‘We’re all paying’: Heroin use spreads misery

Deadly habit grows to fill space left as prescription painkiller abuse is cut

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Clark County heroin use has measurably risen

Local law enforcement officers and drug treatment experts have told The Columbian several times over the past two years that the local rate of heroin use has soared.

Just one measure: According to Daybreak Youth Services, 4 percent of teens admitted in 2008 for inpatient drug rehabilitation services in Clark County reported using heroin. By summer 2012, that number spiked to 15 percent.

According to a June 2013 study by the University of Washington's Alcohol & Drug Abuse Institute, several other indicators show Clark County's problems with heroin and other opiates have grown in the past few years:

o In 2011-12, evidence submitted by police agencies in Clark County tested positive for heroin in 344 cases, more than a sevenfold increase in the rate compared with a decade earlier. The rate was the eighth-greatest among Washington's 39 counties (Cowlitz County, with three times more heroin cases per capita than Clark County, had the state's worst rate.)

o In 2009-11, Clark County recorded 89 deaths attributed to opioid use, a rate of 6.9 deaths per 100,000 population. That was better than the state rate of 8.7 deaths, but compares unfavorably with the 2000-02 rate of 4.5 deaths per 100,000. Cowlitz County was again the worst in the state, with 50 opioid deaths in 2009-11, a rate of 17.6 per 100,000 population.

Because heroin is often injected, diseases such as Hepatitis C, spread by contaminated hypodermic needles, also increased in Clark and Cowlitz counties.

As elsewhere, most of the new addicts were young adults. The Columbian has told the personal stories of two of those people.

-- Craig Brown

Clark County heroin use has measurably risen

Local law enforcement officers and drug treatment experts have told The Columbian several times over the past two years that the local rate of heroin use has soared.

Just one measure: According to Daybreak Youth Services, 4 percent of teens admitted in 2008 for inpatient drug rehabilitation services in Clark County reported using heroin. By summer 2012, that number spiked to 15 percent.

According to a June 2013 study by the University of Washington’s Alcohol & Drug Abuse Institute, several other indicators show Clark County’s problems with heroin and other opiates have grown in the past few years:

o In 2011-12, evidence submitted by police agencies in Clark County tested positive for heroin in 344 cases, more than a sevenfold increase in the rate compared with a decade earlier. The rate was the eighth-greatest among Washington’s 39 counties (Cowlitz County, with three times more heroin cases per capita than Clark County, had the state’s worst rate.)

o In 2009-11, Clark County recorded 89 deaths attributed to opioid use, a rate of 6.9 deaths per 100,000 population. That was better than the state rate of 8.7 deaths, but compares unfavorably with the 2000-02 rate of 4.5 deaths per 100,000. Cowlitz County was again the worst in the state, with 50 opioid deaths in 2009-11, a rate of 17.6 per 100,000 population.

Because heroin is often injected, diseases such as Hepatitis C, spread by contaminated hypodermic needles, also increased in Clark and Cowlitz counties.

As elsewhere, most of the new addicts were young adults. The Columbian has told the personal stories of two of those people.

— Craig Brown

On a beautiful Sunday in October, Detective Dan Douglas stood in a suburban Minnesota home and looked at a lifeless 20-year-old — a needle mark in his arm, a syringe in his pocket. It didn’t take long to realize that the man, fresh out of treatment, was Douglas’ second heroin overdose of the day.

“You just drive away and go, ‘Well, here we go again,’?” says the veteran cop.

In Butler County, Ohio, Sheriff Richard Jones has seen crack, methamphetamine and pills but calls heroin a bigger scourge. Children have been forced into foster care because of addicted parents; shoplifting rings have formed to raise money to buy fixes. A local rehab facility has a six-month wait.

“There are so many residual effects,” he says. “And we’re all paying for it.”

Heroin is spreading its misery across America. And communities everywhere are indeed paying.

Cocaine, painkillers and tranquilizers are all used more than heroin, and the latest federal overdose statistics show that in 2010 the vast majority of drug overdose deaths involved pharmaceuticals, with heroin accounting for less than 10 percent. But heroin’s escalation is troubling.

In 2007, there were an estimated 373,000 heroin users in the U.S. By 2012, the number was 669,000, with the greatest increases among those 18 to 25. First-time users nearly doubled in the six years ending in 2012, from 90,000 to 156,000.

It’s killing because it can be extremely pure or laced with other narcotics. That, coupled with a low tolerance once people start using again after treatment, is catching addicts off guard.

IN MINNESOTA: The message to the masses

The night before Valentine’s Day, some 250 people filed into a church in Spring Lake Park, Minn. There were moms and dads of addicts, as well as children whose parents brought them in hopes of scaring them away from smack.

