What is your experience with heroin addiction?

First a shot, then to the call center : How a Berlin heroin addict found his way back to life

When Hagen Barn enters the well-lit room in this functional building in the north of Berlin at 7.30 a.m., sticks a syringe into his thigh and presses the transparent liquid into the bloodstream, he feels better a few seconds later. Barn, 45 years old, is relieved to sit on an armchair in an adjoining room and let the substance take effect from the syringe.

That Barn, a strong man with a rough voice and pale skin, injects himself in the thigh is because the veins on his arms are scarred. He has already put at least 9,000, maybe 10,000 syringes in kitchens, stairwells, and train stations. When asked about it, Barn estimates that he has spent almost 800,000 euros on heroin over the years - mind you, on substance that contained all kinds of excipients in addition to the desired opium poppy extract. Barn knew men and women he pulled and splashed with who died from infections and overdoses. He contracted hepatitis C himself. He stole, was imprisoned, started therapies, broke them off, and broken relationships.

“There were days when I took five grams of heroin. But the street stuff is filth, ”said Barn one morning a few weeks ago. "Without this stuff I'd be dead." Barn still takes heroin - now on a prescription.

Landlords didn't want junkies

Almost every morning he is given a 98.5 percent heroin solution. A doctor's assistant draws the syringe with a dose suitable for the patient, hands it and the swab to Barn, who sits on a chair at the table in the so-called application room. No dealer, no diluent, no dirt. The idea behind it: By giving addicts the drug under medical supervision, criminal offenses, overdoses and infections are avoided. If dependent, then on pure, licensed heroin. Technical term: diamorphine.

In Berlin this is only available from Thomas Peschel. The specialist in psychiatry, 48, full cheeks, full hair, runs the only diamorphine practice in Berlin in the functional building in Weddingen. It is the largest of the ten diamorphine practices in Germany. Cars are jammed below on the way to the city center. Airplanes thunder over the practice and Tegel Airport is close by. Peschel did not get any other rooms when he was looking for it six years ago. Landlords would not have wanted junkies - and junkies are always there: 120 of the 140 patients registered with Peschel come every day.

On this day, a man in a hat plucks a guitar in the practice, another flips through a notebook, a third smiles at a fourth patient who is looking out the window. A fifth is dozing with headphones over his ears. Next to the application room there is a kitchen, a table tennis table, sofas, books. Sometimes patients and staff have breakfast together: three doctors, twelve medical assistants, social workers from a cooperating association on a daily basis.

Fewer men and women in Germany die of opiates, especially heroin, than in the 1990s. Nevertheless, there were 629 deaths in 2018, 80 in Berlin. The federal drug commissioner estimates that 120,000 heroin addicts live in Germany. Doctors and social workers assume a significantly higher number. Almost 79,000 of the addicts are officially in substitution treatment, mostly with methadone.

Barn is now working in the call center

When Hagen Barn contacted Peschel in 2014, he had already tried everything: “Outpatient and inpatient therapies. Alone and with a lot of help. Methadone too. But when I was worried, I went out and got myself some material again in the U8. ”The prescription methadone alleviates the addictive pressure, but is not enough for many addicts - they still take heroin. Both of these are traded at the stations of the U-Bahn line 8, which are used as transshipment points. Many say they are less energetic on methadone than on heroin.

If Barn takes a shot at Peschel, he walks to the bus 30 minutes later and starts the working day: the five-hour shift in the call center begins at 8:30 a.m. Because his colleagues do not know that he needs heroin, his real name is not given. “I used to be depressed a lot and haven't had a job since my apprenticeship,” says Barn. "Now I live with my loved one and work - that's more than I hoped for." Addicts, says Doctor Peschel, often suffered from mental illnesses. Drugs are then like self-medication.

“I was looking for closeness, I wanted to be caught,” says Barn. “My mother was very young, my father will soon be gone. I had little from the family. ”As a fourteen-year-old he drank eight, nine, ten beers a day. When Barn started an apprenticeship as a mechanic, a colleague raved about heroin.

After 27 years, Barn can still remember the youth club in Bochum, the dealer who took a knife-tip of powder from a sachet. “Light brown, like healing clay. I smoked it, it immediately fascinated me, "says Barn. "Like everyone else, I had to throw up the first time." But the intoxication was nice, peaceful, comforting.

Since that summer's day in 1992, the fabric has not let go of him. Heroin creates what other drugs do, only more intensely: security. Satisfy yourself. Don't regret the past, don't fear the future. Heroin works in the middle of the body, says Barn, and radiates to the fingertips. Other addicts report that heroin creates a physical need for warmth that it can only satisfy itself. Fear, loneliness and chaos disappear behind the search for the material. And that costs dignity, money and time.

Today Barn lives like millions of other Germans. Office job, apartment with the woman he loves, cat, movies on Netflix. Is Hagen Barn still a junkie, someone who should change his everyday life? “He's dependent. And you help addicts by giving them a stable life, ”says his doctor Thomas Peschel. "Then the need for the drug will be less anyway." Heroin can be used like a medicine: "A diabetic gets insulin. And doctors do not refuse him even if he eats cake unreasonably. We demand total abstinence from addicts. Why?"

"Here you know that you can come back tomorrow"

Almost all of his patients took less diamorphine after a few months than at the start of therapy. Less than on the street anyway, because in practice the material is stronger than the stretched material from the black market. Those who do not threaten to get through the night without drugs can pick up a tablet in the evening from the practice: Substitol or L-Polamidon - heroin substitutes, the drugs suppress the desire for addiction. The opiate it contains has a delayed effect and therefore lasts longer. Some patients also take the pills with them on vacation.

