Heroin availability and drug overdoses increase

Heroin availability and drug overdoses increase

By RENEE FOX

Tribune Chronicle

     ö Heroin was present in 2/3 of accidental overdose deaths

ö 42 percent of deaths were a result of a polydrug intoxication

ö Either cocaine, oxycodone, methadone, morphine, hydrocodone, fentanyl, opiates or amphetamines were responsible for 11 of the deaths

ö Six of the people that died suffered from a medical condition and drug overdose

Where the deaths occurred:

Warren: 14

Howland: 8

Niles: 7

Weathersfield: 3

Cortland: 3

Hubbard: 3

Brookfield: 2

Liberty: 2

McDonald: 2

Bazetta: 2

Newton Falls: 1

Masury: 1

Austintown: 1

Braceville: 1

Unknown/ hospital: 4

SOURCE: Trumbull County Coroner's Office

A drug trafficking highway stretching across Ohio may be partially responsible for the availability of heroin and a rise in accidental overdose deaths in Trumbull County, according to law enforcement and industry specialists.

"We are located where the highways between Detroit, Toledo and Columbus meet," Executive Director of the Trumbull County Mental Health and Recovery Board April Caraway said. "That makes the heroin very pure, very cheap and highly accessible." 

Caraway's analysis is backed up with data from Trumbull County Coroner Dr. Humphrey Germaniuk and facts and opinions gathered from law enforcement, counselors and users in a recently released Ohio Substance Abuse Monitoring Network study. OSAM reports on drug trends in eight metro areas across the state, every six months.

Data from Germaniuk show there were 54 accidental overdose deaths in the county, up from 39 in 2013. Heroin caused 20 of those deaths last year -- 36, if counting the number of times heroin showed up in the bloodstream of the deceased, combined in a fatal mixture with other drugs.

According to the OSAM report, the Ohio Bureau of Criminal Investigation Richfield Crime Lab reported an increase in the number of heroin cases it processed between this and the last reporting period.

An Ohio Drug Task Force Report covering 2010 to 2013, shows a sharp increase in heroin trafficking and possession indictments. In 2010, drug task forces across the state generated 470 indictments for heroin trafficking, and 237 indictments for heroin possession. In 2013, there were 1,217 indictments for heroin trafficking and 777 for possession. 

There was more than one accidental death from drug overdose a week last year in Trumbull County, 54 total.

ö 38 men and 16 women died

ö 94 percent were white

ö 0 were 21 or younger

ö 24 percent were aged 22-30 years

ö 37 percent were aged 31-45 years

ö 27 percent were aged 46-56 years

ö 11 percent were aged 57-79 years

 

The report states that heroin was responsible for a 160 percent increase in total drug trafficking indictments and a 200 percent increase in total drug possession indictments.

OSAM examined Trumbull County from January to June with Mahoning, Columbiana, Ashtabula and Jefferson counties, making up the Youngstown region. Toledo, Cleveland, Dayton, Akron-Canton, Cincinnati, Columbus and Athens were also surveyed. Heroin availability increased in six regions and is considered high in all eight.

Drug users undergoing treatment in Columbiana, Jefferson and Mahoning counties were surveyed in focus groups; treatment providers and law enforcement were interviewed in focus groups in Trumbull, Ashtabula and Mahoning counties.

Participants were asked about the availability, pricing and potency of crack and powder cocaine, heroine, prescription opiods, methamphetamines, marijuana and numerous other drugs, to produce epidemiologi­cal descriptions of local substance abuse trends.

They were asked to rank the availability of the substances on a one-to-10 scale, with 10 ranking as the most available. Users, law enforcement and substance abuse treatment counselors agreed, heroin is a "10."

"Heroin, lots and lots of heroin," a specialist commented in the report.

Trumbull County Sheriff Captain Jeff Orr said the majority of heroin in our region comes from Detroit, although Ashtabula sees product from New York. The Valley might be a rest stop for traffickers on their way to other parts of Ohio, according to information garnered during arrests and traffic stops.

In addition to the location of the county, focus group participants and Caraway speculated increased heroin use is a result of a reduction in prescriptions for opiods written by doctors because of stricter regulations. Orr said more prescription drugs are being discovered in busts in the region.

"The No. 1 reason people get hooked on heroin is an addiction to opiates after an injury," Caraway said. "When the doctor takes away the prescription, they get sick, going through withdrawal. They turn to heroin to help with the pain and sickness. It is remarkably cheaper."

The report also found 6 out of 10 heroin users in the region share injection needles.

"More (people share needles) than you believe," a comment in the report states. "The younger kids now, they don't take it serious ... they think they are Superman and won't (catch a disease)."

The OSAM report found an increase in hepatitis C cases among intravenous drug users in the Dayton and Columbus regions.

