Cheaper heroin showing up in Eastern Kentucky as crackdown on pain pills makes that trade less attractive

About 60 grams of heroin, worth about
$8,000. (AP photo)

It was only few months ago that Northern Kentucky law enforcement officers and substance abuse clinics began expressing grave concern that heroin was fast becoming the go-to drug in their region. Today, there are signs that the drug is already moving swiftly east, into the already drug-ravaged mountains of Eastern Kentucky. The reason for the uptick in heroin use? Because pain pills aren't as available anymore.

Federal and state law enforcement have been cracking down on the prescription pain-pill drug trade for years in these parts. They've created electronic prescription-tracking systems, staked out pain management clinics and shut down a drug pipeline that starts in Florida. Some argue that last year's passage of House Bill 1 has discouraged even legitimate doctors from prescribing pain drugs. All these things make heroin usage an unintended consequence of their success, officials fear.

 "There's always some type of drug to step up when another gets taken out," Dan Smoot, law enforcement director of Operation UNITE, which handles drug investigations in 29 Eastern Kentucky counties, told Brett Barrouquere of The Associated Press. "We didn't know it was going to be heroin. We knew something was going to replace pills."

Officials say the heroin is trafficked from Mexico into the U.S., where it first goes to Illinois, Michigan and Ohio. Northern Kentucky counties have been the epicenter of heroin abuse in the state, but law enforcement officials in Louisville, Lexington and Appalachian counties are reporting "a dramatic rise in the number of arrests and seizures related" to heroin. Kentucky State Police seized 11 doses of heroin and other opiates in 2008 in the eastern half of the state; they have seized 395 doses there so far this year.

Users are attracted to heroin's low cost compared to pain pills, Barrouquere reports. A single oxycodone pill can cost from $80 to $100, but heroin can cost as little as $15 to $20 for an amount that will produce the same level of intoxication as one pain pill for 24 hours, Kentucky Office of Drug Control Policy Director Van Ingram said. (Read more)

N. Ky. Chamber to ask state for more funding to fight heroin; London police make first known heroin trafficking arrests there

The Northern Kentucky Chamber of Commerce is planning to lobby the state for more funding for heroin treatment after receiving reports from business and law enforcement about the breadth and depth of the drug problem in the region. Terry DeMio of the Cincinnati Enquirer reports that the chamber's Geraldyn Isler says the area has the “highest volume of people in the state needing substance abuse treatment but is receiving the least amount of funding.”

According to the Northern Kentucky Drug Strike Force, 63 percent of heroin possession and trafficking prosecutions in Kentucky are in Boone, Kenton and Campbell counties, the three urbanized counties in the region. A 2007 University of Kentucky study that shows that the region led the commonwealth in people needing substance abuse treatment, but that it also received the lowest per capita funding from staff coffers for those mental health services for more than a decade.

The chamber told DeMio there are many "hidden costs" to such abuse. Among those costs: increased employee absenteeism, tardiness, job-related injuries and errors. It also notes employee-employer conflict, greater health-insurance costs and crime as likely outcomes of heroin in the region.  (Read more)

There could be other requests for more funding for heroin treatment. This week the London Police Department made the first known arrests for heroin trafficking in Laurel County, The Sentinel-Echo reports.

Northern Kentucky group forms in response to what some consider 'epidemic' of heroin use in their area

Ashel Kruetzkamp with a vial of Naloxone
HCl, used to treat those who overdose
on heroin. (Photo by Patrick Reddy)

Heroin use is reaching such high levels in Northern Kentucky that experts are calling it "a plague." The problem is so dire that local agencies are coming together to form the Northern Kentucky Heroin Impact and Response Workgroup.

Cincinnati Enquirer reporter Terry DeMio reports that the group includes leaders from St. Elizabeth Healthcare, law enforcement, addiction treatment programs, the Northern Kentucky Chamber of Commerce and those who have been impacted by heroin. The goal of the group is “to fight, treat and prevent the destructive force of heroin in our community,” said Dr. Jeremy Engel, a family doctor with St. Elizabeth Physicians, Bellevue. Engel spearheaded the effort based on his belief that heroin use in the area has hit “epidemic” levels.

