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Heroin promises relief from daily struggle

Julia O'Malley
Kristin realizes in a phone call that she had missed a scheduled appointment to visit with her son in mid-March.
MARC LESTER / Anchorage Daily News
Kristin said she preferred not to spend time alone at her apartment in the weeks following her release from prison. She said being lonely made her crave heroin.
MARC LESTER / Anchorage Daily News
In the weeks following her release from prison, Kristin Alexander spent her days going to support group meetings, getting drug tested and trying to get on a waiting list at an inpatient treatment program. She says she often felt overwhelmed and lonely, which made her heroin cravings worse.
MARC LESTER / Anchorage Daily News
In the weeks following her release from prison, Kristin Alexander spent her days going to support group meetings, getting drug tested and trying to get on a waiting list at an inpatient treatment program. She says she often felt overwhelmed and lonely, which made her heroin cravings worse.
MARC LESTER / Anchorage Daily News

A half hour ticked by as I waited for Kristin Alexander at a table in the Spenard Kaladi Brothers. The last time I saw her, the day she got out of jail the week before, photographer Marc Lester and I watched her throw her needles and heroin in a trash bin, her first step to getting clean.

I dialed her number. She didn't pick up. Then I saw her slouching through the door. She apologized. She had the time wrong. Heroin withdrawal brain, she said. She got in line for coffee.

I looked at the line. A fleece-wearing guy with a goatee. A woman fresh from spin class at the gym down the strip mall. A heroin addict in designer jeans with neatly straightened hair. Kristin fit right in. She looked like everyone else.

Police and people at treatment facilities told me that heroin was increasingly a middle-class drug. One officer told me she recently arrested a young, heroin-addicted prostitute who looked like the average Nordstrom shopper. Designer jeans. Dansko clogs. In her back pocket: a Starbucks gift card.

Over the last few years, according to Anchorage police, more addicts with no prior records have been arrested for dealing and prostitution. Some of them, like Kristin, started using other opiates like Oxycontin, then switched to cheaper black tar heroin from Mexico, maybe smoking it before shooting up. Police and prosecutors have seen the same pattern in major cities and suburbs across the U.S.

Kristin poured cream in her coffee. I asked her the last time she thought about getting high.

"I used to get high in the bathroom," she told me, looking down the hall behind me.

Kristin could map every restroom for miles where she could shoot up. Everywhere she went, she saw the fingerprints of her addict life. The parking space where she used to sit and wait for her dealer. The familiar face in a car, rolling slow beside her at the bus stop, asking if she needed a ride. The spot of blood on the sleeve of an old shirt. It made her lonely, she said. Being lonely made her crave heroin.

She looked at the clock. Three hours until her next recovery meeting. Three hours. Just stay clean for three hours. Go to a meeting. Then stay clean for four hours. Go to another meeting. Go home. Watch a movie. Try to sleep. That's how it went.

Kristin shot up for the first time in 2005 in a car with some friends in a South Anchorage parking lot. She'd recently gone through a rough break-up. Loneliness and depression dragged on her. I asked her if she was scared the first time she put a needle in her arm. She wasn't. She'd smoked heroin and Oxycontin a few times before. She craved the smooth rush. She said it cleared out the darkness inside her.

"I knew it could kill me," she said. "I don't think I really cared if it did. Maybe part of me wanted it to."

Before she started using drugs, Kristin thought she couldn't get addicted. Even as her dependence on painkillers grew, she saw her drug use as recreational, like she could quit if she wanted to. But after she shot up a few times, quitting wasn't an option any more, she said.

Her life veered off course in a matter of months. Soon she didn't care about anything outside the immediate need to get high. Danger meant nothing. Pain meant nothing. Filth meant nothing. Other people's feelings meant nothing.

All along, Kristin made rules for herself and broke them. She'd take pills but she wouldn't snort them. She'd snort them, but she'd never shoot heroin. She'd shoot up but she'd never trade sex for drugs. She'd trade sex for drugs, but only with certain people. She'd shoot up and have sex with strangers, but if she got pregnant, she'd quit all of it. And then she got pregnant, and she couldn't quit, and at that point there were no rules left. Every day had only one mission: finding up to $200 to outrun withdrawal symptoms.

Withdrawal, what drug users call getting dope-sick, chases every addict. It feels like the worst flu you've ever had. Your body aches. Your skin hurts. You sweat. You puke. You can't control your bowels. Dread consumes you.

There's also the constant threat of overdose. But that never seemed real to Kristin even when it happened. Once she shot heroin so pure, she passed out in a car with a guy in the parking lot of the Carrs on Muldoon. He thought she was dead and freaked out. He opened the door and kicked her body out onto the ice. She woke up with paramedics peering down at her.

At the coffee shop, I asked about treatment. Heroin users are some of the most likely to relapse. Among admissions to heroin treatment facilities nationally, the majority of patients have already been to treatment five or more times, according to a 2007 survey by the Substance Abuse and Mental Health Services Administration. No other type of drug addiction resulted in such a high percentage of repeat admissions.

With an addiction that is long-term and serious like Kristin's, treatment experts I talked to recommended residential treatment and possibly drugs -- either methadone or a newer drug with a similar function called Buprenorphine-- to decrease the rate of relapse by easing cravings. Most treatment facilities in Alaska treat a wide variety of addictions. There is no facility in the state focussed specifically on heroin.

Kristin had called half a dozen treatment facilities. All required an initial addiction assessment. To get one, she needed $200. Then she'd get on a list, and she'd have to wait. In the meantime, she had recovery meetings and court-mandated drug tests three times a week. If she failed a test, she could end up back in jail.

Other problems piled up. She didn't have a job. If she found someone who would hire her despite her criminal record, she didn't know when she would be heading to drug treatment. And she was still losing her apartment at the end of the month. She didn't know where she was going to live. She teared up.

"I kind of don't believe I'm not going to use," she said.

People in her recovery group kept telling her to find God. God had a plan for her, they said, trust it. But she didn't know what that meant. When she was getting high, every day had a mission, she said. Heroin had been her compass and her comfort. Now she had nothing but questions, fear, and, if she let herself think about it, the ache of regret. God was an invisible concept. She wanted a sign. Something to prove God was out there trying to show her the way.

Cravings hit at night, she told me. She'd fixate on her dealer's phone number. Seven digits like a song she couldn't get out of her head. One night a few days before, she said, she let herself dial. She only had a few minutes left on her pre-paid phone. She could have called someone from her recovery group. But she didn't.

The familiar voice on the line made her forget about dope-sickness, about her mother's face across the courtroom, about her infant son, sleeping at someone else's house. Numb the ache. That's what mattered. Impulse took over.

She got into a borrowed car and drove a familiar route to a grocery store parking lot. It felt like a reflex. She started to pray the need would fade. Holy cross. Maybe something would stop her. Be my light. Maybe she wouldn't get high. Get back Satan. Minutes passed on the dash clock. She dialed the dealer. The voice answered and started to give her directions to another meeting place. Then the phone went dead. Out of minutes.

She said she stared at the steering wheel. She wasn't going to get high.

Was that God? I asked her.

Maybe, she said.

Julia O'Malley writes a regular column. Read her blog at adn.com/jomalley, find her on Facebook or get her Twitter updates at www.twitter.com/adn_jomalley.

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By JULIA O'MALLEY
jomalley@adn.com