Sabrina* has just gotten out of detox at Nassau University Medical Center (NUMC). For six years, she has been doing heroin, so the uproar about the drug hitting Long Island’s little streets is old news to her. It’s not the first time she has been in detox, either. Unless she dies first, it will not be her last.
She is sitting cross-legged on the cement behind a red trailer that is about 100 feet from the entrance to the NUMC emergency room, joined by her new friends Liam* and Becca*. Sabrina sits perilously close to a wine-red vomit stain that is punctuated by tan-filtered cigarette butts. In fact, the cigarette butts behind the red trailer are as numerous as the stars in a clear mountain sky. They are everywhere.
Sabrina’s arms bear the scars of a hardcore junkie. Pits and craters betray the infections and abscesses that have threatened her health more than once in her 26-year-old life. Dark eyeliner is drawn thick around her eyes. She is Italian, she says, with a proud face that belies some rough nights and bad decisions. A nervous hand flicks a cigarette. Sabrina does not know where she is going to sleep that night. She has no money. Everything she owns sits next to her in a black duffel bag.
But she doesn’t care, because Sabrina is already high on heroin she bought, cooked and injected into her veins mere feet away from the entrance to one of the busiest emergency rooms on Long Island.
As the heroin crisis on Long Island grows, and more people need treatment to battle the crushing addiction, the vultures are circling. One year after the overdose death of Massapequa teen Natalie Ciappa took over the headlines and a light was cast on the mounting woes of heroin abuse, it has become so insidious that addicts can buy and shoot the drugs in broad daylight at one of the most visible places on the entire Island.
“I have to do it,” says Sabrina as her voice cracks. “It’s what we all say.”
It has long been known that heroin addicts, especially ones who are less than an hour out of detox, are especially easy prey. People waiting for methadone, a drug used to treat heroin addiction, are targets too. And NUMC has a thriving methadone program, which sees up to 650 people per day. Some people leaving detox never even get past the front doors at NUMC before they have a deal set up.
To a drug dealer, the drug dependency programs at places like NUMC are like the line at McDonald’s, and everyone is hungry. Jeff Reynolds, executive director for the Long Island Council on Alcoholism and Drug Dependency, says those first hours and days of an addict’s recovery are crucial.
“[An addict’s] chances to remain clean are significantly increased the longer they remain abstinent,” says Reynolds. “If you are a drug [dealer], it certainly makes sense to go where people are more vulnerable to use.”
Outside of the emergency room, ambulances, paramedics, hospital security, staff and police officers move about in the carefully synchronized dance of the NUMC emergency lot, unaware of the drug sales and abuse going on just?behind the red trailer in the parking lot. Within earshot of Nassau County cops, hospital security and staff, Sabrina sits with other junkies like herself, not afraid of being caught but only afraid of not being high.
But really, that was never a concern for her while she was in the NUMC detox program. She knew there would be something waiting right outside the door.
Despite the documented increase in heroin’s hold on the youth in Nassau and Suffolk counties, there is little help for people who do not have medical insurance. They have to find a “safety net” location, a hospital with an in-house detox program, so people fighting alcoholism, addicted to barbiturates, opiates and anything else can get a head start on trying to kick their personal habit. In this case, little or no help means exactly 20 beds for people of all ages in both Nassau and Suffolk counties fighting any sort of chemical dependence.
Twenty beds for the whole Island. And the problem has become more widespread. In the heroin series featured in the Press last year, kids in Nassau County were in the spotlight. Almost everyone who was leaving the NUMC detox and interviewed for this story was from Suffolk County.
“It’s a big problem,” says Detective Lt. Peter Donohue with Nassau’s Narcotics and Vice Squad. “We are arresting people from Nassau who say they have tried to get help [at NUMC], but there are no beds because all the Suffolk kids are there. The kids from Nassau have to go all the way to the Bronx. And that is not a good place for an addict to be.”
In other words, a kid with a heroin addiction in the city most likely equals trouble. Law enforcement agencies around the Island have confirmed that the drugs are from Brooklyn, Queens and the Bronx. Long Islanders make the drive to these areas and bring it back over the border.
Getting into the NUMC detox is not an easy feat. Dr. Asma Ejaz oversees the chemical dependency programs at NUMC, which includes the five-day detox program and a 28-day rehab program. She says that there are a lot of people coming for help these days. Most are young people with heroin addictions.
“These days, about 60 to 70 percent are there for heroin,” says Dr. Ejaz. “Roughly 30 to 40 percent are there for alcohol treatment.”
It is a first-come, first-served arrangement. If an addict needs a bed, he or she goes to the emergency room and says so. If there are no beds—which is more often than not the case—then a name is put on the waiting list.
Red Trailer Club
The red trailer is used for decontamination of patients in case of bio-terrorism, chemical spills or any other issue that might necessitate such treatment. Ironic, as there is only contamination going on today next to the trailer.
