Inside story. Pass welcome to inside story, im adam may sitting in for ray suarez. Smack, junk, h, black tash all names for heroin. They are all names for heroin. It can be white, brown, black and sticky. In jected, inhaled, smoked. No matter the choice, its a highly addictive drug. Most shocking, new user are turning to heroin because they became addicted to legally prescribd painkillers. Schedule, the epidemic is spreading from the cities, suburbs to rural america. Al jazeeras jim huli produces us to one recovering act. No one wants to be addicted to heroin. No one wants to sit in the bathroom. Its not easy. Courtney nose the lure of heroin, addiction cost her jobs, friends, loved ones. She did some gaol time. I was smoking it at first. I had a person who introduced me to shooting it. If you do to this way, it will use it. Her dad paid a heavy price. Can you show us what you may be about to lose . Everything you see here. We met courtney last year when her father dan was forced to sell his 40 acre farm to pay courtneys legal go through things that theres nothing you can do to help. She was in withdrawal, struggling and years of drug abuse. Finally she decided to go cold turkey and kicked the habit without professional treatment. That withdrawal process, what was that like . Ugly, messy. We were in for a little while. I would shake it was awful it was like having the flu times 10, and then some. It was ugly. It had to be done. Dan and courtney rented a home in colorado. Sacrifices have to be made. Always. Things are just thing and money is just money, they are things you can get back. Courtneys addiction left him feeling helpless as a father. Their bond has grown. Courtney works for her dad as an apprentice carpenter. Youre pretty lucky. Yes, i guess i am. Im blessed to say that. My trust is restored in courtney by watching her hard work, paying attention to her world. Being open with me. Reporter courtney found support at this rockclimbing gym, where a group of addicts take their live to knew heights. Its a glad perspective to come back and everyone is doing something healthy, good endore fins, not just a high. Its a great feeling. Courtney says he has been free of heroin for a year and a half, and will worry about the temptations but is empowered to be drug free we are joined by dr ramsay, a chief medical officer of the Phoenix Health center, a Substance AbuseTreatment Center located in maryland, and lawrence, clean for 10 years. You shot heroin when you were 15 years old. I have to ask you, you grew up in baltimore, what was it that even made you think you should use heroin at 15. A lot of low selfesteem. Not having both parents. It was things that you most likely wouldnt think of. You know, sense of lack of belonging, things of that nature. Reporter do you remember the first time what it was like. Yes, i remember going out, hanging out with some of the guys. It was like at that time i was like sniffing drugs. Sniffing heroin, and then, like, always running out. You know. I wake up the next day. Some of my friends still had it, i wouldnt. And i remember the time it was one of those days where i thought why do you always have drugs the next day and i never have none. It was let me try the way you was using it. One of my buddies no, you dont want to do this. Yes, let me try. And from that point on it was unmanageable nightmare. It was a whole other part of me came out. Would you hear the doctors story. How common is that, especially a couple of days ago when people used heroin recreationally. Are we seeing a change as to why people are using heroin today. The story is a bit more direct. Way. Children start smoking. Experimenting with some of their parents medication or grandparents medication, prior to getting into the heroin scene. It seems oftentimes theres another underlying condition that sets them into a mode of wanting to selfmedicate. And before long, that feeling that lack of satisfaction or happiness feeling. You said it was a nightmare. What you hear from so many addicts, and recovering addicts. There comes a point you feel sick without it. How soon did that happen for you. Ill. To me it was a difference from sniffing, a great big difference on sniffing, like the route of administration is correct. It was two, three days, you know, and according to, like, the quality of it, sometimes, like, two or three hours is always that graving need for more, just to be outside. Not wanting to be in your own skin. Because a large part of using heroin is you get to be someone else, and you get to lose you, have courage to do things. I have done things using heroin that i wouldnt. Just the whole thing even like having the opportunity or thicking about working thinking about working, having a job, going to work, whatever, its all about the streets. You work for the doctor now, you made a turn around in your life. Doctor, how hard is it for someone like laurence to make this change in your life. You hear that heroin is the most addictive drug. This is more than an addictive substance, isnt it. Thats the beauty of it all. There is trement. The key is individualizing that treatment. Setting a plan that will work for that patient. Oftentimes stigma, fear of getting the care, regulatory processes interfere with your right. You are in western maryland. Thats correct. You have seen reports of increases in heroin use and Overdose Deaths in maryland. What are you seeing at the Treatment Center. To give you an example, if you measure the first three months of the year, the First Quarter and compare 2011 to 2015, we had 193 deaths in the state of maryland, in the First Quarter of 2015. One quarter. One quarter. 