COLUMN ONE : Road to Detox: Do Not Enter : With a will for redemption set to expire within hours, junkies finally seeking drug treatment face a road filled with holes and barriers.

NEW YORK —  They were wasted and ruined dope fiends, breathing in urban grief as if it were oxygen. And there came a madcap day last summer when the two of them desperately wanted to get into a drug program, only to find that their neediness counted for nothing amid the jaded ranks of the social service bureaucracy.

“Maybe we could go to an emergency room and stab each other,” suggested Nelson Martinez after the failed 13-hour scramble around New York City.

Georgie Vega considered the idea seriously. “I suppose that would work,” he said wanly. “But couldn’t we just pretend to faint instead?”

Both men were caught in the ebb tides of life, with needles in their veins and bedlam in their heads. They wanted to get into treatment but had to do it right then, not later. They knew their will for redemption was likely to last only a short time, then the streets would win them back.

So after indulging in a last supper of heroin and cocaine, they had stayed awake well into a hot, still night. By 4 a.m., they made their way to a detox center at Beth Israel Hospital in Lower Manhattan, where the doctors wean addicts from dope, using the synthetic narcotic methadone.

Georgie had been a patient there once before. Getting admitted was quirky. Usually, an applicant was given an appointment to return in a week or two. But sometimes, because of no-shows, there were last-minute beds. In hope, addicts camped out in the pre-dawn and signed their names to a list.

That Thursday morning, three other dope fiends were already ahead of them. “You know, you’ve got to have a Medicaid card,” one of them advised Georgie and Nelson. Without Medicaid or private insurance, nobody was getting in these days.

This was disappointing news. They were inept against such obstacles, unable to follow the poorly marked roadways into social programs. The system requires too much effort from the spent, too many leaps of faith among the faithless.

And it is overloaded. The Bush Administration estimates that there are 5.5 million drug addicts in America, including 1 million who use heroin; of the 5.5 million, about half would probably be in treatment if it were available, 1 million too many for the current number of slots.

Addicts wanting to enter a program face a gnarl of red tape. It was overwhelming to someone like Georgie. There was no central office to find out where there were openings. Even when he did get an appointment, it was for some date rooted in a rational, workaday world where calendars hung on walls.

Then there was the matter of payment. To qualify for Medicaid, he would have to wait in long lines at who knew where. Proof of ID was required: items such as a birth certificate, driver’s license, utility bills, rent receipts.

Georgie had none of the right papers. Twenty-five years on heroin had torn up his copy of the social contract. He was homeless, without income or even a wallet, a vagabond in the storm, sapped by the AIDS virus and a drug habit.

He said to Nelson: “This isn’t going to work. It’ll take us too long to get on Medicaid. I think maybe God wants us on dope to teach us a lesson.”

But Nelson was insistent. We can get “temporary Medicaid,” he said. After all, this was an emergency. They just had to find the right welfare office.

And so the two junkies set out into the maw.

*

Earlier in the summer, Georgie Vega, 38, had gotten lucky in latching onto Nelson Martinez, a guy with some money undergoing a life meltdown. Nelson had recently broken up with his wife and turned to heroin for consolation, raiding his bank account and flushing the savings right out through his veins.

Amiable Georgie was there as a sort of sidekick. In the Bushwick section of Brooklyn, he ran a “shooting gallery,” a little room where addicts did dope. He was an earnest listener, a junkie’s version of the sympathetic bartender.

Nelson, 33, was willing to share his heroin with this likable new friend--and not just the basic $10 bag for “getting straight,” but three or four at a time, enough to bring on the consuming warmth of a good nod.

But as the weeks passed, Nelson began to take stock of himself and tote up the misery: He missed his wife and daughter. Sores pocked his face and hands. He was down to his final $1,000 and the beloved gold chains around his neck.

“If I don’t go into (drug) treatment, I think I’ll kill myself,” he said one afternoon. “I’ve lost it all. Beautiful wife, beautiful apartment, two cars, all up in smoke, man. I think it’s too late for me now.”

“It’s not too late,” Georgie answered.

“Yes, it is.”

“I said that myself once: that I’m an addict and I’ll always be an addict. But here I am, willing to give it another try.”