A few hours before he met and got high with Sabrina, Liam was leaning against a brick wall behind the red trailer. He is wearing a black hoodie and his jeans are baggy. A decorative stone adorns his neck. He is thin, wan and his skin is yellow, despite the driving sun. Liam has been there for more than 24 hours, having come to NUMC on a Thursday morning hoping to get a bed on Friday. But the program was full, he says, so now he is waiting. It is clear that Liam is dope sick, although he says the worst is over.
“The last two days were worse [than today],” says Liam, who has to check himself into the program as part of a court-mandate after he was recently arrested in Nassau for purse snatching. (“There wasn’t even any fucking money in the bag,” he says of the purse in question.)
Liam is from Smithtown. One year ago the town was not on the map as far as heroin use was concerned. It is currently earning a reputation among users as a place to go. Liam has been using heroin for about two years, and injecting the drug for about six months. Just like everyone else, he started out sniffing it as the potency of today’s heroin makes it an easy choice. But in short order, snorting it wasn’t enough and he graduated to the needle.
He does not work, but gets a disability check from the state, although he did not disclose why. He lives at home, and even though his father is disgusted and just about finished with his antics, Liam can still get his father to give up some money from time to time so he can ward away his Jones when he is out of dope. Without completing a short stint in the detox program, Liam will probably have a warrant issued for his arrest. Early in the day, he seems concerned about that possibility. But his dad is running out of patience.
“He said I better stay here and do it,” says Liam. And it’s all up to him, too.
“This is a voluntary program,” says Dr. Ejaz. “The court can recommend treatment.”
People who are on parole or probation will show up as a matter of their release too, says Dr. Ejaz. If he or she does not complete the program and leaves before they are medically ready, their probation or parole officer will be notified.
If you know anything about addiction or addicts, it is easy to spot them in the NUMC waiting room. Most of the men sport close-cropped hair. Both sexes are inked up pretty good on their arms, legs and necks. They take turns using the public phone at the front desk, most giving directions to people who are coming to pick them up. Hours later, most of them will still be sitting by the entrance to the hospital, or behind the red trailer, waiting.
Some have nowhere to go anyway.
They are all white, in their early 20s. The stereotype seems to be taking hold and not letting go. And most see themselves as such:
“I am a fucking 21-year-old junkie,” says Liam. “That’s what I am.”
About an hour later, Liam has been joined by two girls behind the trailer. Sabrina and Becca, a slender girl with dirty blonde hair. She wears long sleeves, despite the warm weather. They are seated on the cement next to the red trailer. Within earshot, cops talk to each other amidst the many ambulances that have brought the infirm to NUMC. If there are cars parked in the stalls in front of the trailer, you can’t see anyone sitting behind it. Plus, hospital staff members go there to smoke cigarettes.
The security detail is zombie-like. Guards wander around aimlessly, taking personal calls on cell phones and disappearing for long periods of time. The only time they snap into any sort of action is when an authorized vehicle parks in the lot. Parking in the emergency zone is a big no-no here. Worse than selling, buying and doing heroin, it seems.
In the summer sun, you can get some shade behind the red trailer, too. Becca has her hands on a knock-off designer bag. She is the girl next door. She has beautiful blue eyes. Her wrists are adorned with bracelets. Becca is articulate, smart and looks pretty good for an 18-year-old woman who slept at a Long Island Railroad station last night.
“I didn’t care, because I was high as hell,” says Becca. As she speaks, her eyes roll slowly in her head. She readily produces a syringe that was just used. Becca is from a well-to-do Suffolk town, too. She did heroin during her senior year of high school, but got clean before going to an upstate SUNY college, where she stayed off the junk until late in the year when an old friend came up to visit and brought heroin with him. She has been shooting ever since, and had not been home for days.
“My parents don’t know where I am at all,” says Becca as she lights a Marlboro, but not before she passes them out to her new friends.
She reaches into her shirt, in her bra, and produces four bundles, or 40 bags, of heroin. They were purchased on the hospital campus, right near the red trailer. She did not know Sabrina or Liam before today. But junkies find each other, says Sabrina.
Sabrina tells of the last time she was here at NUMC, and when she walked outside a guy drove up to her and asked her if she had just come from rehab and if she wanted to get high. She said yes. She left the detox this morning with $55, all gone now after buying dope in the emergency room parking lot.
As the day wears on, a few things become clear. First, Liam is not waiting for a bed anymore. Instead, the grounds of NUMC have become his hangout for the day. Second, Becca seems to be the bridge to the smack. She ushers a few other junkies around, shows them what to do. Some of them disappear into the rest rooms of the ER for extended periods of time. At one point, she slowly traipses past four Nassau cops who are speaking to each other in the parking lot. She adjusts her bra as she gets to the front door. They have no idea she is carrying enough heroin on her to net them a great bust, ruin her weekend—and then some—and maybe rip the lid off the problem of junkies buying dope right next to the hospital.
It can be easy to miss. Any time spent on a busy holiday at the main entrance of NUMC will illustrate that fact. Ambulances fly in and out. So will a helicopter, for that matter. Emotionally disturbed individuals may be ranting to themselves. Distraught families run through the doors. On this particular day, the ER is very busy.
