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New laws designed to stymie the illegal sale and consumption of prescription drugs and methamphetamines in Kentucky have developed a deadly and terrifying side effect: Heroin, the opiate of choice for many in the American drug culture of the 1960s and 1970s, has returned to the streets and in 2012 claimed two lives in Shelby County.
“It was last year that we started seeing more heroin activity here, and we have actually had a couple of fatalities from heroin overdoses in Shelbyville,” Shelbyville Police Chief Danny Goodwin said.
An analysis of statistics supplied by the law enforcement agencies that serve Shelby County indicates that House Bill 1, which in 2011 created more tools and tightened loopholes to control the use of methamphetamines and limit sources of illegal narcotics, appeared to be working, with drug arrests downslightly, from 467 in 2011 to 462.
Those arrests came in 147 cases that confiscated drugs with a total street value of about $110,736.
Kentucky State Police made the most arrests, with 295, followed by the Shelby County Sheriff’s Office with 139, Shelbyville PD with 26 and 2 by the Simpsonville Police Department.
But in contrast to 2011, when nearly two-thirds of all drug cases were narcotics-related and one-third involved marijuana, narcotics compromised 52 percent of drugs cases in Shelby County in 2012.
Marijuana comprised 37 percent, followed by meth at 6.5 percent, with other drugs comprising the rest.
Among them, two cases of heroin – both of which ended in death – that represent only the beginning of a frightening trend, officials say, a trend that has continued to grow in 2013, although exact figures aren’t yet available.
Goodwin said his department made a significant heroin bust just last month in downtown Shelbyville, although he declined to release the details because of an ongoing investigation.
“It was a big rock, though,” he said, saying police confiscated nearly eight grams of heroin, with a street value of approximately $3,600.
KSP Trooper Kendra Wilson said that in addition to making prescription drugs harder to acquire on the street, new laws not only made it more difficult to acquire narcotics but also made manufacturing meth more difficult because its main ingredient, pseudoephedrine, is also more difficult to obtain. That has helped make heroin more desirable for meth addicts as well.
Elizabeth Pulliam, director of Shelby Prevention, an organization that seeks to keep young adults off drugs, said she agreed that the resurgence in heroin use in 2012 came about because of the decreased availability of prescription narcotics on the street.
“People with an addiction, they’re not going to stop using drugs because they’re hard to get,” she said. “If they can’t get their drug of choice, they are going to go find something else.”
Pulliam said that drug abuse, especially of heroin, is becoming more widespread than in previous years, infiltrating more sectors of the community.
“The face of drug abuse has changed from what you used to see in the movies, of somebody out on the street shooting up,” she said. “It can happen to anybody, anywhere. There is a stereotype that drug addicts are bad people, that they are just criminals, but that’s not the truth.
“Addiction does not discriminate. It can happen to anybody, of any nationality, of any socio-economic status.”
One problem addressed
The crackdown on prescription painkiller abuse by the General Assembly and Attorney General Jack Conway’s office was targeted at physicians, forcing them to write fewer prescriptions, and closing down pain clinics all over the state.
Allison Gardner Martin, spokesperson for Conway, said Kentucky Gov. Steve Beshear, as well as several legislators, supported Conway’s measures to stop doctors from over-prescribing painkillers.
“The crackdown isn't just from our office,” she said. “House Bill 1 helped shut down rogue pain clinics, required doctors to use KASPER [a drug registration database], required the Kentucky Board of Medical Licensure to forward doctors suspected of over prescribing to law enforcement and got entrepreneurs out of the pain management business.
“The crackdown is only part of the story. The other reason for the [heroin] increase is because drug manufacturers have made opiate painkillers tamper resistant, meaning addicts cannot crush them to snort or inject them.”
What is heroin?
Heroin, which goes by many street names, such as Big H, black tar, brown sugar, dope, horse, junk, or smack, is a highly addictive drug derived from morphine, obtained from the opium poppy.
It is a sedative that slows body functions and is a white to dark brown powder that can be injected, smoked or inhaled through the nose, and gives users sensations of warmth, relaxation, and diminished physical pain.
Heroin, especially with continued use, also causes clouded mental functioning, slurred speech, a slow gait, impaired vision, vomiting, constipation, and more seriously, collapsed veins, infection of the heart valves, pulmonary complications, and clogged blood vessels. The higher danger of overdoses associated with heroin is caused by the body adapting to the drug over time and requiring increased doses to get the user high.
Heroin is produced mainly in Asia and Latin America. During the past decade, heroin production has been on the rise in Southwest Asia, particularly in Afghanistan, which produced 80 percent of the world’s opium in 2010.
The Office of National Drug Control Policy reports that within the Western hemisphere, opium cultivation and heroin production in Mexico quadrupled from 2001 to 2009, going from 4,400 hectares (one hectare is equivalent to 100 acres), to 19,500 hectares in 2009, going from a potential production of 10.7 metric tons of pure heroin to 50 metric tons.
Overdoses on the rise
Dr. Eric Olson, medical director of the emergency department at Jewish Hospital Shelbyville, said that although prescription drug abuse continues to be a significant problem, heroin use definitely is increasing.
“There are still a lot of them [pills cases] out there, but the cost [of obtaining prescription drugs] is going up; that’s why heroin is there,” he said. “And if people are trying to get high, and pills cost more than heroin, they are going to opt for the heroin, which is becoming more readily available.