Just as Georgie had shared in Nelson’s downfall, he now wanted to join in the resurrection. Georgie had been thinking of entering a program for months now, but one thing or another always held him back. Usually, where there is a will there is a way, but his will had holes and gaps--and so did the way.

*

As the hectic day unrolled, they tried another detox center, at Bellevue Hospital, but it was only for alcoholics. So they settled into the “temporary Medicaid” idea, first returning to the gallery to shoot up more dope. Their wake-up shots had worn off; they needed some heroin to fight off the aches.

Their plan was plausible. It was indeed possible to get emergency Medicaid, and in this the two addicts had a rare advantage. Nelson held five $100 bills in his pocket and was willing to blow some of it on taxis. He wanted to begin at the biggest welfare office he knew of, the one on Northern Boulevard in Queens.

That building had the look of a converted old warehouse. They ambled into a room with long brown walls--a weary, needy-looking place, with lines in front of seven windows and handwritten signs Scotch-taped at odd angles.

They waited their turn, then Georgie went first. “I want to apply for temporary Medicaid,” he said, lowering his head to talk under the glass.

“Are you on welfare?” the clerk asked.

“No.”

“Well, the only way you can get Medicaid is to be on welfare.”

Nelson, dressed better, his gold chains dangling, decided to take over. “We want to get on Medicaid so we can get into detox, please,” he said.

“Sorry, you’d have to wait 30 days anyway,” the clerk responded.

“I might kill myself in 30 days,” Nelson pleaded.

The clerk raised her shoulders in a shrug of apology, but the gesture was not enough to move them on. “It’s done by machines,” she added by way of vague explanation. “They can’t print that fast.”

*

Nelson had regrets so immense they filled nearly all his thoughts. He was smart and educated and born to the middle class. But he had always made more money as an outlaw than by playing it straight. He dealt drugs and had done time on gun charges. Once, while on parole, he had been on welfare.

He remembered his caseworker, a Jamaican with dreadlocks. He and Georgie found him sitting upstairs at a desk against a wall, clipping his fingernails and reading a newspaper. Nelson explained their problems, but the man said that temporary Medicaid cards were issued only for “medical necessities.”

Still, he said his supervisor would return soon from lunch; maybe she could do something for them. “Go and sit down over there,” he suggested. “And try not to nod out or the guards will be chasing you out of here.”

Nelson paced along an aisle of cubicles as Georgie found one of the plastic seats in a large waiting area. His eyes, awash in heroin, were going down like setting suns. He was asleep when Nelson finally got hold of the supervisor.

She was wary of him and impatient--and her answers seemed to lash out like a scolding. “No place that gives welfare and Medicaid can give temporary Medicaid,” she said. “You need to go to a place that just gives Medicaid.”

And such a place was on “16th Street in Manhattan.”

*

The Manhattan location was a long ride away, and there might be a wait when they got there. So Nelson thought they ought to first detour through Spanish Harlem, over to an area he called “Zombie City” because the action never dies. They could buy some dope there on the corner of 116th Street and Lexington Avenue.

Georgie rarely ventured into Manhattan. He seemed a yokel amid the great hum. Nelson sensed this. He began to make fun of Georgie’s rumpled cutoffs. “If we’re going to be dope fiends, let’s at least be clean dope fiends,” he said, steering his pal to a store and treating him to a pair of new jeans.

After that, they hailed a taxi, which fought the traffic down Lexington, past Bloomingdale’s and into the canyons of Midtown high-rises. “I love this city,” Georgie said, gawking at buildings out the window. “Look at this.”

*

The taxi driver dropped them at Union Square, 100 blocks south. They wandered around, asking directions. There was some urgency now. Time had been spilling away. It was already 3:30, and offices would soon close. Also, they needed to shoot up the dope that Nelson had in his pocket.

When they finally found the right building, they did not know which room to enter. People were in a rush. They stopped at a curved desk where a woman was talking into a phone headset. Nelson announced his pressing questions.

“This is Welfare on 16th Street,” the woman answered dismissively. “You want Medicaid over at 330 W. 34th.”

