Pubdate: Sun, 01 Nov 2015 Source: Columbus Dispatch (OH) Copyright: 2015 The Columbus Dispatch Contact: http://www.dispatch.com/ Details: http://www.mapinc.org/media/93 Author: Katharine Q. Seelye, the New York Times SPREAD OF HEROIN CHANGES THE DEBATE NEWTON, N.H. - When Courtney Griffin was using heroin, she lied, disappeared and stole constantly from her parents to support her $400-a-day habit. Her family paid her debts, never filed a police report and kept her addiction secret - until she was found dead last year of an overdose. At Courtney's funeral, they decided to acknowledge the reality that redefined their lives: Their bright, beautiful daughter, only 20, who played the French horn in high school and dreamed of living in Hawaii, had been kicked out of the Marines over drugs. Eventually, she overdosed at her boyfriend's grandmother's house, where she died alone. "When I was a kid, junkies were the worst," Doug Griffin, 63, Courtney's father, recalled in their comfortable home in southeastern New Hampshire. "I used to have an office in New York City. I saw them." Noting that junkies is a word he would never use now, he said that these days, "they're working right next to you, and you don't even know it. They're in my daughter's bedroom - they are my daughter." When the nation's long-running war against drugs was defined by the crack-cocaine epidemic and based in poor, predominantly black urban areas, the public response was defined by zero tolerance and stiff prison sentences. But today's heroin crisis is different. Although heroin use has climbed among all demographic groups, it has skyrocketed among whites; nearly 90 percent of those who tried heroin for the first time in the past decade were white. And the growing army of families of those lost to heroin - many of them in the suburbs and small towns - now are using their influence, anger and grief to cushion the country's approach to drugs, from altering the language around addiction to prodding government to treat it not as a crime, but as a disease. "Because the demographic of people affected are more white, more middle class, these are parents who are empowered," said Michael Botticelli, director of the White House Office of National Drug Control Policy, better known as the nation's drug czar. "They know how to call a legislator, they know how to get angry with their insurance company, they know how to advocate. They have been so instrumental in changing the conversation." The presidential candidates of both parties are now talking about the drug epidemic, with Hillary Clinton holding forums on the issue as Jeb Bush and Carly Fiorina tell their stories of loss while calling for more care and empathy. Recently, President Barack Obama traveled to West Virginia, a mostly white state with a high level of overdoses, to discuss his $133 million proposal to expand access to drug-treatment and -prevention programs. The Justice Department also is in the process of releasing about 6,000 inmates from federal prisons as part of an effort to roll back the severe penalties issued to nonviolent drug dealers in decades past. The new terrain Heroin's spread into the suburbs and small towns grew out of an earlier wave of addiction to prescription painkillers; together, the two trends are ravaging the country. Deaths from heroin rose to 8,260 in 2013, quadrupling since 2000 and aggravating what some already were calling the worst drug-overdose epidemic in U.S. history. Overall, drug overdoses now cause more deaths than car crashes do. Opioids such as OxyContin and other pain medications kill 44 people a day. In New England, the epidemic has grabbed officials by the lapels. The region's old industrial cities, quiet small towns and rural outposts are seeing a near-daily parade of drug summit meetings, task forces, vigils against heroin, pronouncements from lawmakers and news reports on the heroin crisis. New Hampshire is typical of the hardest-hit states. Last year, 325 people died of opioid overdoses, a 68 percent increase from the year before. Potentially hundreds more deaths were averted by emergency medical workers, who last year administered naloxone, a medication that reverses the effects of opioid overdoses, in more than 1,900 cases. Adding to the anxiety and anger among parents, the state also ranks second-to-last, ahead only of Texas, in access to treatment programs; New Hampshire has about 100,000 people in need of treatment, state officials say, but the state's publicly financed system can serve only 4 percent of them. Because New Hampshire holds the first-in-the-nation presidential primary, residents repeatedly have raised the issue of heroin with the 2016 candidates. Clinton still recalls her surprise that the first question she was asked in April, at her first open meeting in New Hampshire as a candidate, was not about the economy or health care, but heroin. Last month, she laid out a $10 billion plan to combat and treat drug addiction over the next decade. Many of the Republican candidates for president have heard similar stories, and they are sharing their own. "I have some personal experience with this as a dad, and it is the most heartbreaking thing in the world to have to go through," Jeb Bush, the former governor of Florida, said at a town-hall style meeting in Merrimack, N.H., in August. His daughter, Noelle, was jailed twice while in rehab, for being caught with prescription pills and accused of having crack cocaine. All this activity has helped create what Timothy Rourke, the chairman of the New Hampshire Governor's Commission on Alcohol and Drug Abuse, said is a perfect storm for change, not unlike the confluence of events that finally produced a response to the AIDS epidemic. "You have a lot of people dying, it's no longer just 'those people,' " he said. "You have people with lived experience demanding better treatment, and you have really good data." And, he said, policymakers know that on top of everything else, substance abuse has become an economic issue. A recent report said the annual cost to New Hampshire in lost productivity, treatment and jail time is $1.8 billion. - --- MAP posted-by: Jay Bergstrom