ANCHORAGE - With one pinch of the needle, Shenna Bolger was hooked on the warm, euphoric wave that washed over her as the black tar heroin coursed through her blood.
That first time was at home with her boyfriend in their Anchorage apartment. A regular user, he stuck her arm. She was curious. And a quick learner. Five years later, dark brown scar tissue traces the veins along the insides of her arms from above her elbows to her wrists as a reminder of what she had become.
She lied. Stole from friends. Set them up, ripped them off. Got others hooked, then sold to them. Watched friends overdose in her house. Worried about getting busted, losing her kids. Shot up in front of her 5-year-old daughter. But none of it mattered at the time. She was dope sick.
"It was just part of the drug addict game," Bolger said. "After I started doing tar, there was nothing else that could make me well."
At the height of her affair with heroin, she was shooting up a gram every day - a $500 habit that could have cost her her life.
Law enforcement officials say they have seen a dramatic increase in the number of heroin cases over the past year or two.
"It went from something that we knew existed and saw periodically to something that is, probably at this point, more than 50 percent of our work," said Sgt. Rob Langendorfer, who runs the Alaska Bureau of Alcohol and Drug Enforcement's Mat-Su unit.
Heroin cases are also booming for Anchorage police, who in 2003 entered evidence from only eight heroin cases into their locker. Last year, there were 49 cases. There are more commonly used drugs in Anchorage - marijuana, cocaine and crack, meth - and therefore bigger drug problems, but stopping the rapid advance of heroin is becoming a top priority for police, said Lt. Nancy Reeder, head of the Anchorage police Metro Drug Enforcement Unit.
Although heroin use is growing, treatment options are not. Since March, the only way to get into Anchorage's only methadone program is to be pregnant: That's what got Bolger, 23 and six months pregnant with her third child, a coveted spot.
Eight of the 77 clients at the Narcotic Drug Treatment Center in Anchorage are pregnant or recently gave birth, said clinical director Ron Greene. And the clinic is taking in an average of two more pregnant women each month.
One theory about the uptick in heroin use is that a rash of methamphetamine lab busts in recent years pushed addicts to take whatever is cheap and available, in this case heroin. But the amount of available meth hasn't declined as quickly as the labs have: It's now being imported, Langendorfer said.
The prevalent theory is that heroin is cheaper and easier to get than prescription medicines like Oxycontin, a much-abused painkiller whose opiatelike effects are similar to heroin's, said Viki Wells, behavioral health specialist with the Alaska Department of Health and Social Services.
Today's addicts are not always stereotypical junkies. Some are longtime drug abusers who switch to something more potent. And there are the high-school kids wanting to party who try Oxys. But there are also people who have had steady jobs and mortgages before being injured and getting an Oxy prescription for the pain, Wells said.
No matter what leads them to try opiates, they get hooked. Some then find out that getting prescription pills is a lot harder than scoring a bag of dope on the streets, Reeder said. And heroin runs about $50 per tenth of a gram dose, making it bargain-basement cheap compared to Oxys, which can run up to $180 each in Alaska.
Bolger knows that well. She used other opiates, but heroin was always just a call away. Now it's been about four months since she has gotten high. At the clinic, she gets homework, counseling and her daily dose of methadone. The drug didn't satisfy her cravings at first, but now she's on the right dose.
"It doesn't make you high at all," she said. "It just makes you normal to where you don't have ideas about using, you don't have cravings, you don't have the withdrawal symptoms."
Heroin has so far remained largely a metropolitan issue in Alaska, but city problems usually foreshadow what's to come in the Bush, said Lt. Andy Greenstreet, deputy commander of the Alaska Bureau of Alcohol and Drug Enforcement. Law enforcement officials across the state say they are stepping up their efforts to stem heroin's flow, primarily by going after the source - or as close to it as possible.
"You can certainly pick end users up on the road, but realistically you're really not having much effect if all you're doing is arresting someone who's using," Reeder said. "What you really want to do is try and cut their head off."