*

There was still time, if only they could make it to the right place. Dope fiends are in the know about many things: which heroin is good, which neighborhoods are hot with cops, which drug programs treat them OK. It is the ins and outs of the social service labyrinth that leave them befuddled.

Policy-makers concede this. “Our addicts are lost in a desert,” said Dr. Beny J. Primm, director of the federal Office for Treatment Improvement at the Department of Health and Human Services. “They don’t know how to engage the system. And when they can’t engage it, they get impatient and give up.”

But the system’s failure is its chaotic structure, not any shortage of treatment slots, Primm said. By his estimate, there were 450 available beds in New York on the very day Nelson and Georgie wandered the desert.

That is a debatable claim. Local officials asked: Show us the beds.

*

At the big office on 34th Street, the two addicts poked their heads through several doorways, begging assistance, then meandering into a huge room with dozens of desks. At a long counter, a woman beside “Table Five” told them they needed to be in “Line One,” over in the far corner.

It was almost 4:30 by then, but Nelson and Georgie set aside a few moments to shoot up their drugs in the men’s room. Georgie removed his shirt so he could use it as a tourniquet. He wrapped it around his left arm, holding one end with his hand, the other with his teeth. He found a plump vein.

Nelson was not as fast at these injection rituals. He ducked into a toilet stall to cook up a shot. Just as Georgie rolled him a lighter under the door, a janitor walked in and sized things up. “Busy, busy, busy,” the man said.

Georgie guessed the janitor might know something about temporary Medicaid. “They sent us to 16th Street, no good,” he said. “So we come here.”

“You’ve got to talk to them,” the janitor said.

“Who’s them?” He pointed toward the rows of desks outside the door. “You know, them.”

*

Georgie waited in Line One, but Nelson dawdled in the john. He had mistakenly dropped a small packet of cocaine into the trash can and was intent on finding it, even if that meant unfolding every discarded paper towel.

The line moved slowly. Georgie’s turn finally came a few minutes before 5 p.m. It was a short discussion. He had been in the wrong spot. He needed to be at the Application Desk, back over by Table Five where he had started.

He hurried across the big room. “Can I ask you a question?” he said to a clerk.

“I’m sorry,” she answered, her fingers busy in a file drawer. “I need to get this out of the way.”

Georgie spoke up with more urgency: “I want to get into detox.”

The woman turned to face him now. “You came too late,” she said, shaking her head. “We’re not giving out any more appointments.”

“We’ve been getting the runaround all day.”

She eyed him more carefully, looking over his sweaty face. She spoke slowly and distinctly for the junkie’s benefit. “When you come back in, all they’ll give you is an appointment,” she said. “You won’t get emergency Medicaid. Then, with an appointment, you have to come back in a week or so and see an interviewer. Then, after they have reviewed the case, the client is contacted by mail, and that takes three weeks or a month.”

Georgie took this in and was stunned. “So the mumbo jumbo about getting on Medicaid the same day is bull----?” he said without anger, just resignation.

“That’s right. The only way to get on is with HIV (the AIDS virus).”

At last, good news. His face brightened. “Well, I’m HIV,” he said.

The clerk took a step back from him. “You’d have to be able to prove it with a certified letter from your doctor,” she said.

With that, Georgie was beaten. His shoulders sagged. And the clerk knew she could shift her attention back to the end-of-the-day filing.

*

Not all was lost, as it turned out. Nelson found his cocaine near the bottom of the trash. “Praise God,” said Georgie, who had lately been drifting to religion. Nelson kissed the medallion on his beloved gold chains.

Georgie then repeated what the clerk had told him, and some of the story hit Nelson like a punch in the gut. “You’re HIV?” he said. “I don’t believe that, bro. That blows my head.”

Later, as they walked out into the street, Georgie admitted that he had not wanted to confide this fact; he was afraid of losing a friend. Nelson reassured him, “If anything, that only brings us closer together.”

It was then that the two started to scheme. Surely, they could get into a hospital that night, somewhere, somehow. They could stab themselves or fake an overdose. Or maybe they could get a room and go cold turkey on their own.

But first things had to come first. While they were thinking over plans, they decided to head back to the gallery to shoot some more dope.

