Doug is in his young twenties. He lives in a suburb just west of Chicago. He has tried methadone based treatment before, but it didn’t work out. This August he started using Suboxone (Buprenorphine) to address his heroin addiction. He felt uncomfortable having a recognizable photograph taken, so here he is shown from behind speaking with his doctor who writes his prescriptions for Suboxone.

Q: How did you find Dr. Maxwell at the CRA site?

Actually, I used to go to CRA for the needle exchange when I was using and I had seen her there a couple of times. I had wanted to quit for a while and I got on line (the internet) and got info on Suboxone. I saw her number on line and didn’t even realize she was the one that I had seen at the needle exchange.

“I was watching the local news saying that heroin use had gone up 470% or something in the suburbs. And I think it could be even higher.”

Q: What was it that had led you to wanting to quit?

Oh yeah, I was just tired of it. I have a son who is a year and a half old- my life- I’m just not going anywhere right now.

I’m actually, since I have quit I have gotten a job, I am going to counseling. I feel better about myself.

Q: What is your drug history like?

I started smoking pot, I was probably 13 or 14, hanging out with friends and drinking. Then I was snorting cocaine. I went from snorting to smoking it. Then one of my friends, his dad actually turned him on to heroin. I tried it once. I liked it, but I didn’t really have access to it until I was 19. Then we started taking rides into the city and since then it has been a constant problem.

Q: Do you think the gateway drug theory is true?

Somewhat, all drugs are gateway drugs really. It depends on the individual more than anything. Some people smoke pot and then move on with their life. Other people with that predisposition though, to be an alcoholic or drug addict, it is a different story.

No one starts off doing heroin or cocaine, that’s the way it seems.

Q: What was the nature of your heroin use?

At first it was, when you don’t have a tolerance, a decent amount will get you high- $5. Half a bag would get me high. But if you use every day, it turns into $5 and then $15 or $20 a day. By the time I was 21, I was doing about $100 a day.

At first I worked, I had a good job. I made about $550 a week. But that wasn’t enough so I had to steal. So I was working a full time job and stealing.

In the end even that wasn’t enough. So I stole more. I ended up getting arrested.

Q: What was the charge?

Friends of mine from the neighborhood were stealing things out of cars and I would take it to the pawn shop for them. When they got busted they told on me too, so it was a possession of stolen property charge.

I got probation on that. I sat in jail for three months. And then I was let out on probation. I never went to trial, I pleaded guilty. It was on two accounts. I got two years probation and if I complete it successfully, they will drop the two felony charges down to misdemeanors.

Q: Where are your friends from the neighborhood now?

Still doing their own thing I guess. A couple moved away, a couple of them died. For the most part I don’t talk to them.

Q: Were their deaths drug related?

Yeah, heroin.

Q: So, when did you start with Suboxone?

About three weeks ago.

Q: How is Suboxone working for you?

I don’t physically have any cravings. When you come off heroin you have a hunger that never goes away- all day you’re thinking about it, but with Suboxone it wipes it all away. Now, it is purely mental, out of habit, getting money, how to get to the city. Now when I get that in my head I focus on what I am trying to do with my life.

Q: What has been your parents’ reaction?

They are skeptical. I have been on methadone before and just gone back to using. So they are supportive, but it is hard to explain to them how Suboxone makes me feel, that it is different from methadone. I have hurt them in the past and they don’t want it to happen again.

Q: Do you have siblings? Where are they now?

I have two brothers and a sister. Both brothers are in California, one is at Berkeley studying political science and I have another who works in San Francisco. My sister, she is a bartender.

Q: Have they had problems with addiction?

When my brothers were younger they were dead heads. My older brother had done acid and coke, went around with the Grateful Dead, but it was something he got tired of and just grew out of. He thought I would do the same, but obviously it’s been a different story.

Q: Have they had a different reaction to your problems with addiction than your parents?

They don’t… My oldest brother just thought I would grow out of it. I guess he couldn’t relate to it you know.

Q: What was your experience with the methadone clinic?

It didn’t really work well. Part of it, I don’t think I was really ready to stop at the time. The withdrawal was horrible. I was on a really small dose- and after 3 weeks just couldn’t eat.

I should have been on a higher dose, but that was my decision.

With Suboxone I get a prescription for a pharmacy. I take it once a day. With the clinic I had to drive half an hour each way, and then wait in line with other addicts you know are still using, so it is just a temptation. This is a lot easier- I don’t have to be around those people, the temptation.

Q: How are you able to pay for Suboxone?

Yeah, I have insurance thank God. Because it is expensive- about $20 a day. About twice as expensive as methadone. I have public aid through the state. But I have insurance through my job so I plan on using that instead.

Q: How do the pharmacists treat you? Has there been any prejudice?

I actually had a problem- I was going to Walgreen’s. The drug Suboxone is only for one purpose- treatment of heroin addiction. I had problems with Walgreen’s- they didn’t seem to want to work very hard to get my insurance. I actually went to two of them and had the same problem. Then I took it to an Osco and they had it done in three days- it was fine.

But I did get that feeling at Walgreen’s- that if this was a medication for an elderly person, like blood pressure medicine, that they would have worked harder- but that this was more my problem than theirs.

Q: How would you characterize the drug problem in the Chicago and Chicago suburban area?

It’s bad. Getting worse, too.

I was watching the local news saying that heroin use had gone up 470% or something in the suburbs. And I think it could be even higher. Ten years ago I didn’t know anybody using heroin and now I know tons of people. There’s a town that’s real rich around here, and it’s just interesting that heroin has found it’s way out to the suburbs, whereas before it was just a city, a ghetto drug. And kids are getting younger and younger- going into rehab you know, before they are even 16.

Q: What is being done about the problem?

Um, hmmm… I don’t see anything being done. It’s still- the way people see addiction, non-addicts like police, schools, they don’t see it as a disease, they see it as will power- they are handling it the wrong way, so they are not going to get any changes, any positive change, they are going about it the wrong way to begin with.

Q: What do you think should be done then?

Jeez. I think for one to start with, more awareness and education as far as, instead of saying this is taboo, that if you try this it will kill you, instead of spreading lies about it, be truthful. Don’t just say, “Don’t do it,” but explain why not to do it, the detriments from it.

Q: What would you say are the detriments? What would you tell a group of students?

I would just explain my whole history with it. The presumptions I had about it. Just give them facts about it you know. Give them reasons, show them proof.

Q: What were your presumptions when you started using harder drugs?

Well, I don’t know, but what I am talking about- the whole ecstasy thing, instead of telling people ecstasy will kill you, but if you do ecstasy and dance all night and get dehydrated and hypothermia and pretty much cook yourself, they should explain you have to take breaks and drink water. It seems like they are just out there to scare people, to use scare tactics.

People will make choices whether blindly or with facts, so why not give them the information you know?

Q: What are your plans at this point?

To work, save money. I am also involved in DCFS (Department of Child and Family Services). Me and my fiancé were using and somebody called or whatever because we were on drugs, so my son is living with my fiancé’s mother. It was pretty much like a last chance. She is in treatment and I am in counseling now.

Q: Do you have an idea of what field you would like to go into?

I am not sure, I am thinking about taking my test for a real estate license. I think I would be good at that.