Heroin, the addictive opiate shoved into the shadows during the decade-long reign of cocaine, is making an alarming resurgence in Baltimore and other large U.S. cities in purer form than ever.
While Baltimore has always had a steady number of intravenous heroin addicts, officials in treatment and law enforcement say more people are getting hooked now because this high quality heroin can be snorted or smoked.
One West Baltimore drug trafficker markets his heroin -- up to 92 percent pure -- under the brand name "Unforgettable." Other dealers have labeled their heroin with names like "Killer B" and "Royal."
About two years ago, the average street-level purity of Baltimore heroin was about 4 percent to 7 percent. This year, the average purity rose to about 70 percent in some areas of the city.
The arrival of this potent heroin is the result of a worldwide glut of opium from poppy-growing countries and the emergence of Colombia as a heroin producer.
"The Colombians have shown us what they could do with running the cocaine market, but the heroin move is a new one, a frightening one," said Craig N. Chretien, special agent in charge of the Baltimore office of the U.S. Drug Enforcement Administration.
"They might not have the poppy yield of other countries yet, but they have recruited chemists from Southeast and Southwest Asia and Mexico to convert poppy to gum opium into heroin," said Mr. Chretien, who spent nearly four years chasing the Shining Path guerrillas -- a Maoist group linked to the cocaine trade -- before being assigned to Baltimore.
Police here first detected the potentially lethal street heroin in April. Since then, the stronger narcotic has been turning up in an increasing number of reports and seizures.
At no time since the 1930s have narcotics addicts had access to such plentiful quantities of high-grade narcotics. Then, law enforcement was not as stringent, and it was easier to obtain pharmaceutical morphine from doctors and opium from illicit sources, according to drug abuse experts.
"Heroin is cheaper than it's ever been, $5 and $10 capsules, all over town," said Richard Lane, executive director of the Man Alive methadone clinic which began treating addicts in 1967.
"The older addicts say the dope's much, much better," Mr. Lane said. "They are still selling stuff junkies can inject with some degree of certainty, 5 to 7 percent, but the potent stuff gets mixed up with the weaker narcotic and people fall out, overdose.
"You just don't know what you're getting," said Mr. Lane. "And yes, users who sniff or smoke heroin get just as addicted as the ones who shoot it."
"In West Baltimore, for instance, there is heroin being peddled on the street that is, on average, 71 percent pure," said Capt. Michael Andrew, commander of the Baltimore Police Department's drug enforcement section.
East Coast overdoses
The high-grade heroin is leaving its mark on East Coast cities. In Boston, last September, 14 people suffered heroin overdoses -- one fatal -- in two days. In New York, heroin sellers are replacing dealers in areas traditionally occupied by crack cocaine dealers.
According to the latest figures available, easy access to high-grade heroin here has placed Baltimore second only to New York City in hospital emergency room admissions for heroin overdose cases.
The National Institute on Drug Abuse in Rockville says at least 3,922 episodes of emergency room episodes involving heroin were reported in Baltimore-area hospitals in 1991, the most recent time available. New York City reported at least 6,172 emergency room cases in the same time frame.
"Actually, heroin never went away -- people, the media just paid more attention to the emergence of cocaine and the attendant violence," said Dr. John E. Smialek, chief medical examiner for Maryland. "The overdose cases we are seeing now are your dyed-in-the-wool heroin addicts, people in their late 20s and 30s."
Dr. Smialek said there were 104 overdose deaths in the state in 1990, most of them in Baltimore City. The following year, 108 heroin overdose cases were recorded statewide.
Through November of this year, 101 people have died from heroin intoxication. The total jumps to 136 through September with inclusion of deaths caused by the use of heroin combined with alcohol, Dr. Smialek said.
As the availability of heroin increases, the number of addicts seeking treatment at methadone clinics is also climbing.
The number of addicts seeking slots in methadone programs rose 4 percent statewide in fiscal 1992 compared to the previous year, said Bill Rusinko, chief of information services for the state Alcohol and Drug Abuse Administration.
With the more potent form of heroin available, there has been a significant increase in people snorting it, Mr. Rusinko said.
Interviews with addicts seeking treatment in Maryland showed that from last July to December, about 1,500 people were inhaling, Mr. Rusinko said.