RENEE MONTAGNE, host:
Dallas is in the midst of a crisis that's hard to even imagine, involving as it does 9-year-old junkies. Drug abuse experts call it a mini-epidemic among young Hispanics snorting a mild but addictive heroin called cheese. After aggressive action by the community, overdoses among these juvenile addicts are dropping, but the drug appears to be as popular as ever, as NPR's John Burnett reports from Dallas.
JOHN BURNETT: Cheese heroin is Mexican black-tar heroin diluted with over-the-counter sleep medication such as Tylenol PM. Sniffing heroin is not particularly new, but addiction experts say this outbreak in Dallas is unprecedented. Typically, people who inhale heroin are older and they're white. In Dallas, however, users are mostly Latino, and they're young, really young.
Dr. CARLOS TIRADO (University of Texas Southwestern Medical Center): The reports that we were seeing were pretty striking, kids as young as 9 or 10 years of age coming to the hospital emergency rooms or detox facilities in acute heroin withdrawal.
BURNETT: Dr. Carlos Tirado is a psychiatry professor and medical director of a drug treatment center in Dallas. He says substance abuse clinics began seeing younger and younger cheese heroin addicts.
Dr. TIRADO: We really didn't know what to do with a 9-year-old in opiate withdrawal or what the treatment ramifications of that are. Do you send a 9-year-old to an AA meeting? What do you do with a 9-year-old in terms of keeping them sober once they've developed this problem with chronic drug use?
BURNETT: A more typical user is 17-year-old Lizbeth. She's the daughter of immigrants from Juarez, Mexico, who moved to Dallas to get away from the border's violent drug culture. She attends a public school in North Dallas that has a large Hispanic population, within which, she says, sniffing cheese is commonplace.
Wearing a gray hoodie and hoop earrings, she sits on a couch at Phoenix House, a residential treatment center in Dallas. Lizbeth says she started snorting heroin at 14.
LIZBETH: I thought that since it was like used as sniffing, I would like try to deny, you know, no, this is just cheese or whatever, it's not as bad as shooting it up.
BURNETT: She says she entered treatment - now for the second time - because she came to hate withdrawal symptoms.
LIZBETH: I was tired of feeling my bones started hurting. I was tired of my headaches, cold sweats, and all that. So I told my mom to bring - me because I'm already going to be 18 and I don't want to look at myself like being a junkie, you know, like some people I see in the streets. I don't want to be like them. I want to have a better life.
BURNETT: No one had ever heard of cheese heroin anywhere in the nation before the first case was discovered in Thomas Jefferson High School in August 2005. Since then, Detective Jeremy Liebbe with the Dallas Independent School District Police Department has arrested and interviewed more than 300 users.
Liebbe learned that cheese is only $1 or $2 a line - cheap enough for a middle-schooler's lunch budget. And because cheese heroin is low-grade, only 1 to 3 percent pure heroin, it wears off quickly. Withdrawal sets in, and heavy users require frequent hits.
Detective JEREMY LIEBBE (Dallas Independent School District): They say, you know, I'll wake up in the morning and I'm already hurting, so I used some cheese. If I don't use during second period, withdrawal will kick in by third period. Then lunch, then sixth period, then immediately after school, then after dinner, then before bed. And the ones that are really bad off are winding up being woken up in the middle of the night by withdrawal sickness.
BURNETT: Though there's some data that heroin inhaling is growing more popular among young Hispanics in a handful of other Texas cities, it's too early to call it a trend. Still, Robert Lubran, an official at the federal Substance Abuse and Mental Health Services Administration, says they're closely watching the situation in Dallas.
Mr. ROBERT LUBRAN (Substance Abuse and Mental Health Services Administration): The concern is that the people who market these dugs are very savvy, and if there's a profit to be made by moving to another community, we know they'll do that. This is a product that is easily transportable, it is low cost, and it is highly addictive.
BURNETT: In Dallas, things have improved in the past two and a half years. The county medical examiner reported eight overdose deaths from cheese heroin alone or in combination with other drugs, but there has not been a death since last July. Police arrests of heroin dealers in schools and neighborhoods are up. Dallas County formed a cheese heroin task force. And there's now an aggressive education program in the schools, which includes this video.
(Soundbite of video)
Unidentified Man: This is a very, very serious thing.
Unidentified Woman #1: But we need to talk about it or it will only get worse.
Unidentified Woman #2: And more of our friends will die.
Unidentified Woman #3: People who are snorting cheese are risking their lives.
BURNETT: Cheese heroin is not as prevalent in the schools as it once was, but parents say it's still rampant in Hispanic immigrant neighborhoods. Directors of local drug treatment centers report steady admissions of young addicts. Said the school district detective: this is not a problem we can arrest our way out of.
John Burnett, NPR News.