Pubdate: Sun, 12 Jul 2015
Source: Los Angeles Times (CA)
Copyright: 2015 Los Angeles Times
Contact:  http://www.latimes.com/
Details: http://www.mapinc.org/media/248
Author: Lisa Girion

THE DEVASTATING PATH FROM PAIN PILLS TO HEROIN

Officials Sound the Alarm As Research Shows Heroin Users Are More 
Likely to Be Wealthy, Privately Insured and 18 to 25

Standing in the pulpit above Austin Klimusko's casket three years 
ago, his mother used his death to draw the connection between pills 
from a pharmacy and drugs from the street.

"When his prescriptions dried up, he turned to heroin," Susan 
Klimusko said in a frank eulogy meant as a warning to the young 
mourners at Simi Valley's Cornerstone Church.

Last week, the nation's top public health official used the bully 
pulpit to sound the same alarm. The prescription drug epidemic is 
stoking the nation's appetite for heroin with disastrous results, Dr. 
Tom Frieden, director of the U.S. Centers for Disease Control and 
Prevention, told reporters in a teleconference.

"We are priming people to addiction to heroin with overuse of 
prescription opiates, which are, after all, essentially the same 
chemical with the same impact on the brain," he said.

Frieden made his comments as he announced that heroin use had 
increased 62% and related deaths had nearly quadrupled since 2002.

The biggest increases were among groups associated with a parallel 
rise in the use of prescription painkillers, such as OxyContin and 
Vicodin. Today's heroin user is increasingly likely to be wealthy, 
privately insured and between the ages of 18 and 25, according to the 
study by researchers at the CDC and the U.S. Food and Drug Administration.

It is a phenomenon familiar to people on the front lines of the 
crisis from Simi Valley to San Diego.

"The face of the heroin addict has changed very much to that of an 
18- to 25 year-old surfer kind of guy," said Susan Bower, a San Diego 
County health official who noted the shift there a few years ago.

And the prescription painkiller has become the new gateway drug to 
heroin use, eclipsing marijuana, cocaine and alcohol, the study 
found. People addicted to narcotic painkillers are 40 times more 
likely to misuse heroin, it reported.

At the same time, Frieden said, the flow of cheap heroin from Mexico 
has surged, offering users a ready supply of an inexpensive 
substitute to prescription painkillers.

"It's really a one-two punch," he said. "Those two factors are 
driving the increase and will drive the strategies we need to turn 
this around."

Frieden called for a series of responses, including a crackdown on 
heroin, more treatment and more judicious prescribing.

"For prescription opiates, the risks are very palpable," he said. "A 
few doses and someone can have a life of addiction. A few pills too 
many and someone can die of an overdose."

The findings offer a glimpse into the "real devastation the epidemic 
is causing to communities across the country," Frieden said.

One affected area is Ventura County, where heroin-involved deaths 
more than doubled between 2009 and 2012 to 43. But in 2013, heroin 
deaths retreated, while deaths involving prescription painkillers 
jumped to 69. The shift coincided with a law enforcement push against 
heroin trafficking and may be further evidence of the 
interchangeability of legal and illegal drugs.

"You work one side of the problem, but then you see a ballooning on 
the other side," said Patrick Zarate, who manages alcohol and drug 
programs for Ventura County. "We will probably continue to see a bit 
of back and forth over time."

Simi Valley, on Ventura County's eastern edge, is emblematic of the 
tandem crisis of pills and heroin. Austin Klimusko was one of several 
young overdose victims whose deaths brought the community to 
Cornerstone Church in 2012. Less than a week after his funeral, 
another family was planning a service for a daughter. And Austin, 23, 
was buried in the same cemetery as another victim who died at 21.

At his funeral, the Rev. Pat McCoy summed up the devastation.

"All of us, everyone sitting in this room, has been affected by what 
happened," McCoy said. "We don't want that to keep happening. This is 
the fourth time I've done this in the last eight months. And I don't 
want to do it anymore."

Austin's death illustrates heroin's new reach. He grew up in a 
comfortable ranch home with a swimming pool and three dogs. He hung 
out with his older brother and the boys in the neighborhood. He liked 
to make them laugh. He loved Harry Potter books. He was enrolled in 
gifted classes. His mother is a hospital nurse; his father owned an 
electronics manufacturing plant. The family traveled to Mexico and 
Europe, and enjoyed skiing and fishing.

After high school, Austin moved to San Diego with friends. Susan 
Klimusko realized that her son had a serious drug problem when he 
accidentally "pocket dialed" her one night and she overheard him 
pressuring a friend to take drugs. She demanded he move back home in 
the belief that she could help him stop. Instead, he found a new 
supplier for his oxycodone habit, a medical clinic in Reseda.

"It just got worse and worse and worse," she recalled. "He was a 
walking zombie."

His parents persuaded him to check into the Malibu Beach Recovery 
Center on his 21st birthday. He stayed sober, working in his father's 
plant, for more than a year. But then, he slipped. Before long, Susan 
Klimusko said, he was spending his entire paycheck on prescriptions 
for oxycodone and other pills. At some point, he switched to heroin, 
pawning family valuables for cash. His parents locked their wallets 
in a safe when they went to bed.

His parents pleaded with Austin to give rehab another try. He agreed, 
driving himself to a facility in Bakersfield. "We were so hopeful," 
Susan Klimusko said.

Sober for almost 90 days, Austin came home for Christmas, hung out 
and exchanged gifts. His parents gave him a Lakers snuggie. Austin 
headed back to Bakersfield, where he had a new job and a new 
girlfriend. It looked like a fresh start. But a few days later, he 
was dead of a heroin overdose.

Susan Klimusko viewed her son's addiction as a battle that she lost. 
But she hasn't stopped fighting a bigger war. Beginning with her 
son's eulogy, she has been working to help other families struggling 
with addiction. She consoles grieving mothers and she counsels 
addicts who end up in the hospital where she works.

"Healing from heroin is a very long process," she tells them. "I say, 
'I'm a mom. I lost my kid. I understand.' "
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