Choosing death over heroin

A FADED colour photograph stands framed on the TV set in Bernie Howard's sittingroom. Taken in 1981, it shows six seven year old Dublin boys on a school trip to the Shannon, their arms around each other, shining, happy, their whole lives ahead of them.

"Four of them are addicts now, heroin addicts", Bernie observes, "and Stephen is dead."

Last July Bernie's only son and the youngest of her three children, Stephen, hanged himself in the hall of his home in Dublin's north inner city. Addicted to heroin, he had battled with it and those in authority there to help him, for almost the last three of his 21 years.

A year later the devastation wrought by heroin on the family left behind does not lessen. As the shock and the numbness wane, the reality is only harder to live.

"People are working and laughing and joking and I'm trying to be normal while inside me is screaming," says Bernie.

"I don't even feel myself. Even the air seems to be different. Everything. The family's not the same. Nothing seems the same anymore. Sometimes I say: `If I just go to sleep long enough I might wake up and be grand'. But I don't even sleep. I just smoke all night." There were 11 heroin related deaths in the area in the fortnight around Stephen's death.

"We have a whole generation destroyed down here by drugs, all Stephen's age. The morning Stephen died there was another lad getting buried a few doors down. He had ODed. There's one girl up the way and she has three daughters on heroin, three beautiful girls. I don't care what anybody says, the politicians don't know what is going on down here. They don't take it seriously, or else they don't care enough."

Bernie, her husband Noel and I sit in the front room of their East Wall home. Her second daughter Nathalie's children hop in and out on skipping ropes. "She found him." Bernie tells me as Cheryl, a pretty little thing of about six gambols in. Bernie, diminutive and soft spoken, smokes furiously, hardly touching the tea Noel has made.

Stephen was 17 when he was given his first Ecstasy tablet "for a joke, to see what his reaction would be".

"He couldn't hold alcohol," explains Bernie. "But the Ecstasy, he loved the Ecstasy, the buzz he got off it and it didn't make him sick."

"I always knew when he'd been on the Ecstasy. He had loads of energy. He'd be up scrubbing the place," says Bernie, half laughing. "He couldn't sleep though and so he was taking the relaxant tablets, sleeping tablets, `roche' [cannabis] - anything he could get his hands on. And then he started smoking heroin - to come down off the Esctasy."

Stephen spent his childhood days perhaps much as Cheryl, with his companions circling the dusty streets on bikes and kicking footballs against the graffiti covered walls. He had his tea every evening in one of the matchbox houses that radiate in terraces along the docks.

He worked regularly with children in Glebe House, a project for deprived youngsters in Northern Ireland and, ..... loved children. Children and disco dancing - they were his life until the drugs. He did a course in childminding and he actually, believe it or not, went around the schools telling children how to say no to drugs, showing them the effects of drugs, what drugs to watch. And then it started for him so simply."

Stephen had been smoking heroin for about a year when Bernie first found out. His older sister, Celine, had been trying to detox him at her home in another part of Dublin. Celine had bought methadone, a heroine substitute, on the street. Although they had not wanted to tell Bernie, Stephen decided to.

"Oh I tell you, it was like someone telling me there and than that he was dead. The feeling was unbelievable. I felt like my heart was going to burst. `Why Stephen?' I kept saying `Why'?."

THE mother brought her heroin addicted, methadone using son home and so embarked on an almost two year battle to get him off. "I didn't know where to go. I did know who to ring," Bernie remembers. "It was Stephen's employer who got them an appointment with the Amiens Street City Clinic. At Amiens Street, however, Stephen did not qualify for treatment. They were told that only addicts that have been injecting for two years were taken onto the programme. "Smokers weren't classified as addicts," she says.

Dr Brian Sweeny of the Eastern Health Board (EHB) told The Irish Times that a heroin smoker would not qualify for methadone treatment, though criteria are "under constant review".

"The lady there was a professional. `Go home', she said to me. `Plenty of hot baths for the pain, and Ponstan. No coffee or coke or tea.' And Stephen was telling me he was addicted, that he needed something. So I tried to get him into Trinity Court."

Trinity Court provides methadone maintenance programmes run by the National Drug Treatment Centre and by the EHB. Different criteria apply to different individuals seeking treatment. In Stephen's case six heroin infected urine samples were required to ascertain that he was using heroin. At this stage he was maintaining on street purchased methadone.

"So he had to go back on heroin to go on the programme. I had to get him some heroin," says Bernie.

When Stephen was then accepted for the programme, he collected and took his allowance of methadone for the 18 days. There was no after care scheme at that time. With no support and no follow up he was left to his and his society's same devices as he had been two and a half weeks earlier.