So far, though, the numbers indicate their efforts have not dissuaded drug runners from importing the stuff. In 2004, for example, state drug officials seized 113 grams of heroin. Last year, they seized 10 times that, according to the Alaska Bureau of Alcohol and Drug Enforcement's annual drug report. Federal drug seizures are up as well. In 2002, the Drug Enforcement Administration seized only 0.1 kilograms of the drug in Alaska. Last year, it seized nearly three.
The center where Bolger is a client is one of two clinics in Alaska that treat patients with methadone, a drug that reduces opiate withdrawal symptoms. The Interior AIDS Association in Fairbanks is at capacity, as is the Anchorage clinic, which has a 27-person waiting list. As recently as May, there were 45 on it. But after months of waiting, many stopped calling.
"I know what they're doing," Greene said. "They're out committing crimes trying to get their drugs, that's what they're doing. They feel like there's no hope, and they've just given up."
Addicts on the list are desperate, and they're waiting six months or more in some cases. Some call twice a day saying they're stealing and prostituting. They beg to get in. Some parents have even offered bribes to get their kids into the program, Greene said.
Even clinics that don't offer methadone are getting pinched. For example, in the Matanuska-Susitna Borough last year, Reba Brady saw five heroin addicts treated at Ascent Treatment Services. As of Wednesday, she had 14 in treatment and 12 more pending cases this year.
Other drug treatment centers across the state offer drug counseling without the medication, and, for those who have insurance or can afford it, there are about 40 doctors in the state who are qualified to prescribe buprenorphine - an alternative to methadone, Wells said.
But few addicts can afford such medication - often a crucial component to ending heroin addiction. So for many, methadone clinics are rehab Shangri-Las because they rein in withdrawal symptoms. The Anchorage clinic treats all opiate addicts, and, according to Wells, 39 percent of those on the wait list in 2007 reported heroin as their drug of choice. That jumped to 62 percent in the first quarter of this year. At the same time, 77 percent also reported being injection drug users.
"You have to be really, really desperate and willing to do anything before you go to a methadone program for treatment," Wells said. "The people that they see are pretty much late-stage and they have pretty much gone through any savings; most aren't working, they have a chaotic work history. They don't have insurance."
While the number of heroin users is apparently rising, the number of people the clinic can afford to treat is not. There are 77 people in treatment - down from 83 a month ago - but Greene says he only can cover 75. Next year, that number will be down to 64, and he is reducing the number of patients by only accepting pregnant women.
By using methadone - considered a safe alternative to heroin for fetuses - to prevent pregnant women from using, the clinic hopes to prevent future, costlier problems in the child's life, he said.
Bolger said her kids are her motivation to keep clean. Bolger's mother has custody of her 5-year-old daughter, Bionka, and she wants the child back. There is also her 7-month-old-son, Zaradesht, who tested positive for drugs when he was born, prompting the Alaska Office of Children's Services to take him away. Bolger has since gotten him back, she said, and, though he went through withdrawals for a while, he seemed healthy as he played with her fingers in her apartment one recent afternoon.
Bolger doesn't want to go through that again. The clinic lets users decide how long they want to stay, and she plans to remain at least until she gives birth.
Getting in wasn't easy, and this isn't her first time trying to clean up. She's tried it all. Cold turkey, with the simultaneous sweats and chills, the cramps, the unrest, the desperation. She once tried a local rehab clinic but dropped out her second day. Too much temptation here. She had some success at an Outside rehab clinic. But when she returned to Alaska, and her crowd, she got sucked back in.
"I thought that would never happen," she said. "Happened to me twice."
Ellen Field, 51, has been a patient at the Anchorage clinic for more than three years. Bolger considers her something of a sponsor and even moved into an East Anchorage apartment directly below Field's where she can find support 24/7.
"Some days she can be hard, and I believe that's part of fighting the addiction," Field said. "It's a battle for her every day."