August 8 - 15, 1 9 9 6

[Heroin]

Cleaning Up

Over and over again, former junkies make the same point: getting clean and staying clean are two different things. Many are able to go clean for short periods. But most experts say -- and the former addicts interviewed for this article agree -- that almost nobody can stay clean for any length of time, or even consider permanent sobriety, without the assistance of a fully supportive program. This usually includes detox (lasting anywhere from five days to four weeks), daily meetings in the early stages of kicking, and regular follow-up care. Several former junkies also say that acupuncture is a great aid, helping them relieve both physical and mental anxieties associated with withdrawal.

Many say that leaving their present environment is a common way of trying to kick. (A number of fellow users of the former junkies interviewed for this article have since left Boston.) But a move is useful only if the intent of getting clean is to stay clean permanently. Otherwise, a change of scene could slide into the phenomenon known as "tuning up" -- when a longtime junkie goes clean so he or she can get healthy enough to start using again.

Fortunately, there is help to be found in Boston:

* Narcotics Anonymous and Alcoholics Anonymous are both nationally known, well-recognized associations that offer 12-step programs. These groups have helped hundreds of thousands of people, although some of their methods and spiritual leanings don't appeal to everyone. Both AA and NA can be easily reached Monday through Saturday until 9 p.m. at (617) 426-9444; in addition, NA can be reached directly at (617) 884-7709.

* Self Management and Recovery Training (SMART) is a nonprofit volunteer organization (formerly called Rational Recovery) that manages a network of 41 self-help groups throughout Massachusetts for those with alcohol or other drug-abuse problems. Unlike AA or NA, this organization avoids 12-step programs and uses a "Cognitive Behavioral Construct," which stresses self-empowerment through positive decision-making. SMART's number is (617) 891-7574.

* Music Cares is a national organization set up by the National Academy of Recording Arts and Sciences. Staffed by professional social workers during business hours, Music Cares also offers an after-hours referral service for substance abusers. It can be reached at (800) 687-4227.

* Two 24-hour crisis hotlines also offer help: the Good Samaritans, which can be reached at (617) 247-0220, and the Massachusetts Alcohol and Drug Hotline, at (617) 445-1500. Both of these services will refer people to support groups and detox centers -- and assist those who lack funds or health insurance.

-- JB