Engel points to first nine months of 2012 when St. Elizabeth Healthcare treated 311 heroin overdose patients in the emergency rooms of its five hospitals. For the same time period in 2011, the heroin overdoses presented in those emergency rooms numbered 186. With help from the chamber, St. Elizabeth Healthcare and others, Engel is forming the task force under the NKY Vision 2015 umbrella. (Read more)

Covington police chief: New prescription-drug law has unintended consequence of encouraging pain pill addicts to use heroin, commit crimes

Black tar heroin

Kentucky's new prescription drug law may be having its desired effect of taking prescription painkillers off the streets, but could be forcing those very same addicts into using heroin. That's the view of Covington Police Chief Spike Jones, who took his case to the state Senate Judiciary Committee last week to complain about increased crime in his area and to ask for some money for help.

The drug law passed in April 2012, designated House Bill 1, requires Kentucky doctors to complete patients' medical histories, conduct physicals, check photo identifications and run names through the state's KASPER (Kentucky All Schedule Prescription Electronic Reporting) database before prescribing a controlled substance for pain relief. It has required a vast network of oversight of doctors and patients by government and licensing entities. This has reportedly caused some doctors to stop writing those prescriptions completely.

Tiffany Wilson of Cincinnati's WKRC-TV reports that Chief Jones reports more prostitution, theft, car thefts and car break-ins in his northern Kentucky region. He asked the state legislature for money to research how deep the problem is and to discuss the need for more treatment facilities. 

Jones pointed to the recent closure of the pain management clinic of Dr. Gary Shearer in Florence as adding to the problem. Shearer's license was suspended following the death of 15 patients from prescription-drug overdoses. These patients, Jones told Wilson, are exactly the ones at risk for taking the next step and turning to heroin. He added that heroin dealers will often give potential customers the first hit for free, "and from that point, there's no returning to prescription pills." (Read more)

New form of Oxy is harder to inhale and inject, so drug users are turning to heroin, Opana for high

A new formulation of OxyContin makes it harder to
inhale or inject. Drug Enforcement Administration photo.

A change in the formulation of the powerful drug OxyContin has addicts turning to another high to fuel their habit: heroin.

Researchers at the Washington University School of Medicine in St. Louis had more than 2,500 patients from 150 drug rehabilitation treatment centers in 39 states respond to survey questions that had a particular focus on the reformulation of OxyContin, reports research-reporting service Newswise. The new formula makes it harder to crush the pills, making inhaling or injecting them more difficult.

Since the new version of the drug was introduced, "inhalation or intravenous administration has dropped significantly," said lead investigator Theodore J. Cicero. But drug use has not lessened, with addicts turning to heroin instead, which is also inhaled or injected. "We're now seeing reports from across the country of large quantities of heroin appearing in suburbs and rural areas," Cicero said.

OxyContin was originally designed to be released in the body slowly, preventing an immediate high. But by crushing the pills and inhaling them or dissolving them in water and then injecting the solution, addicts were able to get "an immediate rush," Newswise reports.

Moreover, because OxyContin was designed to be slow-release, it contained large amounts of the generic drug oxycodone, which spurred even more in demand. The new version of the drug was introduced in 2010.

Survey results show "users who selected OxyContin as their primary drug of abuse has decreased from 35.6 percent of respondents before the release of the abuse-deterrant formulation to 12.8 percent now," Newswise reports. (Read more)

The Centers for Disease Control and Prevention has called prescription drug abuse an "epidemic." In Kentucky, about a 1,000 people die each year from prescription drug overdoses. More people die in Kentucky from prescription drug overdoses than they do from traffic accidents.

Law enforcement is also seeing that drug seekers are switching from OxyContin to the prescription drug Opana, reports Donna Leinwand Leger for USA Today. "A few years ago, it was OxyContin. Now it's Opana," said Raquel Foster, a police spokeswoman for the Fort Wayne Police Department.

As a new, harder-to-abuse formulation of Opana hits the market, however, "they are going to find a way to satisfy their addiction," said DEA Special Agent Gary Boggs of the Office of Diversion Control. "When they either can't get those particular pharmaceuticals or can't afford them, they now gravitate to heroin."  (Read more)