Heroin Makes a Comeback
Heroin Use Surges, Opiate Use Declines
Say the word “heroin” and most people conjure up images of a downtrodden junkie, living in an urban ghetto. In fact, the opposite is true. Today’s heroin user is more affluent and more likely to be Caucasian living in the suburbs or in a rural area, according to a recent study released by Missouri Recovery Network (Heroin and Opiate Use in Missouri: 2001 to 2011).
Heroin is on the rise throughout the U.S., but especially in Missouri. The study reports that 24 percent of law enforcement agencies in Missouri indicate that heroin is the greatest drug threat, while only 13 percent of law enforcement agencies indicate that cocaine is the major drug threat in their Missouri community. Kansas City’s heroin problem is worsening and the availability of heroin has greatly increased in the Kansas City metropolitan area since 2007.
The U.S. Drug Enforcement Administration (DEA) reports that heroin availability in the Midwest increased by 50 percent from 2008 to 2010, and that the Midwest has the second highest rate of the four regions. Only eastern states rank higher.
One big reason for heroin’s second grandstand is that opiate (painkillers like oxycodone and hydrocodone) users are turning to heroin because illicit prescription drugs are increasingly difficult to get. However, the “heroin high” is cheaper and easier to score.
Missouri’s rate of opiate pill sales are ranked first—higher than Kansas, Iowa, North and South Dakota, Minnesota, Nebraska and Illinois. Oxycodone and hydrocodone are the most commonly abused controlled prescription drugs in Kansas City. Drug experts say that the heroin sold today is generally purer and thereby more potent than in past decades. The result is increasing risks of overdose. Many Missouri law enforcement officials say they are more concerned about heroin than methamphetamine.
“We’ve been on the national news for meth,” said Brenda Schell, executive director of the Missouri Recovery Network. “Now, we’ve found that heroin and opiate use has [triumphed] over the meth problem. Heroin is one of the most severe and significant problems in Missouri.”
Rural towns will feel the impact, too. “Due to the low cost and the availability of heroin, we will definitely see a rise in overdoses and addictions,” said Kathileen Grose, MA, LPC, CRAADC, MARS, Pathway Community Health’s director of Addiction and Recovery Services Northwest Region. “Many overdose deaths happen after a person has decided to quit, has not used for some time and then one day relapses – using the same amount of the drug they used to use. The body cannot tolerate the large volume of the drug used and spontaneous death occurs.”
Emergency rooms are also impacted by increased heroin use. From 2006 to 2010, the percentage of heroin or opiate abuse diagnoses in the state’s hospitals rose 63.1 percent and nearly half of all hospital admissions for drugs were due to heroin or other opiates. St. Louis and Springfield are the top two cities in this category.
Missouri’s fatality statistics are even more alarming. Deaths due to heroin have more than tripled in just four years from 69 deaths in 2007 to 245 deaths in 2011, 207 deaths in 2012 and 210 last year, according to Missouri Department of Health and Human Services. Missouri’s drug overdose rate is much higher than the national average and is the highest in the region.
“In Missouri, kids younger and younger are trying it,” Schell said. “They become addicted.”
Grose offers this advice: “Parents and family members, take your old opiate pain medications to the Drug Take Back events or drop them off at a local police department that has a drug disposal drop box,” she said. “Do this [before] your child or loved one discovers the treasure trove of ways to get high right at home in their own medicine cabinets. If we can stop the initial use of opiate pain medications to get high, we can slow the progression to use heroin when users run out of prescription medications.”
Missouri Recovery Network’s study reports that 56.5 percent of people admitted to public treatment centers in 2011 were age 30 and under, compared with 38.4 percent in 2001. Additionally, 60 percent of people admitted to publicly funded treatment centers in 2011 were white, while African Americans made up 30 percent admissions.
“People stereotype that these individuals are African American, but that’s not the case,” Schell said. “There is more suburban use.” Forty percent of those admitted are female, another shift in the demographics compared to one-third a decade ago.
Grose said the physical indicators of heroin use include a chemically enforced euphoria, nodding as in a dreamlike state and near sleep or drifting off for minutes or hours. She said for more tenured abusers, heroin may act like a stimulant that enables them to go about normal routines.
For others, it leaves them completely powerless to do anything. Other indicators are constricted pupils, slow breathing (which is how an overdose kills), itching, nausea and vomiting.
A heroin high now costs less than a decent bottle of wine, a movie ticket or a meal for two at a fast food restaurant. New federal laws that tighten access to opiates increased the price of prescription pain meds like OxyContin and Vicodin. A $10 bag of heroin offers a much cheaper high.
Some police agencies are taking a more holistic approach to treating the problem. Rather than throw users in jail, they help them seek treatment—often with the user’s record expunged if they stay clean.
In the St. Louis region, the problem is so bad that the police have hosted town hall meetings at high school gyms to warn students and parents about the addictive nature of heroin, and the potential for a fatal overdose.
Grose said that drug courts can be a more effective alternative to jail time because participants are highly supervised by the drug court team and court which supports compliance through treatment. She said this helps to create an abstinent lifestyle.
“Many participants are provided additional community support services to help them improve overall life functioning,” she said. “Drug courts provide positive incentives and pro-social learning opportunities, help the participant find employment and become a productive member in the community.”
Grose said participants must submit to frequent drug testing to help combat relapse during their participation in the program. “Drug court programs offer a team approach to help give an educational hand-up to the participants rather than punishment.”