him, 'You might be fooling yourself, but
you're not fooling me.'"
Matic drove Young across the river to the Danmoore Hotel,
a 122-bed drug-and-alcohol-free community, where he checked
into a room on the third floor. She took him to the Salvation
Army for a box of groceries and some pots and pans. She
helped him sign up for acupuncture, a bus pass and the
Oregon Health Plan. She took him to 12-step meetings.
She even took him and her other "mentees" to movies.
These things sound trivial--even absurd. But addiction
experts say they are precisely the sort of minor tasks
that newly recovering addicts cannot seem to accomplish
on their own. "When you're fresh in recovery, everyday
things seem like gigantic obstacles," says Randy Sorvisto,
another mentor. "It's like a brick wall, and every brick
represents a responsibility. I look at that wall and I
look at all those problems and I can't figure out how
to do it. Getting on food stamps. Getting a counselor.
Joining a gym. And you think, 'If I did one hit of dope,
I'd feel better, and I could do all this.'"
Today, Brian Young works as a computer support technician
and lives in the Shoreline Apartments, next door to RAP's
headquarters. He has been clean for 14 months--and credits
Matic with playing an integral role in his recovery. "She
is an incredibly strong woman," he says. "It was real
clear to me it wasn't worth bullshitting her, because
she knows the game."
The mentor program, which has so far served almost 200
clients, is no panacea--heroin addiction is, after all,
an incurable disease--and is no substitute for 12-step
meetings. But when allied with acupuncture, and drug-and-alcohol-free
housing, the mentors can make a big difference. According
to preliminary figures, the mentoring program has almost
tripled the number of junkies who are still clean at six
months, from 16 percent to 42 percent. "It's outstanding
what they've done," says Hooper's Dr. Thayer.
For all RAP's successes, it still faces extraordinary
challenges. Last summer, Greg Forgrave, a recovering heroin
addict who had been active in RAP, died of an overdose.
He had been clean nine months. Forgrave's death was like
a two-by-four across the face for the fledgling organization.
"I wanted to scream and nothing came out," says Young,
who was one of Forgrave's closest friends. "I wanted to
cry and didn't know how."
Forgrave's death underscored the insidious nature of
heroin addiction; it also highlights the peculiar paradox
facing an organization made up of ex-junkies. On one hand,
in order to put a face on the statistics, RAP members
have decided to go public with their stories. But there
is always the risk that an individual member will relapse.
"We're always talking about this," says Levine. "What
if we stick our neck in the noose and screw up? We're
human beings. We're afraid. But somebody's got to do this.
Somebody's got to take the risk. People are dying. It's
as simple as that."