"I wanted to believe he was off drugs but he was still dabbling. It's so open out there. It's all there is. People are selling it on every corner. If there was even something for them to come back to after treatment."

There were times in the two years Bernie battled to get him off heroin that he seemed to be doing okay and then would come home "absolutely out of it".

"I'd say: `Why Stephen?' and he'd say: Ah, such and such asked me to go half'." It wasn't a matter, Bernie explains, of resisting temptation, it was that, as Stephen put it, "before, when I hadn't got the money he went half with me".

"That's what happens out there. They all know each other. It's all their friends. They keep each other going. They need treatment, all of them".

She brought Stephen to Merchant's Quay, a voluntary counselling service where, if in attendance for six weeks, an addict "might go on a list to maybe get treatment ... There's no methadone there" To get methadone Stephen would need to have had it already prescribed by his GP.

At Sister Consilio's in patient addiction treatment centre in Kildare his sleeping pills were confiscated at admission and he did not last more than a couple of days there.

Still smoking rather than injecting heroin, and therefore not eligible for the Amiens Street City Clinic, nor having the mental strength to attend, with no methadone, the Merchant's Quay programme, Stephen joined a Christian addiction support group, Outreach.

Stephen brought a friend of his, who was also an addict, to one of the Outreach meetings and she went on to England soon afterwards, to do the group's programme there. Stephen died two weeks after she left. He was going to follow her.

"She visited me there a few weeks ago." Bernie smiles. "Only for Smallie," she said - that's what they called Stephen - "only for Smallie I couldn't be alive today.' She is doing brilliant now ... She was only back a few days and she was offered heroin."

In the weeks leading up to his death Stephen had begun shop lifting and stealing money from his family.

"That was annoying him. It was all getting to him. Then the three days before [his suicide] he was really agitated, giving out, crying."

Celine called St Vincent's Hospital and told them that her brother was suicidal. St Vincent's, however, would not deal with a drug addict. The only hospital that provides in patient psychiatric care, in Dublin, for suicidal drug addicts is Beaumont Hospital and even there one has to have been attending Pearse Street as an out patient first.

A private clinic, at £50 per session, was the only option left open to them. Bernie was determined they'd work it out somehow.

"And he seemed really calm then," says Bernie "And that night we were all going to bed and he was taking off his shoes and he said: `Well, that's it now Ma. You'll never have to worry about me and drugs again. I swear, I am finished on drugs. That's the end of it. And that night he hanged himself."

It was Cheryl who found her uncle suspended by his neck from the spiral staircase.

The five year old called: "Granda, Stephen won't talk to me. He just keeps looking at me with his eyes".

"I'll never forget his face the morning Noel called me. I didn't even know what he was talking about. I couldn't even grasp it. I couldn't believe it. I still can't believe it. And I'm going around saying: `How is everybody so normal?' For the first few months I was saying that `How is everybody so normal? My whole inside is torn apart."

"I'd try to be joking and all. Sometimes I'd be having a conversation and I wouldn't even know what the person is saying to me. I'd just feel like screaming at them `Go away. Just go away.'"

"I'll never get over it. Noel never will. Noel says he passes those stairs a million times and sees Stephen every time. Noel had to cut him down.

Grief gets entangled in a mess of hurt, guilt and anger."

"There is a strong feeling of failure, of `What did I do wrong, that he couldn't come to me?' But then he thought he was easing our pain by getting out of our lives. He saw the trouble that was in the house because of the drugs, the fighting."

And then the anger - "at Stephen, because he wasn't without knowing how much we loved him. I feel really angry at the Government for not getting him the help that he needed, and St Vincent's, and my own doctor. I'm very angry with them all. I really am."

"If one of their children was on drugs they'd put them in a private clinic. We have to cry out for help. We haven't the money for private clinics. When I heard Stephen was on drugs I thought that there should be clinics everywhere. Every community should have one."

SOME of the money being put into prison building, she says, would be far better spent on drug treatment. "Why build a prison waiting on children to do wrong instead of helping them, educating them, not to do wrong? If they were taught in the schools against drugs there wouldn't he a whole new generation destroyed."

Her nine year old grandson knows all about drugs, where to get them, who sells them, what's available. And that's not from the school.

That's from seeing it on every corner. Politicians think we're exaggerating when we tell them there's youngsters of 13 on heroin. It's getting worse and it's not going away.

Just before he died Stephen told his mother: "Drugs have f...ed up my life. Look after the children. Don't let them near drugs."

"I have six grandchildren. It's them I have to worry about now." Bernie looks toward the faded snapshot of hope and optimism on top of the TV.

"Stephen didn't want to be on drugs. I'd love to just hug him. I'd love him back as the old Stephen. He was gas. He idolised me, always making me cups of tea. He was very good, he was really good.