From the Charlotte Observer, April 5, 2012

Eds. Note – Below is an excerpt from a longer national story about heroin.  You can read the rest here.

Before 9 o’clock every weekday morning, the secret to one of the most successful drug rehabilitation clinics in Portland, Ore., waits behind a locked door. Meet David Fitzgerald, leader of the mentor program at Central City Concern, which claims a 60 percent success rate for treating heroin addiction.

The lock, Fitzgerald says, is a necessity because his addicts will take every opportunity offered, including early access to the “mentor room.”

Inside, the walls are covered in photos, including a collage from last year’s group picnic. Recovering addicts smile and hold plates of food. Seven months later, Fitzgerald looks over the faces. Are they all still sober? Are they all still alive?

“Most of them,” he says. “Not all.”

Heroin cut a gash through the Pacific Northwest in the 1990s. Then prescription pills took over until prices rose. Now the percentage of those in treatment for heroin in Oregon is back up to levels not seen since the ’90s — nearly 8,000 people last year — and the addicts are getting younger.

Central City’s clients reflect that. In 2008, 25 percent of them were younger than 35. Last year that went to 40 percent.

“A lot of them aren’t ready at a younger age,” Fitzgerald says. “The drug scene, it’s fast … it’s different. It’s harder than it was.”

Fitzgerald, 63, speaks with a laconic prison patois, a reflection of 20-plus years incarcerated, all the while addicted to various drugs. The worst was heroin. In 1997 he got sober, and in 1999 he joined Central City Concern, then a burgeoning outfit.

Fitzgerald saw that the usual path for treating addiction wasn’t working. Addicts were processed through detox for seven or eight days, then handed a list of tasks that included finding work, meeting with a probation officer, and locating the drop site for their daily food box.

“Like they’re going to do any of that,” Fitzgerald scoffs. “First thing they do is see somebody they know, get that fix.”

Central City Concern instead accompanies clients to housing appointments, keeps their daylight hours filled with to-dos and requires they spend idle hours at the facility, where they also sleep.

It’s a bare-bones staff operating on a razor-thin budget, and the crop of younger addicts presents a new problem: finding appropriately aged mentors to match them with. But Fitzgerald has hope in 26-year-old Felecia Padgett, who remembers clearly the first time she fired heroin into her veins.

“I heard one time somebody say it’s like kissing God,” says Padgett. “It is. It’s like getting to touch heaven.”

Padgett’s six-year tumble involved, in order: heroin smoked, heroin shot intravenously, homelessness, one overdose, two close calls, a suicide attempt, arrest, jail, arrest, jail, arrest, jail and, finally, a one-shot, last-chance stop at Central City.

Before sobriety, she found herself selling to people younger than herself, suburban kids rolling up in their parents’ cars.

Fitzgerald doesn’t yet have money to pay her, and Padgett herself is still in recovery. But she, and others like her, may play a crucial role in confronting the problem as the face of Portland’s heroin addiction gets younger.

Fitzgerald knows that many of the clients he sees at 25 may be back in rehab at 35, but he tries to remain optimistic that some of what they learn at Central City will, ultimately, make a difference.

“That’s about all you can do,” he says, “hope some of it sticks.”