Heroin is also losing its stigma, according to treatment providers interviewed. That's bad news in a county that saw deaths from the drug nearly double in the last two years.

Accidental overdoses are my primary concern, Caraway said. Trumbull County has gotten worse; we rank sixth (out of 88) in the state for accidental overdoses on heroin, up from ninth.

Of concern is a rise in the number of adolescent heroin users, according to the majority of the region treatment providers surveyed by OSAM. Last year, none of the people who suffered a fatal overdose was under the age of 22.

Between 2010 and 2013, 260,158 grams of heroin were removed from the streets according to the Ohio Drug Task Force Report.

Last month, Warren police recovered nearly four pounds of heroin worth at least $250,000 from 1538 North Road; Ricardo McKinney was charged with felony possession. The bust was the biggest ever in Warren, the second largest in Trumbull County, according to police.

According to national data from the Centers for Disease Control, more people ages 25 to 64 die from drug overdose than traffic accidents. Overdoses were the leading cause of deaths from injury in 2012 and the drug overdose rate has more than doubled since 1999.

Accidental drug overdoses in Trumbull County 2010-2014:

2010: 49

2011: 59

2012: 36

2013: 39

2014: 54

From heroin:

2010: 6

2011: 19

2012: 10

2013: 12

2014: 20

Solutions

Although there won't always be an emergency worker of law enforcement professional nearby when someone is suffering from a heroin overdose, a dose of naxalone, or Narcan, swiftly administered can save someone's life.

Earlier this month, St. Joseph Warren Hospital donated 40 of the pricey kits to the Trumbull County Sheriff's office. A spray that enters the body through the nostrils, Narcan acts to reverse respiratory depression by blocking the receptors activated by opiods. Narcan acts as an antidote to a body over-exposed to heroin and other opiates, including some prescription drugs.

Dr. Edward J. Novosel, associate medical director at the hospital, said many overdose victims die before first responders arrive or before he or she can be transported for medical treatment.

"Having Narcan available as soon as the sheriff's deputies arrive is a lifesaver," Novosel said. "The sooner the Narcan is administered, the better the chances the overdose victim will survive."

The price of naxalone has only increased as its efficacy has become known. The primary solution to a heroin overdose is prevention.

"We need to have some realism in the classroom, not just a teacher reading from a book," Orr said. "The police, the addicts, the coroner and social workers, the people out there seeing the effects, need to share their experiences with kids."

There are new government standards for drug abuse education, Orr said, requiring students to learn about prescription drug addiction. Opiod addictions usually begin with prescription drugs, Orr said; and students should be learning about addiction from more industry professionals, not just teachers.

"I think we will see some positive changes in the years to come," Orr said. "We have strategic partnerships with the MHRB and are working to get awareness out in the community."

The MHRB has allocated $826,000 to pay for addiction and detoxification services for those that need the help and cannot afford it. Trumbull County does not have a treatment center that offers a place to detox; residents seeking help have to go to Mahoning County, Caraway said. The process usually takes 5 to 7 days and costs a minimum of $2,700. Caraway said by the time many addicts reach treatment, heroin doesn't even give them a high anymore; they take it to avoid the extreme aches and flu-like symptoms withdrawal causes.

The MHRB works to match users with a program that will work for the individual and also sponsors the Alliance for Substance Abuse Prevention, ASAP. Using marketing and public awareness, the board hopes to prevent drug use with school programs, advertising and focusing public awareness on the problem, Caraway said.

ASAP hosts programs like Hope for Recovery, where addicts, the coroner and other industry professionals speak about their experiences and the effects of drug use, designed to educate the public on addiction prevention and intervention.

Other trends

The OSAM report includes information on all illegal drug trends in monitored regions of Ohio, and found the availability of bath salts and synthetic marijuana has gone down during the reporting period, largely due to busts on known sellers.

Powdered and crack cocaine use and availability has remained relatively stable. The substance, in either version, was present in 35 percent of Mahoning County Coroner drug deaths. A new trend, users reported, is mixing crack cocaine with Kool-Aid or vinegar, in order to inject it. Also, because of the length of time crack has been on the streets now, there are more older users now.

"A treatment provider explained that heroin seems more fatal, while crack cocaine users can use it for a longer period of time," the OSAM report states.

Prescription drugs are just as available on the streets as ever before; Percocet and oxycodone were listed by users and professionals as the most widely available illegally trafficked prescribed medication.

And Roxicodone use is on the rise, according to an officer in the OSAM report, "More people are being prescribed (Roxicodone 30 mg), so it is going to be... a lot more accessible."

One or more prescription opiod was present in half of all drug-related deaths in Mahoning County over the OSAM reporting period.

"I don't think anyone takes their pills anymore. I think they just sell them," a study participant said.

rfox@tribtoday.com