Heroin epidemic hits county

By her own account, Janet had a pretty good life before heroin.

By the time the drug was through with her, however, she had earned a felony record; lost a good nursing job, her childhood home and two cars; caused untold suffering to her parents; and placed her now 5-year-old daughter into therapy to deal with the emotional damage of having an addict for a mom.

"œPeople get this idea that (heroin users) are getting high all the time," she said. "œNo. We were just maintaining, so we weren't sick. We didn't have enough money to get high... All you're trying to do is trying to feel normal. It's the worst feeling in the world, and I can't imagine going back to it."

After pleading guilty to a theft offense, "Janet" voluntarily admitted to being a heroin addict "“ the court apparently hadn't known she was "“ and asked her attorney for help in kicking her habit. Among local addicts, this makes her one of the smarter and more fortunate ones.

According to local medical and social-service experts, opiate abuse "“ intravenous heroin in particular "“ is expanding rapidly in Athens and surrounding counties. And this is happening at a time when a money-strapped state is taking funds away from agencies that help people kick their habits.

PRIOR TO ABOUT 2000, according to Joe Gay, director of the regional addiction/mental health clinic Health Recovery Services, "we were seeing very few cases of opiate abuse. It was very rare." Then around 2005, he recalled, HRS "started seeing people addicted to Oxycontin," a pharmaceutical opiate substitute.

As doctors and authorities began cracking down on pharmaceutical opiates, and an influx of relatively cheap heroin began showing up in Ohio, Gay speculated many people who had been addicted to prescription opiates switched to heroin.

And while illicitly obtained pharmaceuticals don't seem to have gone away by any means, and probably still account for more abuse cases, heroin has become much easer to find, Gay noted, and is increasing quickly in popularity. "It's more available now," he said. "It's just flowing in."

In different interviews by The Athens NEWS for this story, in fact, some version of the same phrase kept coming up to describe heroin's availability in this area: "It's everywhere."

Kim Brozak, a case manager at the local Bassett House drug-rehab facility for juveniles, said buying opiates on the street in most Athens County villages seems to have become almost absurdly easy. "I can't think of one town where you couldn't walk in, you yourself, and within 15 minutes, get your drugs and be on your way back to Athens," she said.

On her home turf in the Glouster area, "Janet" estimated, scoring some heroin would take "less than five minutes."

LOCAL EXPERTS SEEMED to agree that the opiate problem has been getting worse for a few years, but that within the last 12 to 18 months, the plague has begun to spread much more rapidly.

Looking at clients from Athens and three adjacent counties, according to Gay, the number of HRS outpatient admissions in which the person described heroin as his or her "drug of choice" was 60 last year "“ up from just nine in 2006, an increase of well over 500 percent. The number for 2009 is projected to be up to 69.

Given that a serious heroin addiction can cost, Gay said, "anywhere from $80 to $200 a day," many addicts steal, deal drugs, or engage in prostitution to get the money to feed their habits. This means the problem is showing up heavily among those arrested for criminal offenses.

Jeremy Tolson, warden of the Southeastern Ohio Regional Jail in Nelsonville, said he's definitely noticed an upsurge of inmates coming through his doors suffering from heroin dependency.

"For two or three years, it's been increasing," Tolson said. He estimated that at this point, "at least a quarter" of his inmates, and possibly as many as 30 to 35 percent, come into jail with heroin or other opiate habits.

"And that's the ones that we know about," he added.

Given that a heroin addiction requires constant feeding "“ "Janet" guessed she had to shoot up about once every seven hours to avoid withdrawal "“ even a short stay behind bars brings on the "dope sickness" "“ slang term for the pain and nausea of quitting cold turkey.

Tolson said he sees a lot of this, and also hears from suffering inmates that they hate the drug they can't stop using.

"There's not too many of them in here who don't want to quit, I can tell you that," he said. "Every one of them wants to quit."

IT'S NOT JUST ADULTS, either. At Bassett House, said Program Director John Padget, "we are seeing kids as young as 13 that are shooting up heroin."

The facility holds 24 juveniles, and "as of right now," Padget reported, "five of those 24 kids are in here for opiates. I know that at least three of them are shooting heroin."

As with adults, Padget said, the curve on local heroin use, slowly increasing for some time, now seems to be shooting upward exponentially.

"Yes, the problem has grown by leaps and bounds," he said. "It is much worse today than it was even a year ago."

He, like others, cited the ready availability of the drug on local streets as a big part of the problem.

"I actually had a kid tell me the other day that it's easier to find heroin on the street than it is to find marijuana," he recalled. "You could have knocked me over with a feather."
Padget said he doesn't see much light at the end of the tunnel yet. "The problem's getting worse, and the kids that are using are getting younger," he said. "I wish I knew how to stop it... I would love to work myself out of a job. I would go pump gas somewhere, if that meant there weren't any more kids using drugs and alcohol. But I think my job's secure, unfortunately."