Anyone who is dependent on getting heroin from the changing dealers in the U8 goes out two, sometimes three times a day to buy the stretched stuff because it was too weak or he is afraid that it will soon be empty to get. Those who live like this are arrested, do not work, get sicker. "But here you know that you can come back tomorrow," says Barn. And “the turn”, the intoxication in practice, is gentler, but not less intense. The first time at Peschel reminded him of the first heroin intoxication in 1992.

Back then he was able to get money quickly, overdraft facilities were cheap, and his account was constantly overdrawn. At the turn of the millennium, the 1.80 meter man was emaciated, weighed 50 kilograms, and splashed himself in the neck. A drug advisor told his father that the boy had to end up at the bottom before he could stop. Addiction was considered a weak will, not a disease. Former Health Minister Horst Seehofer, CSU, rejected diamorphine practices, the CDU MPs are also against it. It was not until the red-green federal government began a field test: 80 percent of the 1,000 addicts taking part had a decline in consumption. In 2009, the Bundestag allowed heroin to be dispensed under strict conditions: the patients must be older than 23, have been dependent for at least five years and have failed two therapies.

In 2013 in Berlin, of all people, it was a health senator from the CDU, Mario Czaja, who supported the opening of the first heroin practice. Clinics did not want to carry out the treatment, and a resident doctor could not be found for a long time. Many feared that the expensive security measures and the looming annoyance with landlords and neighbors would not be offset by the 50 euros that health insurance companies pay per diamorphine patient per day.

Finally, Thomas Peschel came to Berlin from Hanover. He was already working in the diamorphine practice of the university clinic in Hanover. There he observed that diamorphine patients were less likely to become criminals and more likely to cultivate their partnerships. Studies from six countries have shown that certain patients are helped better in this way than with substitutes - that's why the health insurers pay for the diamorphine treatment.

Peschel called the practice "Patrida", Greek for home. The drug comes there from closed opium poppy fields of the pharmaceutical industry in Tasmania via a Swiss high-security laboratory and a secret warehouse in Germany. Armed vendors then bring the heroin to the police-checked practice vault.

The rush is great, and Barn also had to wait more than a year before he got a place at Peschel. Because he still injected heroin despite methadone, a social worker recommended the practice in Wedding. Peschel has to check every interested party: Is he really dependent, what does he still suffer from? Has other therapies failed, so have the legal criteria for heroin treatment been met?

The aim of therapy is not to end addiction

In Berlin, Peschel estimates, 500 men and women would be eligible for diamorphine therapy. That was recognized in the Senate. The state drug commissioner Christine Köhler-Azara says that Peschel's work is important and that it complements other addiction support programs. Finally, in a few months, a second diamorphine practice will open in Berlin.

If Peschel's patients stop using heroin, the doctor will be happy. It is not the aim of therapy. "I have no intention of getting people abstinent," says the doctor. "Some patients try and are so unhappy that they fail in everyday life, completely isolate themselves." Currently, a third of his patients work regularly - most of them had no prospect of a job five years ago. A visit to the practice helps to regulate the daily routine, to stabilize life.

Susanne Rieger's life was rather unstable when she moved from Bavaria to Berlin in 2014. Rieger is tall, slim, and she balances her paleness with brightly colored robes. In practice today she only picks up pills. In Bavaria, Rieger, who does not want to speak under her real name, was arrested for heroin trafficking. According to Section 35 of the Narcotics Act, the court ruled on therapy instead of imprisonment. “But you're a zombie on methadone,” she says. "I relapsed."

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Her life, too, needed more confidence. When Rieger was eleven, his parents separated. She went to a convent school, started smoking weed at 13, drank alcohol, and was expelled from school. At 15 she moved in with her boyfriend, at 16 she had her first daughter and at 18 she graduated from secondary school. “Everything was too much,” says Rieger. “I was overwhelmed.” She tried the laboratory drug crystal meth. She met her new boyfriend in therapy, and they moved to the country: “Unfortunately I find the only junkie in a village with 500 people.” A neighbor, the syringes already ready , offered her heroin.

She only avoided drugs when she was pregnant. Their son was born in 2002, their second daughter in 2006. Peschel thinks this is plausible - consumers repeatedly stopped injecting, smoking and sniffing if there was a significant reason for them. “I was discreet,” says Rieger. "Until I was arrested in 2014, the children hardly noticed anything."

Addicts always find their way back to life - thanks to Peschel

Rieger married her husband in 2009. Now she was taking fentanyl, the active ingredient made from the drug of the same name that is stronger than heroin. After her court case in Bavaria, the children were living with relatives and foster parents at the time, she began the therapy ordered in Berlin. In vain. In January 2016, she bought “a ball” at Moritzplatz underground station, commercially available heroin wrapped in foil: “In Berlin, of all places, there is only dirty stuff.” Her husband died of an overdose in a hallway on Osloer Strasse.

Rieger was specifically looking for a diamorphine practice. In the first few weeks she injected herself three doses a day at Peschel's, after a few months two, and finally one. Today she works in service in a hotel and also helps in the kitchen. The children live with her. The youth welfare office, she says, doesn't see any danger. Your son is top of the class. And Rieger paints. So well that a Neukölln gallery has exhibited some pictures. Peschel bought a picture from her. It can be seen in bold oil colors: Amy Winehouse. The singer took heroin, she died of alcohol poisoning.

Hagen Barn will ring the doorbell again the next day and put a syringe in place. Then drive to work, later home to his wife. The two recently married. Today Barn weighs 92 kilograms. Susanne Rieger will not be going to Peschel anytime soon. She doesn't need the material right now.

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