This post is part of a collaborative narrative series composed of my writing and Chris Arnade's photos exploring issues of addiction, poverty, prostitution and urban anthropology in Hunts Point, Bronx. For more on the series, look here.
Data were analyzed from the nationwide Treatment Outcome Prospective Study (TOPS) to assess whether current and former methadone patients substitute other drugs for heroin. The sample comprised 513 heroin users who were admitted to methadone programs in 10 cities across the United States and followed for at least 1 year. Structured face-to-face interviews were administered at admission and at follow-up to assess use of six substances: cocaine, amphetamines, illegal methadone, tranquilizers, marijuana, and alcohol. The study found a decline in the use of all substances except alcohol. Patients who substantially reduced or eliminated their use of heroin during the follow-up year were more likely to decrease their use of other drugs than were patients who continued to use heroin on a weekly or more frequent basis. These findings suggest that methadone programs indirectly reduce patients' use of cocaine, amphetamines, illegal methadone, tranquilizers, and marijuana, insofar as they are successful in eliminating or decreasing heroin use. Similar reductions in drug use were found among patients who were not enrolled in methadone programs during the follow-up year. These findings do not support the commonly held belief that heroin addicts substitute other drugs for heroin.¹
Takeesha, Hunts Point. Courtesy of Chris Arnade.
There is a storm of moods when the three friends come together. Women who live here and there, no place the same for over a month.
They meet at the outpatient methadone program, the clinic meant to get them off heroin, at 4:30 p.m., the final time to get their medicine. If they're late, they wait until the next day and spend a night in withdrawal.
After their meds, after exiting the low, crowded building, they want to take a ride. Takeesha wants the drugs that R has, to sell them. She has $60 to trade for drugs. R wants a ride home. Nikki is along for the money: Takeesha owes her.
At the program, R got a Xanex sampler and Takeesha needs to follow if she wants access to the rest. R claims she has more where the Xanex came from. It's up the Bronx, and the driver needs to hurry because they can't afford to wait.
Takeesha droops in her seat, lost to a combination of methadone and previously-shot heroin, while R sits on the floor, face in between passenger and driver's seats, with a mouth that pours directions in conflict with the car's GPS, words heightened from crack.
The car only has two seats for the three women, but no one cares.
R doesn't want to drive near Lincoln Hospital. Are we going anywhere near Lincoln Hospital? They fucked her over major, didn't give her the meds she needs. She's still in pain, her fucking back. She wants the music turned up; Trey Songz gets louder.
As the clock nears 5, the traffic gets worse and R more agitated. The war between car GPS and human directions continues and escalates.
Near a tall cluster of public housing units, the car pulls over. R shakes Takeesha from her hunch, and the two go upstairs. It's minutes and minutes before Takeesha returns, alone and with pills. She is more awake.
Nikki having waited and been strung along, sullen, wants her cut to buy dope.
Nikki, Hunts Point. Courtesy of Chris Arnade.
Takeesha buys Nikki Chinese food and says she has nothing left for a cut; she says she gave it all to R to buy the pills to sell. Voices grow, a bra shaken to prove free of money.
The next time they're all together, Takeesha, high and unfocused, gives the money to the others to deal with. She decides to wait in the car.
$100, major money. R and Nikki plan to score drugs from a dealer in a building outside of Hunts Point. They know a guy who has just what's needed. They'll be right back, just need to go into a high-rise, in cluster of housing projects at a busy intersection. They're not bringing anyone else; their guy might freak out.
Takeesha obsesses over a nylon tiger catsuit on someone else's smartphone while they're gone. Please, please buy it for her. Please. She rubs her face into the friend to whom she's begging, purple lipstick smearing the accosted woman's shirt and cheek.
After 30 minutes, annoyed, she calls Nikki's cell over and over. Two minutes, dial. Five minutes, dial. Curse into voicemail. Curse again into voicemail.
She leaves the car to buy a blue snowcone and to stare at the intersection with force of will before returning.
An hour and a half later, the car drives the five minutes back to Hunts Point.
More hours later, the others tell Takeesha the cops rolled up on them. Too bad, they had to swallow the stash. We were the ones taking the risk, weren't we? Who the fuck are you to say anything?