Officials at NUMC were tight-lipped about the problem. But it is clear they may be overwhelmed by the heroin scourge that is strangling the region.
“It is the mission of the Nassau Health Care Corporation to take care of a very difficult population of Nassau, Suffolk and Queens residents, suffering from many afflictions, including substance abuse problems,” says Arthur A. Gianelli, president and CEO of the Nassau Health Care Corporation, which runs NUMC. “Illegal activities are the responsibility of the Nassau County Police Department and any time that we observe any criminal activity occurring on our campus or on our units, we notify the Nassau County Police Department.
“This epidemic of drug dependency is a society-wide issue that is overwhelming resources, pointing to the need to expand services and resources to treat this difficult population,” says Gianelli.
Nassau County Executive Tom Suozzi, who has a heroin summit planned for July 28, was shocked at the revelations of heroin sales and use on the grounds of the hospital.
“This is very disturbing news, and I am going to call [NCPD] Commissioner [Lawrence] Mulvey and Art Gianelli to address this,” says Suozzi. “Obviously, there is a terrible incentive for dealers. We have to make sure they know they are going to jail.”
But the problem is not new, and the cops are doing everything they can with the resources available, according to NCPD spokesperson Detective Sgt. Anthony Repalone.
“It is a shame. These people are vulnerable, and dealers are aware of it,” says Repalone. “The Nassau County Police Department has definitely been taking steps to deal with it.”
According to police sources, there have been many complaints about drug activity near or at the county-run methadone clinic. Donohue says this is an age-old problem. In January and February, NCPD Commissioner Mulvey announced a serious crackdown on heroin sales in the county. One of the hot spots was the area immediately adjacent to NUMC. Through buy-and-bust operations, six arrests were made right next to the hospital.
Generally, dealers will cruise the hospital grounds and entrance, looking for customers. Then, they will arrange a sale at a nearby strip mall or fast food parking lot.
Don’t let a low number of six arrests mislead, either. In total, 95 arrests were made during that initiative. And Donohue says that there have been 232 arrests already this year, compared to 211 in all of 2008, which puts the NCPD on pace to see more than twice the amount of heroin-related lockups this year.
Cops focused on the area around the detox clinic not just because junkies who were recently released are easy targets for dealers. Addicts who are being treated with methadone are known to sell their liquid doses by holding the drug in their mouths and then performing a “spit back,” wherein they will give the dose to someone by spitting down their throat.
Today though, those police efforts are too late for Sabrina, Becca and Liam. Hours after he last went to check if a bed was open, Liam is stumbling across the parking lot. His head is drooped, pants are falling down. He is wearing black slippers, which are almost off of his feet as the heroin pushes him forward clumsily. Back behind the red trailer, which has had new visitors over the day, Sabrina is crying. Liam slides over and puts his arm around her.
“I just want to stop,” she says. “I just want to stop it.”
She did, for the few days she was in detox. But that is gone now. Erased by drugs she shot into her blood an hour after walking back into the world. Heroin is a lifelong addiction fed by decision, pain, vicious dealers and insatiable cravings. Detox is a baby step in that long walk, and many of these addicts are taking that step when they are still teenagers. There is a lot of walking to do after that.
These kids couldn’t even get out of the parking lot before they were high.
* These names have been changed to protect the identities of these subjects.
An Addict Helps Parents Spot The Signs
It was a dark period for John S*. In a few short months his best friend was critically injured after being run down by a car. His beloved grandmother died, and his girlfriend broke his heart. Although he seldom drank and never smoked pot, John had been taking pills for a while, and his depression after these events made him up the ante. He graduated from Vicodin to Percocet to OxyContin pretty quick. But the price of the synthetic heroin was prohibitive. Someone turned him on to real heroin instead, which cost much less and gave a better high. John was hooked—and fast. His parents began to wonder. They overheard a conversation a friend had in his house about dope. Then his mother found a few syringes. Having dealt with addiction with some of her family when she was young, it was too much to deal with. John’s father gave him an ultimatum: the drugs or your family.
That night, John went out and did heroin, but he could not forget the ordeal and he wanted to stop. Since January 2008, John has been clean with the help of Soboxone. Now just 20 years old, John knows he has a battle ahead of him. One of the ways he is tackling his addiction is helping educate parents about the warning signs of heroin addiction through his website www.parentalunderground.com. The site, although still in its infancy, provides a road map that parents can follow. It is a map drawn by someone who, at such a young age, was able to stop before he went too far and ended up in jail, on the streets or dead.
“Most parents are just oblivious,” says John. “They think of spoons and needles. They have these images. But there is a lot more they need to know.”
Heard It Here First
In the June 26, 2008 cover of the Long Island Press, “Long Highland,” the Press began a series of nationally-recognized stories that exposed the heroin scourge that has since worsened. Within two weeks of the first story, teenager Natalie Ciappa became the tragic poster child of the new age of heroin after she died from an overdose.
To read all five parts of our groundbreaking and award-winning Heroin coverage, go to www.longislandpress.com/heroin