Pubdate: Sun, 15 Jun 2014
Source: Post-Star, The ( NY)
Copyright: 2014 Glens Falls Newspapers Inc.
Contact: http://www.poststar.com/app/contact/?form=letter
Website: http://www.poststar.net/
Details: http://www.mapinc.org/media/1068
Author: Don Lehman
Referenced: Heroin overdoses map http://mapinc.org/url/FZwNchF2

An unwanted visitor; Heroin creeps into Glens Falls region

Editor's note: The rise of opioid painkillers such as oxycodone has
had an unforeseen consequence, as addicts turn to heroin when pills
become hard to get. Abuse of heroin has spilled across all social
strata and led to an increase in overdoses nationwide. The trend has
not skirted our area. Heroin has come to the Glens Falls area,
attended by addiction, crime and death. A map of heroin overdoses in
the Glens Falls region in 2013-14 is seen below.

She thought he was sleeping.

Her boyfriend was a heavy heroin user, but he sometimes napped as he
came down from an opioid high.

This time, as he sat in a living room chair, the 47-year-old Hudson
Falls resident didn't wake up.

By the time the girlfriend realized he was not breathing, it was too
late.

The dose of heroin he had injected hours earlier had apparently proved
fatal.

"He had needle marks all over his feet. His girlfriend had seen him
use (heroin) earlier," Hudson Falls Police Detective Scott Gillis
said. "She just thought he was sleeping."

The man's overdose last fall was one of at least seven confirmed or
suspected heroin overdose deaths in the Glens Falls region over the
past year. That does not include the death last week in Albany of a
local man who is also believed to have died of a heroin overdose, and
numerous near-death overdoses as well.

Unlike car crashes, homicides or other unnatural deaths that generate
media attention and headlines, the spate of heroin overdose deaths in
Warren, Washington and Saratoga counties has drawn little notice.

Gillis said police are awaiting toxicology tests to show the level of
heroin in the bloodstream of the Hudson Falls man who died last fall,
so it is still unknown whether he received a contaminated batch of
heroin or a stronger dose - known as a "hot load" - than that to which
he was accustomed.

Because crime labs are backed up by growing caseloads, and overdose
deaths usually don't lead to criminal charges that require expedited
tests, it can take months for police to get confirmation of their
overdose suspicions.

Public perception of heroin use, based on experiences from the 1960s
and 1970s, is of a hard-core street drug used by junkies outside the
mainstream and the middle class. But the recent increase in use has
spared no social strata.

Star high school athletes and children of local doctors, lawyers and
other well-to-do area residents have found themselves grappling with
opioid addiction.

Washington County Sheriff Jeff Murphy tells of affluent parents going
to pawn shops to buy back items their addict children have stolen and
sold. Others tell of parents quitting jobs to stay home to protect
their property from their own children.

"This has affected everyone," Murphy said.

Warren County District Attorney Kate Hogan knows of a local teen who
graduated from high school as an honor student, went to SUNY
Plattsburgh and returned home after the first semester addicted to
heroin.

"The heartache this drug is causing is unbelievable," she
said.

The rise in heroin addiction is happening across the country,
according to David Saffer, executive director of The Council for
Prevention in Kingsbury.

And while solutions have been hard to come by, there is hope, he
said.

"It is one of the most complex issues any of us have dealt with in a
long time," Saffer said.

Regional history

Will Valenza, Glens Falls' chief of police, said heroin has long been
a problem in New York City, where he began his police career in the
1990s. But heroin use was isolated to certain groups, generally the
poor.

When he moved north to Warren County and took a job with Glens Falls
Police, heroin was not an issue.

"When I came here, you never heard about or saw heroin," Valenza
said.

Local police saw pockets of heroin use in the region at times in the
1990s and early 2000s, with two deaths in 2001 in southern Washington
County prompting concern the drug was becoming more prevalent.

It was in the mid-2000s, however, when powerful opioid-based
prescription painkillers like OxyContin and hydrocodone became popular
with drug abusers, that the foundation was laid for a serious local
heroin problem.

Many users started taking painkillers for legitimate injuries but
found them to be highly addictive, said Warren County sheriff's Sgt.
Tony Breen, supervisor of the narcotics enforcement unit.

"These pills are just as addictive as heroin," said Jeff Gildersleeve,
a Warren County sheriff's narcotics investigator and retired State
Police narcotics investigator.

Doctors who overprescribe opiates without fully accounting for the
risk have played a significant part in the addiction problem, Breen
said.