“Heroin is much more dangerous [than pills] in terms of overdosing. You can overdose to the point where you stop breathing far more easily than you can on just plain pills. We do see overdoses from both, but in general, we see more fatalities from heroin overdoses, because those people become unconscious literally within seconds of taking the drug, and if there’s no one to take care of them or no one realizes how serious it is, then that person just becomes unconscious and dies.
“Once in a while [we can save them], but in the majority of cases, they’re often dead before they get to the ER.”
Olson said the scenario he described is much more prevalent in Jefferson County, and he wouldn’t speculate on exactly how many deaths occurred in Shelby County this year were because of heroin overdose.
“It’s hard to say – we haven’t tracked particular numbers or anyone like that yet,” he said. “We’re seeing far more heroin, and I’d be interested in seeing what kind of a percentage increase it is, but the number of overdoses have gone through the roof compared to prior years.
"We still see a lot of pill abuse, but a lot of these doctors who were writing monthly prescriptions for all those pills got shut down.”
He said the trend in Shelby is mirrored in most places around Kentucky, especially Louisville.
“We are seeing this everywhere, but St. Mary’s [hospital, also a part of KentuckyOne Health, JHS’ parent] is probably the worst, in the south end,” he said.
And Wilson said a lot of the heroin availability is coming into Shelbyville from larger cities.
“In Franklin County and Jefferson, especially, there is a definite resurgence in heroin, and that is bleeding over into Shelby County,” she said.
Shelby County judges at both the district and circuit court levels say they are concerned with the increased number of drug-related crimes, especially heroin.
“A lot of it goes back to drugs – theft, robbery, forgery, it’s all related to substance abuse issues,” District Judge Linda Armstrong said. “That is the big underlying problem in a lot of these cases. Now we are seeing that since people on prescription pain killers [illegally] can’t get them anymore, heroin use has increased, and I think it’s because heroin is an opiate and has a similar effect as prescription pain pills. So as laws regulating prescription pain pills have tightened up, now we are seeing people resorting more to heroin. It’s very frustrating.”
Said Circuit Judge Charles Hickman, who also heads up the Shelby County Drug Court:
“Drug dealers are pretty resourceful in replacing one drug with another.”
Hickman said that the heroin problem may be even more widespread than the court can determine.
“We are sometimes not privy to the information about the drug of choice,” he said.
He echoed Armstrong’s opinion that drug abuse in general is probably more rampant than people, including law enforcement and court officials, realize.
“I’d say in the majority of theft-related cases, even when they are not charged with a drug crime, the underlying cause is to support a drug habit,” he said.
The problem of trying to get a handle on one problem only to cause another is frustrating, Goodwin said.
“It has been a personal observation of mine, that when we had what seemed to be a large increase in meth, the government was able to crack down on most all of the key ingredients, making it more difficult to obtain,” he said. “Then when there was a decrease in meth, we saw an increase in prescription pills.
“Then there was a large crackdown on doctor shopping, and less prescriptions were being written for narcotics, then now it seems that we’re seeing an increase in heroin, which has increased dramatically coming over into our country.”
And he said he didn’t see an answer.
“It would appear to me that in this country as a whole we have a large population that abuses drugs, and until the demand is reduced, the supply will continue to increase,” he said. “It’s just a simple issue of supply and demand.
“We tried education, from DARE programs to drug rehabilitation. I wish I had the answer. We try to enforce the law, but there are so many people skirting the law, it’s just an ongoing issue; I guess you could call it a pandemic, because it’s not just here, it’s everywhere. I don’t believe there’s anywhere in the United States that it hasn’t touched.”
“That’s why organizations like Shelby Prevention are so important, because you constantly have to stay on top of this,” she said.
“It’s [heroin] an opiate, just like lots of painkillers that are out there, so helping people get access to treatment is important. It’s important to educate the public, to let them know the dangers and understand the full scope of the issue. We’re seeing great strides being made against prescription drug abuse, but yet we need to continue that and also address the rising trend in heroin use.”
Olson said he urges anyone with an addiction to get treatment as soon as possible.
“We see an awful lot of people whose lives get ended by it and lose their jobs and families and children,” he said. “Even if they don’t die, a lot of these people’s lives are just completely ruined. I recommend treatment centers; there are a lot of them around. Otherwise, there’s really not a good ending for a lot of these people.”
Martin said the attorney general’s office is aware of the need to address the heroin problem.
“The issue is these opiate addicts need treatment,” she said. “Attorney General Conway is looking for ways to help fund additional in-patient treatment centers in Kentucky…and is working with Sen. Katy Stine on a piece of legislation for the next legislative session to help crack down on heroin.”
Is jail the answer for addicts?
Hickman said that in addition to the punitive aspect, the corrections system must do its part in helping inmates with drug rehabilitation and be very selective with those who are granted early release.
“We incarcerate five times more people in Kentucky than we should be,” he said. “We can’t afford to house all those people. From a fiscal standpoint, we just can’t afford it. “[We need to be] looking for an alternative to save money and to protect the public at the same time.
“I want the public to be educated on these changes [in the corrections system].”
Drug counseling services
§ Creative Spirits:502-633-5054
§ Serenity Center:502-647-5555
§ Seven Counties Services:502-633-5683
§ Shelby County Drug Court:502-647-3774
§ 24- Hour Crisis Information Line:1 800 221-0446 or 1 877 589-4259