HEROIN IS ALSO an equal-opportunity drug in terms of gender. At the Women's Rural Recovery Program, Program Director Cathy Chelak estimated that three out of four clients have problems with heroin or some other form of opiate addiction. About three or four years ago, she said, that number would have been about one in four.

Chelak said she believes women "tend to become addicted quicker" than men, and often "have less resources to use to get out of addiction."

The impact of heroin on women also takes different forms, Chelak said. Prostitution to earn drug money is common, she said, which typically involves unsafe sex. It also means women are hooked on heroin while pregnant.

With slots for 16 women, Chelak said, at any given time 10 or 11 of those are likely to be struggling with opiate abuse.

"You're probably looking at two of those being pregnant and using an opiate "“ even IV use," she added. This can lead to serious developmental problems for the child after it's born, she said.

Other problems associated with heroin abuse are the infections such as HIV and hepatitis that come from sharing needles "“ quite common among area addicts, by all reports.
"Probably three-quarters of the women here at any given time will have hepatitis," Chelak said.

AND OF COURSE, the possibility of death is always lurking for a heroin addict. According to numbers from the Ohio Department of Health, Athens County had five opiate-related deaths in each of the years 2005, 2006 and 2007. Only one of the 15 fatalities was attributed to heroin, while four were from methadone and 10 from "other opioids."

More recent numbers weren't available from DOH, but a survey of coroner's reports on file with the Athens County Clerk of Courts suggests that in 2008 and 2009, at least 13 overdose deaths so far have been attributed in whole or part to opiates. Victims have ranged from an 18-year-old McArthur man to a 49-year-old woman from Jacksonville, and include two local college students who overdosed together on alcohol and heroin a year ago at a local apartment complex.

For every overdose that kills a user, however, there are probably multiple ODs that aren't fatal.

Jim Schulz, emergency room unit manager at O'Bleness Memorial Hospital, said the ER does seem to be seeing more opiate overdose cases in recent months, though he noted carefully that ER doctors don't necessarily distinguish what drug is involved when they're trying to re-start someone's breathing, and aren't legally required to report illegal drug overdoses to law enforcement.

"What is happening more than I remember from past years is that people are admitting to the use of heroin, as if it's as inconsequential as the use of marijuana," Schulz said.
And even for chronic users who don't die from an overdose, noted Chelak of WRRP, life expectancy is shortened by many different health impacts.

She noted that in group sessions, she sometimes goes around the group, asking for ages of the women involved, and virtually never gets anyone past their 40s. "You know the reason for that?" she asked. "Because women (using heroin) don't make it to the age of 50."

"JANET" RECALLED HOW she began taking prescription opiates like Oxycontin about seven years ago, to deal with the pain of a medical condition for which she'd undergone multiple surgeries, then moved on to heroin.

After getting involved with a man who sometimes bought prescription opiates on the street, Janet recalled, she began obtaining her prescription painkillers illegally, and began snorting rather than swallowing them. Eventually, she moved into injecting them with a needle.

At the peak of her prescription opiate habit, Janet said, she and her boyfriend (and daughter's father) were together using 10 to 15 80-milligram Oxycontin pills a day. They began traveling to a methadone clinic in West Virginia to obtain the legal heroin substitute, and eventually moved to shooting the real thing.
"He started to buy heroin, which was definitely cheaper, but it was much more addictive," she remembered. "As soon as I started shooting the heroin, it was just a nightmare. It hit so fast." This triggered a downward spiral into stealing and dealing, with Janet's boyfriend "“ from whom she's now split "“ driving to Columbus constantly to bring back heroin, some to sell, some to shoot up.

"We never made money off it, of course "“ we used it," she said.

Janet said she knows her story could have ended much more tragically, as it does for many other addicts.

"I'm very lucky "“ I had a life without drugs," she noted. "That's the life I liked. I would ask myself, 'How did you let yourself get to this point?' Because I had a great life."

Now, she said, she worries about the others who may want to clean up as she did, and can't find the resources locally to help them through it. In the area around Athens County, she said, there is now only one facility for heroin addicts to detox safely under medical supervision.

"You hear people complain about (the problem), but you don't hear, what is there you can do about it?" she said.

GAY OF HRS NOTED that the amount of money the state spends on prevention, treatment and research into substance abuse has long been a small fraction of what it spends on dealing with its impacts, through the justice system, the health-care system, and elsewhere.

With the prospect of even more funding cuts, Gay said, HRS is working to give priority to opioid users in admission and treatment, and has put together an informal organization, the "Opioid Response Group," to share information and coordinate efforts among local professionals. HRS is also on the hunt for state and federal grant monies, to pay for not only treatment, but also training and coordination of effort.

Gay said that though getting an addict off opiates and keeping him that way can be expensive, he believes it's still a better bargain for the community at large than not addressing the problem. But as things stand now, he said, his organization, even with a policy of giving opiate users top priority, can't even provide help for all the junkies who are seeking it.

"For the first time ever, we are turning people away," he reported.