200 deaths. Compared to 70, four years ago. Form. Are we doing enough about it. Well at least there is an awareness. At least we are inching or managing the stigma. The biggest problem i used to have is methadone, you know. Dont come back to my home stuff. These are replacement therapy drugs for those unfamiliar. These are targeted medications that help in the overall process. When you have aspects of the brain that are dysfunction am. You cannot expect talking you out of it will do it. How important is inpatient therapy coupled with these replacement therapies. Do you need both of them to be successful. The addiction medicine disexed criteria developed criteria that gives us the level of care the patient needs. That is the secret. The secret is making sure that the patient is getting the specific treatment needed for the level of ailment. Lawrence, what worked for you . Well, at 12 i started with marijuana, and 15 i injected. What worked for me, i was on the met programme, i wasnt using heroin. I wasnt using heroin. Treatment. See what im saying. You were getting the methadone, but not the treatment. One of things that im so with and on board with, like, at the facilitility i work at, you know, is that we do counselling. Once you get once you find out where a patient at, and you give them therapy. We are the doctors there. Its a multiwrong approach. Theres no solution for all of this. People need to look at all the options. Thank you for sharing your expertise, and lawrence, thank you for sharing your story, sobriety. Good to have you back. Thank you so much. Oxycontin, perka set, vicodin. The path from painkiller to heroin junkie, traversed by a Record Number of americans across all income levels, well talk to a doctor who says its high time for more public dollars to attack this heroin epidemic. Being a musician, theres no demand. World renowned artist lang lang the moment youre on stage, its timeless american schools falling flat. There are no music class in public schools. And his plan to bring music back. Music makes people happier. Every tuesday night. I lived that character. Go one on one with americas movers and shakers. We will be able to see change. Gripping. Inspiring. Entertaining. Talk to al jazeera. Only on al jazeera america. Welcome back to inside story, im adam may killing in for ray suarez. We are examining heroins new high. A new study shows heroin use spiked across the u. S. Over the past decade. That number grew by around 300,000 people, and its across all income levels. Most of the new users are white. Experts believe many switch from synthetic painkillers to heroin because its cheaper. Three in every 1,000 americans say they have used heroin in the past year, that is up from less than two. 1,000 a decade ago. More people are dying from heroin overdoses. More than 8,000 in 2013 alone. It looks like the number will be higher in the next couple of years. Researchers found that people who used painkillers were 40 times more likely to abuse heroin. With me is dr Julia Goerges benjamin, director of the Public Health association. Thank you for joining us. You hear these numbers, how big is the epidemic in this country. Its a big epidemic. A lot is preventible. So its a crisis. Its preventible. Are we doing enough to prevent the crisis. We dont have a plan or the funds to address the funding. Here is a plan i brought up. Education, monitoring, medical disposal and enforcement. On paper it looks like it will nip it in the bud. Its wonderful if they have a plan, they work hard, and with State Government and health departments, slowly lacking, and it cirs a lose of action not only in the federal level and also at the local level. Money is lacking. How much are you talking. Is it underfunded severely how much are we talking . I believe its seriously underfunded. I was the Health Officer from the state of maryland. I can tell you that we had all kinds of challenges trying to make sure we could provide all the needs for those in the door. I can tell you there was a real problem getting people in beds. What do you think is the best thing that we should throw the money from now. Is it Treatment Facilities education. I think we need to put something in all those areas. Lets talk about some of the things we can do quickly, educating the public about the risk. If we take one or two of these codings, its not a big deal, for many people, you know, take a couple of those pills over time, theyll be adibilityd. And they often then once the medicine runs out, they are addicted. And now they are struggling to figure out how to keep the high going, or deal with their pain. When you are looking at a street cost of oxy versus heroin, theres a big difference, and for some theres no other choice. What responsibility did the Pharmaceutical Company have in this, what responsibility do doctors have in this. Who is prescribing the painkillers, someone to turn the lense on saying you have to slow this down. We need the medications when we need them. They are good. When overprescribed and overused, bad idea. One of the other big problems, of course, is if everyone thinks about these, opens up their own cabinets and sees what is in there. You have all kind of the medications that you have had over the years that you have not used, they are there, and what happens is grandkids come over, take the medications and they experiment with the drugs. That is how they can get in the hands of someone and start a new user. Thank you for being with us here on inside story. We talked about who is addicted and why. Up next, well take you to the streets of baltimore. Some call it the heroin capital. Nation. The new Health Commissioner has a startling approach to fight this epidemic. Well dive in next. Youre saying everyone, so. Im