From the stage, Dan Douglas gripped a microphone as a photograph appeared overhead on a screen: A woman in the fetal position on a bathroom floor. Then another: A woman “on the nod” — passed out with drug paraphernalia and a shoe near her face.

“You just don’t win with heroin,” Douglas said. “You die or you go to jail.”

It was the third such forum over two weeks in Anoka County, home to 335,000. Since 1999, 55 Anoka County residents have died from heroin-related causes. Only one other Minnesota county reported more — 58 — and its population is more than three times Anoka’s.

Five years ago, county officials were focused on stamping out meth labs. Then investigators noticed a climb in pharmacy robberies, and started finding Percocet and OxyContin during routine marijuana busts.

As prescription drug abuse rose, so, too, did crackdowns on pill mills and tracking of prescriptions. Users turned to heroin. “It hit us in the face in the form of dead bodies,” says Douglas.

Authorities are working to educate doctors about the dangers of overprescribing painkillers and are fighting to get heroin off the streets. The idea for the forums came not from police but rather from Valerie Pap, a third-grade teacher whose youngest son, Tanner, died of a heroin overdose at 21.

Tanner graduated from high school with honors. In fall 2012, he was pursuing a psychology degree at the University of Minnesota, and dreamed of becoming a drug counselor. He had not, to his mother’s knowledge, ever used drugs — and certainly not heroin.

Then one day Tanner’s roommates found him unconscious in his bedroom.

Amid her grief, Pap realized something needed to be done to educate others. At each forum, she shares her family’s story.

“Our lives have been forever changed,” she told the crowd in Spring Lake Park. “Heroin took it all away.”

IN OHIO: OD antidote helps save some

Brakes screech. The hospital door flies open. A panicked voice shouts: “Help my friend!” An unconscious young man, in the throes of a heroin overdose, is lifted onto a gurney.

The “drive-up, drop-off,” has happened repeatedly at Ohio’s Fort Hamilton Hospital. The staff’s quick response and a dose of naloxone, an opiate-reversing drug, bring most patients back. Some are put on ventilators. A few never revive.

“We’ve certainly had our share of deaths,” says Dr. Marcus Romanello, head of the ER. “At least five died that I am acutely aware of … I personally cared for them.”

Romanello joined the hospital about two years ago, just as the rise of heroin was becoming noticeable in Hamilton, a blue-collar city of 60,000 people. Now it seems to be reaching into nearly every part of daily life.

“If you stood next to somebody and just started a conversation about heroin, you’d hear: ‘Oh yeah, my nephew’s on heroin. My next-door neighbor’s on heroin,’?” says Candy Murray Abbott, who helped her own 27-year-old son in withdrawal.

Heroin-related deaths have more than tripled in Butler County. There were 55 last year, and in one two-week period, Hamilton’s paramedic units responded to 18 heroin overdoses.

Users run the gamut, says EMS veteran Jennifer Mason — from streetwalkers to business executives. They die in cars, public parks, restaurant bathrooms.

Romanello’s hospital saw 200 heroin overdose cases last year. Patients usually bounce back quickly after being given naloxone, or Narcan. It blocks the brain receptors that opiates latch onto and helps the body “remember” to take in air.

Romanello says his patients are usually relieved and grateful by the time they leave his hospital. “They say, ‘Thank you for saving my life,’ and walk out the door. But then, the withdrawal symptoms start to kick in.”

“You would think that stopping breathing is hitting rock bottom,” adds Mason. “They don’t remember that. … You’ve blocked the heroin, and they have to have it. They go back out to get more.”

IN OREGON: A former addict fights back

They smile from photos: recovering addicts holding plates of food at a group picnic last year. In Central City Concern in downtown Portland, David Fitzgerald looks over the faces.

Are they all still sober? Are they all still alive?

“Most of them,” says Fitzgerald, a former addict who leads the rehab clinic’s mentor program. “Not all.”

Heroin cut a gash through the Pacific Northwest in the 1990s. Then prescription pills took over until prices rose. Now the percentage of those in treatment for heroin in Oregon is back up to levels not seen since the ’90s — nearly 8,000 people last year — and the addicts are getting younger.

Central City’s clients reflect that. In 2008, 25 percent were younger than 35. Last year it was 40 percent.

The crop of younger addicts presents a new problem — finding appropriately aged mentors to match them with. But Fitzgerald has hope in Felecia Padgett, 26. Before sobriety, Padgett sold heroin to people younger than herself, suburban kids in their parents’ cars. Using heroin, she says, was like “getting to touch heaven.”

Fitzgerald doesn’t yet have money to pay her, and Padgett herself is still in recovery. But she, and others like her, may play a crucial role as Portland’s heroin addiction gets younger.

“The drug scene, it’s fast … it’s different,” Fitzgerald says. “It’s harder than it was.”