And there they went, two heroin addicts pushing through the rush-hour crowds near Greeley Square, eager to hail a cab on the Avenue of the Americas.

*

This is how it turned out: There was a newspaperman who had been hanging around the gallery, asking his questions, sifting through the archeology of people’s lives. He watched as the heroin teased at the sweet tooth of addicts’ souls, and he felt cravings of his own, for all the details he could get.

In return, he did not give much, some sodas and sandwiches and a few times a new pair of sneakers. More than anything, the addicts seemed to need him to listen; some confessed sins and wept into his notebook, though they would have been better off revealing themselves to a social worker or a doctor.

The reporter wanted to dispense some antidote for the drug life, but he had little to offer but curiosity. Then one day, he interviewed the city’s chief policy adviser on drug abuse, David Condliffe, who had never been to a shooting gallery. The reporter agreed to take him, though he wanted a favor in return. Surely, Condliffe could get these addicts into treatment.

Then the reporter would be able to say an easier goodby to these people who had watched out for him in a dangerous place, giving them -- and his conscience -- a comforting ending.

For three days, a large mobile unit parked down the block from the gallery. A half-dozen city workers sat inside, screening the two-dozen or so dope fiends who came in, using a portable phone to locate beds in a drug program.

If there were 450 available slots in this great city, they were impossible to find by these workers who knew the system. Placements came grudgingly.

And even then there were problems. Sometimes, when a spot opened up, the addicts refused to go right in, insisting they had business to settle first. Other times, the addicts wanted to go immediately and appointments made for a few days ahead were useless, set aside as heroin overcame their penitent mood.

Jo-nice Williams had tuberculosis, and the places that agreed to treat her TB would not do anything for her drug habit and vice versa. Nelson Martinez refused help altogether. He was doing too much cocaine by then and spewing a scary delirium. Paranoia percolated in his eyes, and he began to carry a gun.

The lovers Lourdes Pabon and Lips Santiago got an appointment for 7 a.m. two days hence. She was five months’ pregnant, poisoning her womb with dope. But then the couple overslept through this chance at salvation, lying beside each other on a cot in the shooting gallery, Lips snoring with his mouth wide open and flies dancing around his breath.

Georgie Vega was mistakenly sent to a program with no heroin detox, then was refused at another place because he had no Social Security card. A city worker gave him a ride to his mother’s apartment to get the card, but by then he was dope sick and came out instead with an electric fan. With a dope fiend’s practiced alchemy, he quickly turned it into gold.

*

Two days after the van left, Nelson was shot in his legs and hips and a hand, right in front of the gallery. He had begun to deal coke, and the story going around was that he was interloping in someone else’s territory. As he bled in the street, some creep slipped the gold chains off his neck.

This shooting seemed a bad omen. Many of the usual faces began to vanish. One morning, Jo-nice Williams arose at 5:30 and somehow got a bed over at Beth Israel. “I feel great, and when I get out of here, I’m going to be all right, unless life leads me back to Bushwick,” she said, drug-free in the hospital.

Back to Bushwick is where life led, and when she went up to the gallery, Lips and Lourdes were gone. There had been a fire, further damaging what was already a half-demolished house. Lips claimed the police set the blaze, and when he went to file a complaint, he was arrested for violating his parole.

The stress seemed to send Lourdes into premature labor. A drug-exposed boy was born Aug. 28, weighing only 3 pounds and 10 ounces. The mother entered a detox program, pledging her love to Lips and planning to get an apartment. He asked her to smuggle him some drugs into the jail at Rikers Island.

Georgie Vega was also arrested. He had not visited his parole officer in years, and the detectives found him when they made a periodic check at his mother’s house. The heroin at Rikers was so damned expensive; he had to go cold turkey. For weeks, his stomach cramped up and he could not eat or sleep.

Since then, jail time has freed him to study the Bible, which he had been longing to do. Worship seemed to have immediate rewards. In court, the judge said he only had to serve three more months. He should be out by Christmas.

“I had prayed on it, and God looked out for me,” Georgie said with a gush of enthusiasm. “That God, I guess He knows what He’s doing.”