saying everything. Government committees. Theyre spending money, theyre not saving it. Costing millions and getting nothing. Its a bogus sham. America tonight investigates. Money for nothing. Theyve gotten away with it for years. Im adam may filling in for ray suarez. Tonight on inside story we are talking about heroins new high. Baltimore is ground zero for heroin. They are planning to open 24 hours emergency addiction clinics, and its all handing out a lifesaving drug that will reverse overdoses and are doing this citywide. These are what we give our clients. Heroin. This will save our lives. Inside the cramped quarters of a small bus in baltimore, they are handing out a miracle drug. David, who doesnt want to lose of lat name is volunteering. Here, david hands out nal oxygen, a drug that can reverse a heroin overdose. In a matter of seconds. The person will come out of it right away. Its part of an initiative by the city of baltimore, to train every resident to use nal oxygen. Health commissioner says the need is that urgent. This is the equivalent of having a defibrillator for heart attacks, in office buildings. Everyone should have the ability to save them. You are saying everyone. Everyone reporter baltimore is called the heroin capital of the nation. Every day someone dies of a drug overdose. Its epidemic. 103 people last year died from drug overdoses. Its almost one a day. Just in our city. When we look at the city, there has been a 23 increase over the previous year. If we had any other disease causing this death, if we said ebola is causing 303 deaths, wed mobilize every resource to address that. David was one of baltimores addicted. Homeless for years, he was luck of course, helped off the streets by a good samar tan. Shes now in longterm recovery. You have to look at it as a person with a disease. They are suffering from a disease that robs them of their life. To thank the people that get here and give back and help someone else, thats the biggest reword in and of itself. Joining me, dr leanne webb. I was there last week when the guys unveiled the new plan. Thank you for allowing us the chance to speak about the plan as unveiled by the mayor. She set up a task force to study the issue of heroin addiction in the city, and we are focussing on saving lives. There is no miracle drug, that ive used hundreds of times. And i have seen how someone can be almost dead. Using this medication, literally it will save their life it. Theres no question that nal oxygen, used in more and more municipalities and states is saving lives and can reduce Overdose Deaths. What happens after that. What happens after that addict is brought back to life. We have a mantra, which is that we have to save a life to day. In order to allow the person to have a future tomorrow. Its critical that everyone in the city carries nal ox own. Not just paramedics and police officers, but every single individual, every citizen has the ability to save a life. You want every Single Person in the city of baltimore to have the opportunity to carry this drug in their pocket. Is anyone else this. I hope that every city across the u. S. Will follow baltimores example, and do this. We should have the ability to save someones listen. Every person does. I can show you how to use nal ox ill in 30 seconds. Youre dead. When i visited you you showed me how it works, it is simple, its like sniffing something if you have a gold, a nasal inhaler. The next question is if you have an addict. You bring them back to life, how do you guarantee in this person does not go out on to the streets, uses drugs and keeps the vicious cycle going. We believe in something called treatment on demand, meaning that at the moment that you need treatment, you have to get it immediately. Just like if you go to the er, you are seen by a doctor, if you have a heart atactish seen in the attack, you are seen by a director that day. If you go to a hospital seeking help for addiction, likely you will not get a slot, whether inpatient or outpatient for weeks. We would never think about telling anyone with a medical illness that they cant get treatments for weeks and months. Addiction is a disease. The plan in that. We would like it established. We are planning to a 24 7 emergency room an er for Mental Health and addiction, and want to make sure for every person leaving the gaol, they have a case manager that can follow them and make sure they get the care they need. Will that be expensive . It doesnt cost as much as you think it might. Our estimates are that for both of these programs, for both the Care Management and also for the 24 7 erie otters, that it will cost about 20 mill 24 7 e. R. , that it about cost about 20 million. How much is spent on putting people in gaol. How much lost productivity is there. When we put these people in gaol, rather than giving them the care they need to be productive members of the society, and family members, the toll that heroin had, is not just individual. Heroin is a family disease and community disease. We see the toll that heroin epidemic has taken there, with the breakdown of poverty, point to heroin as a root cause that led to a lot of situations. It will be interesting to see how the plan unfods. Thank you for joining us here. That is tonights inside story. Programme. Well talk about the cost of space, a lot of people discussing new images coming out of pluto, but the price tag 700 million was it worth it. What is the future of space night. For ray suarez, im adam may have a great night. On mairkt, big salaries bad on america tonight, big salaries, bad expense reports, what do californians get . Im trying to see about cash control. 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