The mountains of Colorado and Vermont have long drawn skiers, hikers and nature lovers. Lately, an unwelcome guest has been showing up more and more in these pastoral settings: Heroin.
Colorado and Vermont, like rural and suburban areas from Wisconsin to Texas and New Jersey to Oregon, have seen a boom in heroin use, particularly among the young, over the last five years, catching communities unprepared for the scourge.
The impact of heroin addiction was brought home to Vermonters when police linked the death of a teenage girl in a New York City brothel to what they said was a prostitution ring running from Burlington, Vt., to the Bronx. Police said Vermont girls got hooked on heroin that was introduced to the area by dealers from New York and then were lured into prostitution with promises of money and drugs.
It's a pattern that has been observed all across the country.
"Heroin dealers are dealing and marketing to young people," said Gladys Zelman of Maple Leaf Farm, a substance abuse treatment center in Vermont. "There's no question it's here, it's damaging and kids are dying."
What has been observed over the last several years is a sharp reversal of the trend over the previous 15 years, when heroin use was on the decline and was virtually unknown in most rural areas of the country.
Bored to Death
The revival is blamed in part on the arrival of black tar heroin on the American market, which is often as much as 70 percent to 90 percent pure, allowing new users afraid of injecting the drug to get a powerful high by smoking or inhaling.
There's another, older force driving the boom, though. Boredom.
"I asked a young person what to do about it and she said, 'Well, we're bored. We need transportation to get to places, to do things. We need to have other things to do,'" Zelman said.
It hasn't helped that the price of heroin has tumbled, even as purity has soared.
"What we've noticed here is that there's definitely been an increase in heroin use among the kids we deal with," said Jamie VanLeeuwen, a program coordinator at Urban Peak, which runs the only licensed homeless and runaway youth shelters in Colorado. "A bag of heroin — good for a weekend high — goes for $20 to $40. That's not an expensive high."
In Vermont, heroin is often introduced by visiting dealers from Boston, New York or New Jersey who might even hand out free samples, get a few kids hooked, then return to their urban homes and let their new clients come to them. Those first new addicts then become dealers or prostitutes to support their own habits.
"We've seen more women, young girls addicted to heroin than ever before," Zelman said. "They are prostituting themselves to keep up their habits. And they sell the drug themselves, so the dealers aren't even really around. It's a pyramid."
Drugs Taking Root in Rural Areas
Separate studies of drug use in Vermont, New Jersey and Colorado this year confirm what a Center on Addiction and Substance Abuse study found last year — that smoking, drinking and drug abuse are all more prevalent among teenagers in rural America than in the major cities, and heroin use is soaring outside of urban areas.
According to the CASA study, eighth-graders in rural parts of the country are 83 percent more likely to smoke crack cocaine, and 30 percent of people surveyed in rural and suburban areas said heroin was "very easy" to get in their town.
Since 1996, the White House Office of National Drug Control Policy has added Iowa, Kansas, Nebraska, South Dakota, Kentucky, Tennessee and West Virginia to its list of High Intensity Drug Trafficking Areas.
The studies in Vermont, Colorado and New Jersey were all done among people entering treatment for drug or alcohol abuse.
In Vermont, according to the state Department of Health, the number of 18- to 24-year-olds seeking treatment for heroin addiction jumped from 22 in 1997 to 124 in 2000. In Colorado, state admissions for heroin treatment among 18- to 25-year-olds increased from 148 in 1993 to 346 in 1999, and as a percentage of total admissions for substance abuse rose from 8.9 percent to 16.7 percent over the same period.
"When you see that big an increase in young users, it is an element of concern," said Bruce Mendelson, a data analyst with the Colorado state Alcohol and Drug Abuse Division, which did the study in that state, released this month. "While the numbers aren't large, it's of concern, particularly when you're seeing it spread to suburban users who might think when they're smoking or inhaling it it's not addictive, but that's just not true."
The numbers, however, are larger in New Jersey. A study released last week by the federal Centers for Disease Control said that in rural and suburban areas 691 18- to 25-year-olds were treated for heroin addiction in 1993. By 1999, the number jumped to 1,817. In urban parts of the state, the trend was the opposite, with 2,018 young city dwellers receiving treatment in 1993, and 1,076 being admitted to treatment 1999. Also over that time span, the percentage of all users who took heroin by injecting it jumped from a third to half.
The CASA study found that rural communities and small and midsize cities are unprepared to deal with the consequences of the rise in drug abuse.
In Vermont, the death of 16-year-old Christal Jean Jones spurred the state government to address the problem, with the Legislature drawing up proposals for funding projects, and a commission being convened this summer by Gov. Howard Dean to look at broad social issues related to troubled youth.
VanLeeuwen and Zelman both said there is a desperate need for more treatment facilities in their states, and for government to focus more on prevention and treatment than punishment.
"Let's address this problem and treat it early so we don't start seeing the other side," VanLeeuwen said.