Pubdate: Sun, 29 Jul 2012
Source: Tribune, The (San Luis Obispo, CA)
Copyright: 2012 The Tribune
Contact:  http://www.sanluisobispo.com/
Details: http://www.mapinc.org/media/391
Author: Jonah Owen Lamb

HEROIN IN PARADISE; DRUG USE IN SLO COUNTY

Admissions for treatment, sheriff's seizures and overdose deaths are
on the rise

When Christa Holt last used heroin in March, she was on a three-month
binge. Still, she had to spin her arm in circles to pump hard-to-find
veins with blood so that she could inject the drug.

The 27-year-old Arroyo Grande resident was at her nadir.

She had begun using methamphetamine at age 11. By her early 20s, she
had become addicted to prescription pills. She turned to heroin this
year after her younger brother, Andrew, died of a heroin overdose in
2011.

"I was just curious what was so hard-core that killed my brother.
What's so  awesome about this that my brother could not stop," she
explained.

Holt and her 24-year-old brother tragically exemplify the growing
presence of heroin in San Luis Obispo County.

Law enforcement officials and treatment specialists say the drug is
relatively cheap, readily available and an easy replacement for widely
abused opiate-based prescription drugs that are harder to find and
less potent.

Black tar heroin, much of it from Mexico, is now nearly as ubiquitous
as meth in the county, police officials say. (In recent years, Mexico
has been second only to Afghanistan in heroin poppy cultivation,
according to the U.S. Drug Enforcement Administration, and the drug is
being smuggled across the border.)

"It's important that the public know  that this is not an issue that
only happens in Detroit or Los Angeles and can happen here," said
Brian Beetham, a sergeant with the San Luis Obispo County Sheriff's
Office who heads the county's 14-member narcotics unit.

Law enforcement It is almost impossible to determine the extent of
illegal drugs in San Luis Obispo County, law enforcement officials
say, but their experience suggests a recent surge of heroin.

For the first six months of this year, the Sheriff's Office reported
44 cases that involved the seizure of heroin. That compares to 36 in
all of 2011 and 22 the year before.

Over a longer period, the number of people in the county's drug
treatment program using heroin as their primary drug has more than
quadrupled since 2006, growing from 2.1 percent to 8.9 percent in
2011-12. Furthermore, Beetham's team is increasingly coming across
heroin when deputies investigate other drug activity. And they are
receiving a lot more complaints about heroin use.

"It does seem, from our perspective, to be gaining in proportion in
the last six months," he said.

While they have not come across massive quantities of heroin, it has
become almost as normal in busts as meth, which Beetham characterized
as the "workhorse" of the drug world.

He believes heroin has become more prevalent because a reformulation
of prescription painkiller drugs such as oxycodone, commonly referred
to as Oxycontin or Oxy, has made them harder to smoke and because
heroin is relatively cheaper ($10 to $20 for a tenth of a gram) than
Oxy ($20 and up for a pill).

"For whatever reason, it seems like  people that were formerly big
into prescription meds are now moving to heroin," Beetham said.

Trajectory into drugs

Holt began using Oxy with friends in her late teens and soon wanted it
all the time. She found a ready seller too; an older woman in Pismo
Beach with a prescription sold her Oxy for $20 a pill.

"At the height of my using, I would do, like, five a day," Holt
said.

Then she was busted with 50 pills and convicted of felony possession.
That began her long and mostly failed attempts at getting clean.

Holt rationalized her use of pills over harder drugs such as
heroin.

"It's not dirty; it's not called black tar heroin. And it comes in a
nice pill," she said.

Becky Torres, who manages an outpatient narcotics drug treatment
center in Atascadero, said the majority of her young patients with
heroin dependency have a similar trajectory to Holt's.

In 2010 when she took over at Aegis Medical Systems Inc., it had 130
patients, with a mixture of individuals dependent on opiate
prescription painkillers and heroin. Now, Aegis has 210 patients,
including 60 percent with heroin problems, Torres said.

About 60 of her current patients are 18 to 26 years old (Aegis does
not treat minors), and most started using Vicodin, moved to stronger
Oxycontin and then to heroin because it was cheaper and easier to get,
she said. Two years ago, only 10 of her patients were in that age group.

Torres said her older patients become dependent on prescription
opiates and continue using them because they have the money and can
navigate their way from doctor to doctor to get their fix.

Numbers on the rise From an emergency medicine standpoint, it's
difficult to pinpoint the scope of heroin in SLO County, according to
local doctors.

Since 2007, there have been seven accidental heroin overdose deaths in
the county -- one in 2007, two in 2008 and four last year.

Holt's brother Andrew was one of those who died in
2011.

"He got out (of prison) on Sunday and he died on a Tuesday," said
Suzie Craig, their mother.

Meanwhile, since 2006, only 19 people have been treated at local
hospitals for accidental heroin overdoses, according to the Office of
Statewide Health Planning and Development. Additionally, since January
at least six of 35 patients administered with an anti-narcotic
medicine used to stop overdoses were using heroin, said Joe Piedalue,
director of operations for San Luis Ambulance, which operates
countywide except in Cambria.

Medical officials and doctors caution against using drug overdose
numbers to determine the extent to which any drug is used or its
impact, because each drug acts differently on the body. Some are more
apt to cause an overdose.

Trying to remain clean

Holt said she's been clean since March. She was drug-free for a time
in 2011 after moving to Texas and living with relatives. She was
pregnant and had a job.

But when her brother overdosed in May 2011, all of that fell apart.
She took whatever illegal drug she could get.

When frustrated relatives dropped her at her mom's house in Arroyo
Grande in January, Holt had burned almost all of her bridges.

In her wake was a toddler son she no longer has custody of, a
boyfriend who she said died of sleep apnea, and a criminal record. She
kept using drugs, however, only stopping when her mom persuaded her to
admit herself to Arroyo Grande Community Hospital.

Holt said she does not want to end up like her brother and one day
hopes to reunite with her son.

But right now, she is living day-to-day.

"I'm trying to stay six months clean."

Heroin addiction

About 23 percent of those who use heroin become dependent on it. For
them, withdrawal includes muscle and bone pain, insomnia, diarrhea and
vomiting, cold flashes and severe craving.

Heroin is particularly dangerous because it can depress respiratory
function, which is often what causes an overdose.

Dr. Mario San Bartolome, a Pismo Beach-based specialist in addiction,
said dependency doesn't necessarily translate to addiction.

Addiction occurs when the dependency impacts the rest of a person's
life to such an extent that all that matters is getting drugs.

While methamphetamine and heroin are major worries for local law
enforcement, the illegal use and abuse of synthesized prescription
opiates such as Oxycontin, codeine and Vicodin are on the rise, too.

"Prescription drug abuse is our big issue," said Dr. Thomas Ronay, the
county's emergency medical services agency director.

Another addiction: Prescription drugs

While it is impossible to say exactly how many people abuse
prescription drugs locally, more people have accidentally overdosed on
these drugs in recent years than on other drugs such as
methamphetamine.

 From 2006 to 2010, for example, 211 prescription drug overdose victims
were treated at local hospitals, compared to 76 meth overdose victims,
according to state statistics.

And last year, 27 of 44 accidental drug overdose deaths in the county
were caused by some form of prescription drug, in most cases opiates,
according to the San Luis Obispo County Coroner Unit.

Ronay attributes some of the drug overdose problems to a change in
state legislation that encouraged physicians to more liberally
prescribe painkillers -- which may have inadvertently helped cause an
increase in dependency.
- ---
MAP posted-by: Matt