Pubdate: Fri, 04 Aug 2006
Source: St. Paul Pioneer Press (MN)
Copyright: 2006 St. Paul Pioneer Press
Contact:  http://www.twincities.com/
Details: http://www.mapinc.org/media/379
Author: David Hanners
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)
Bookmark: http://www.mapinc.org/find?136 (Methadone)
Bookmark: http://www.mapinc.org/rehab.htm (Treatment)

HEROIN DEATHS UP, SAYS STUDY

Greater Availability, Potency Of Drug May Explain 42% Increase

The first thing you notice after the flood of heroin hits your 
bloodstream is that your breathing slows. In a few minutes, organs 
starved for oxygen begin breaking down.

As they do, your blood vessels start leaking. Air blends with blood, 
creating a frothy mix that fills your lungs and oozes from your 
mouth. After you die, the medical examiner who performs your autopsy 
will refer to it as a "foam cone."

That scene is becoming more common in the Twin Cities, according to 
an alarming report to be released today by the Hazelden Foundation. 
Opiate-related overdose deaths were up 42 percent in the metro area 
last year compared with 2004.

Police, emergency room personnel, medical examiners and those who 
provide substance-abuse treatment have noted the increase.

"Something changed in the Twin Cities in the year 2000 as it relates 
to heroin availability," said Carol Falkowski, director of research 
communications for Hazelden and the report's author.

"Prior to that, we weren't a prime market for heroin. Beginning in 
2000, heroin availability increased, and now, six years later, we're 
starting to see the long-term effects of that."

According to statistics from the medical examiners' offices in 
Hennepin and Ramsey counties, there were 102 opiate-related 
accidental overdose deaths in the five-county Twin Cities area last 
year. In 2000, there were 58.

There are two theories behind the increase. One is that heroin use is 
on the rise, particularly in young adults. Another is that purer - 
and more potent - heroin is reaching the Twin Cities, Falkowski said.

"It could be attributed in part to an unusually pure batch of street 
heroin that can result in overdose deaths for both experienced and 
novice users, or it could reflect new, inexperienced users who don't 
know the dose amount that they can tolerate, or some combination of 
the both of those," she said.

Dr. Kathryn Berg, Hennepin County's chief assistant medical examiner, 
said her office has seen the effects of the increase.

"The heroin available to these people was more pure than what they'd 
seen in awhile," she said.

"The person who uses this drug probably would unknowingly be taking 
what they thought was a safe amount for themselves, but in effect 
they were taking more."

The Hazelden Foundation, based in Center City, is one of the nation's 
oldest private drug- and alcohol-treatment facilities. The nonprofit 
organization also collects and analyzes data on drug-use trends and 
publishes a report twice a year that looks at overdose deaths, 
treatment-program admissions, drug-related emergency-room visits, 
drug seizures and other information.

The report to be released today also found that cocaine-related 
overdose deaths went up, from 49 in 2004 to 62 last year. Fatal 
overdoses from methamphetamine declined over the same period, from 20 to 14.

But it was the increase in opiate-related overdose deaths that has 
experts concerned. The opiates include heroin, methadone, oxycodone 
and a relatively new narcotic, fentanyl.

"It is such a marked increase that at a minimum, it is something we 
should watch in the future, and especially in light of some deaths 
and outbreaks of heroin-related deaths in other parts of the 
country," Falkowski said.

She was referring to a recent spate of fatalities in Detroit, 
Chicago, Philadelphia and Camden, N.J., resulting from drug users who 
took a potent mix of heroin and fentanyl.

Fentanyl is a synthetic opiate developed to ease the excruciating 
pain often felt by terminal cancer patients. Most of the fentanyl 
sold on the street is not pharmaceutical grade; rather, it is cooked 
up in clandestine labs, probably in Mexico, law enforcement 
authorities believe. Once the drug makes it to the retail level, it 
is mixed with heroin and often sold as heroin.

One of the drug's street names is "Death Bags."

Todd Axtell, who heads the St. Paul police narcotics unit, said he 
suspects fentanyl may have contributed to some of the overdose deaths locally.

"That's a concern to us," he said. "We're trying to address the 
supply of that drug into St. Paul and the metro area."

He said the new drug is showing up on the streets at a time when more 
young people are experimenting with heroin.

"The issues that we're hearing is that if that's not mixed the right 
way, that can be fatal," he said of the heroin-fentanyl combo. "It's 
not just the amount of heroin coming in; that really hasn't increased 
a whole lot. What we've seen on the street is that more people seem 
to be using it right now, and a lot of younger people are using it."

Proving fentanyl's role in an overdose death can be difficult from a 
forensic examination, though, said Berg. Like heroin, once it enters 
the body, it metabolizes rapidly into morphine. Proving its existence 
often depends on evidence found at the scene of the overdose or 
witness statements.
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MAP posted-by: Beth Wehrman