Pubdate: Thu, 15 May 2014
Source: Macomb Daily, The (MI)
Copyright: 2014 The Macomb Daily
Contact:  http://www.macombdaily.com/
Details: http://www.mapinc.org/media/2253
Author: John Turk

MANY DIFFERING METHODS TO TRACK HEROIN OVERDOSES AT COUNTY, STATE
LEVELS COULD CLOUD REAL IMPACT OF DRUG

A bedroom in Jeannie Richards' Waterford Township home is never
used.

The walls are painted a unique shade of blue that her son, Bryan,
picked out when he was 13 years old. Some of Bryan's old tennis shoes
line the closet, along with a dusty, black Detroit Tigers baseball hat
that was his favorite.

The room hasn't changed much since Bryan's death in 2012 at 26. His
death certificate listed the cause as an overdose, a suicide from
taking too many prescription pills. But Jeannie knew there was more to
the story.

"I saw a spoon next to his bed, put it in a baggy and took it to the
medical examiner's office," said Jeannie. "I thought I had found a
clue. =C2=85 Bryan had been using heroin for two years."

An examination of death records in Michigan and across the country by
The Oakland Press and Digital First Media shows a large discrepancy in
a perceived growing use of heroin and overdose deaths, and reporting
that makes it nearly impossible to know just how many have died from
it.

That's because there's no central place to report direct heroin
deaths, and because heroin breaks down quickly in the body, making it
difficult to name as a cause of death with scientific certainty.

A quick look at the who reports and who doesn't shows the
problem:

? Oakland County doesn't officially track the number of heroin-related
deaths in the county; the state reported 16 from 2010-2012. However,
county records show at least 59 died from heroin-related causes in
2013.

? Macomb County reported 191 deaths in 2010-2012; the Michigan
Department of Community Health counted 202.

? Wayne County doesn't report directly to the state, due to multiple
drugs often listed as a cause of death. The state numbers for
2010-2012 total 179 heroin-related deaths.

? While Michigan ranked among the top ten states for heroin-related
deaths from 1999 through 2010, only 65.8 percent of the cases listed
the drug as a specific cause of death.

? The state tallied 27 heroin-related deaths in Washtenaw County for
2010-2012.

? Genesee County, which does not capture the heroin-related death data
on its own, had 84 deaths in 2010-2012, according to the state.

While the MDCH and the Centers for Disease Control and Prevention in
Atlanta get their data from death certificates, many counties do their
own investigations, which include toxicology reports, medical
histories and more. Some counties, such as Oakland, don't have a
system that pulls strictly heroin-related death data, while others -
Wayne County, for example - directly report to the MDCH.

Oakland County Medical Examiner's Office Administrator Bob Gerds said
heroin-related deaths are difficult to classify simply because of how
quickly heroin breaks down in the body - aside from the discrepancies
in data gathering across the state.

"A metabolite called 6-Monoacetylmorphine, or 6-MAM, has to be present
in the body in order for it to be classified as a heroin death," Gerds
said.

But 6-MAM has a very short half-life of six to 25 minutes, said county
Forensic Toxicologist Diana Schell. After seven half-lives - 42
minutes to three hours, sometimes less - the compound is not even
detectable except through time-consuming toxicology screenings.

While 16 heroin-related deaths in two years in Oakland may not seem
like much, Oakland County Sheriff Michael Bouchard recently said
heroin use has jumped 300 percent since last year.

Other counties, including Macomb, Wayne, Genesee and Washtenaw, have
also reported a rise in the deaths from 2010-2012, according to the
MDCH.

Keeping better track of where heroin is prevalent is a start to
learning how to combat the problem, said Jan Ivinson from Royal Oak.

Her son Tom started using heroin in 2004. He didn't die from an
overdose, however. He was murdered in 2010 over a $150 debt involving
the drug, she said.

Ivinson said that even if the numbers are misleading, she's grateful
for the amount of support she's seen from awareness groups that have
sprouted with the increase in heroin use in the community.

"I can't even begin to imagine that happening five years ago, when we
were shuttered in our own houses trying to help our own kids," she
said.

Jeannie Richards also says more needs to be done, that people need to
know how bad the problem is so help can be offered in areas with high
usage and death rates.

For more than a year, she's been reaching some via Bryan's HOPE, an
outreach group seeking to destigmatize heroin addiction and bring
awareness and resources to bear.

"I'm pretty sure that they could tell you how many drunk drivers
(there were) or how many murders with a gun," said Jeannie of her
support for a stronger data set for heroin-related deaths. "We need to
get those numbers, to know if we're winning, if we're improving."
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MAP posted-by: Matt