Medical guidelines that require doctors to treat pain have also led
doctors to put patients on painkillers, or risk disciplinary action
for improper care, Warren County District Attorney Kate Hogan said.

"A lot of addicts start off with legal use and move into the illegal
realm," Breen said.

Pills like OxyContin became black market commodities and their street
value grew to the point higher doses were worth $100 and more per pill.

Pill addicts turned to crime, including pharmacy burglaries and
robberies, to support their habits. Drug task forces turned their
attention to dealers were selling pills, many of them obtained through
Medicaid-paid prescriptions.

"Two years ago we couldn't stop buying pills," Breen
said.

The state and federal governments responded with crackdowns on
prescription fraud and "doctor-shopping," in which addicts bounced
from doctor to doctor, complaining of pain, to get
prescriptions.

The crackdown worked, but it forced opioid addicts to look for an
alternative to pills. They turned to heroin, a powdered opioid that
because of an increase in purity, could be snorted or smoked by
entry-level users, and which has fallen in price as worldwide
production has grown.

Opioids are derived from the poppy plant. The emancipation of
Afghanistan's poppy fields during the U.S. war on the Taliban and an
increase in poppy production in Central America and South America has
resulted in more of the drug pouring into the U.S. through the Mexican
border.

Heroin has become more pure and cheaper than it has been in decades,
and it has been sought out by legions of pill addicts who were having
difficulty getting pills or affording them. Hard-core users moved from
snorting and smoking to injecting as they sought a quicker, better
high.

The rate of the increase in heroin's use over just a few years has
been shocking to many in the drug treatment and law enforcement world.

Overdoses

Heroin and other opium-based drugs affect the brain's
neurotransmitters, blocking pain.

But the drugs can also cause the brain to slow the respiratory system,
and a fatal dose will gradually cause victims to stop breathing and
their hearts to stop beating.

Overdoses can be reversed by a medication that undoes heroin's effect
on the brain, but only if it is given while the user is still
breathing. State programs are putting more of that drug, naloxone, in
the hands of police and emergency medical technicians.

The region has dealt with occasional heroin and painkiller pill or
patch overdose deaths over the years, but the recent surge in deaths
mirrors statewide and nationwide trends.

Nationally, opioid overdose deaths have more than quadrupled since
1999, to the point where more people died of drug overdoses in 2013
than in car crashes. National statistics show use has nearly doubled
since 2007.

Until the recent attention given to the surge in heroin use,
Washington County Undersheriff John Winchell said heroin overdose
deaths were sometimes covered up by police, coroners or others to
spare the victim's family the perceived shame of their loved one being
seen as an addict.

"The number of overdose deaths is underreported," he
said.

Warren County sheriff's Lt. Steve Stockdale said a number of recent
heroin overdoses in the region occurred among users who had just
gotten out of jail.

The users believe they can resume using the same amount of heroin when
they get out as they did when they went in, but their tolerance has
gone down during their enforced sobriety while incarcerated. The dose
after a hiatus in jail has proved fatal in some circumstances.

Hogan said her office frequently comes in contact with heroin addicts
as victims or defendants in criminal cases. And the stories they tell
of how tough the drug is to beat are "heartbreaking."

One described how bad the nausea, vomiting and pain of withdrawal was
when heroin wasn't available.

"She said 'You don't understand how bad it is to be dopesick,'" Hogan
said.

Saffer's organization, The Council for Prevention, has helped put
together a task force of law enforcement, treatment providers, clergy
and social services groups to address the problem locally.

The task force has been meeting monthly and looking at ways providers,
community groups and law enforcement have countered heroin addiction
in other parts of the state and country.

The region suffers from a lack of rehabilitation resources, including
a methadone clinic, and funding for rehabilitation is often
inadequate, Washington County District Attorney Tony Jordan said.

Educating would-be heroin and painkiller users on the drug's
addictiveness is a major part of the battle to keep people from using
it in the first place, Jordan said.

So far, the message hasn't gotten out as needed, he
said.

The criminal justice system is weighing programs for drug users -
alternatives to incarceration - to try to break their habits.

Hogan said one of two things will happen to opioid users once they
become addicted.

"In the end, it's either recovery or death," she said. "And recovery
is a day-to-day struggle for the rest of their lives."

Coming tomorrow: Local police face new challenges in dealing with the
rise in prescription drug abuse and heroin addiction.
- ---
MAP posted-by: Matt