She was 16 and already using meth, so why try heroin?

Her boyfriend was using it, and wanted her to, but she wasn’t interested, until the day that her friends held her down and injected her with the opiate.

She liked it immediately, and started using it, heavily.

“In my teen years, I would use almost two grams a day,” said Raechel Femling, who still has a black mark on her arm from that day, 14 years ago.

To heroin, she added uppers, usually cocaine or crack, and “popping pills, anything, any kind of opiate I could get.” She quit using a couple of times, and when she was pregnant, but after her daughter was born, she got hooked on prescription pain killers and spiraled back down again. That boyfriend went to prison on drug charges. She went to detox twice.

Now, after years of heroin addiction, she’s almost free of all that. She’s living with her parents, raising her two children, and about to graduate from college and from a rehab program. She has chronic pain from multiple car accidents, too, but she can still see the appeal heroin has for users.

“It’s pretty powerful and makes you forget everything,” she said.

Like a hammer

Heroin is fast-acting, slamming into the brain like a sledgehammer, explains Dr. Alan Johnson of the Snoqualmie Ridge Medical Clinic.

This effect, which also comes with methamphetamine use, or smoking oxycodone, is what makes these drugs so addictive, he adds.

Johnson has been treating opiate addicts for two years and, like nearly everyone who deals professionally with illegal drug users, he believes most people can’t tell who is a drug user and who isn’t.

“People might have the perception of a drug user or a marijuana user,” said Snoqualmie Police Sergeant Steve McCulley, “but from the population in our city, which ranges from upper middle class to working class to whatever, there is no typical drug user.”

Nor is there a typical introduction to drugs. Johnson said most of his patients got addicted to drugs that a friend let them try, or that a physician prescribed for them. Betsy Gudz, a chemical dependence counselor with Snoqualmie’s Friends of Youth, thinks that at the ages she sees, the main factors are “boredom, curiosity, and opportunity. Often times, the younger ones… either have older siblings, or they have friends who have older siblings, so there’s the opportunity.”

The wide availability of prescription pain-killers (legal opiates) is part of what’s creating that opportunity, according to McCulley. His department made 37 drug arrests in 2009, 36 in 2010, and 18 through July 5 of this year, all for illegal drugs. However, he says prescription drug abuse is definitely on the rise.

“People who have prescription drugs, especially with kids in the house, should keep them locked, keep them hidden, because friends might come up and visit the bathroom and take them,” McCulley said.

Prescription drugs are perceived to be safer by many users. The danger, however, is in their high cost, and decreasing availability. A single Oxycodone pill has an estimated street value of between $4 and $15.

“That’s probably why everyone is using heroin, because it’s cheaper,” said Femling, who used to get her drugs from friends. She didn’t know where they got them, but knew they probably stole to get the money for the drugs, something she would never do.

“I always thought first,” she said. “Even when I was really screwed up, I wouldn’t dream of stealing something…. I’d rather be sick (from withdrawal) than do something stupid.”

Oxycodone is also not as useable any more. Until earlier this year, users could burn an oxycodone pill on a piece of foil and inhale the smoke, referred to as “chasing the dragon.” Manufacturers have since changed the formula of the pill coating, to dissolve into a gelatin-like substance when heat is applied, so more users are switching to heroin to feed their addiction, or more accurately, their dependence.

Pill abuse on the rise, numbers say

Prescription drug abuse is also increasing dramatically, and could replace methamphetamine as the biggest drug problem in the state of Washington, according to the Washington Attorney General’s website.

Although the statistics surrounding meth use are improving—the numbers of meth labs reported have dropped by 87 percent, and meth-related deaths dropped by a third—the statistics on prescription drug abuse are worse than ever:

Drug overdoses are now the leading cause of accidental death in Washington, and the majority of overdoses involved prescription drugs.

Prescription drugs kill more people in Washington State than heroin, cocaine and meth combined.

Methadone, a prescription pain reliever, is the leading cause of death in drug-related unintentional poisonings.

People have easy access to prescription drugs, even illegally. They can get them on the Internet, from friends or relatives with valid prescriptions, by making fraudulent visits to emergency rooms, buying them on the street, or stealing from pharmacies.

According to the latest Snoqualmie Valley Healthy Youth Survey, 12 percent of 12th graders used prescription pain medications to get high in the past 30 days.

More than 47 percent of teens get prescription drugs from their friends for free. About 10 percent buy them from their friends, and another 10 percent take them from friends without asking.

Defining addiction

The federal definition of dependence that doctors like Johnson must use in treating addicts asks whether a person is spending time and energy exclusively on getting more of the drug. Addicts are unable to function without it, letting all other aspects of life fall apart and using a drug more than they want to.

In the case of opiates, using too much will kill you, because that’s what the drug does. One physical effect of opiates is the activation of receptors in the brain that cause a slowing, relaxing effect.

“If all your receptors are turned on, you get the effects of opiates and you slow down all the way to dying,” Johnson said.

Each year in King County, about 30 people kill themselves with drug overdoses, according to the King County Medical Examiner’s 2009 annual report, the most current one published. Another 200 to 250 die from accidental overdoses.

Other effects of long-term opiate use include frequent infections from dirty needles, a weakened immune system, heart and liver problems, and trouble breathing. There are treatment options, but they often require a painful withdrawal process, about four days long, followed by extensive counseling and group therapy.

Only people who are truly motivated choose treatment voluntarily, as Femling did, but compared with the rush users can get from opiates, treatment is hardly an attractive option.

Femling went through a suboxone treatment program with Johnson for two years, and is ready to graduate, but also nervous. The suboxone, an opiate that is effective in a stepped rehab program, has been her safety net, the thing that she always knew she had to fall back on after a bad day. She is sure she wouldn’t do it, not with her family near and an 8-year-old daughter and 5 year-old son to look after, but says it’s nice to know there is still something to lean on.

“After this, I’ll ask him to put me on those opiate blockers,” she said. Her memories of the feeling she got when she was using are still too vivid.

“You just want to get higher and higher,” she said.