Heroin making inroads in Ky.'s pain pill country

Availability, cost attracting users

By Brett Barrouquere/Associated Press, Published:

BURLINGTON, Ky. (AP) — Kentucky officials agreed they had to rid their state of a pain pill abuse scourge that had reached epidemic levels. They cracked down on the prescribers, set up an electronic system to track pills and clogged up a pipeline that had roots in Florida.

As those efforts began paying off and pills weren't as easily had, law enforcement came across a surprising discovery — they busted more people for a drug that had long ago faded into the background. That drug is heroin.

"There's always some type of drug to step up when another gets taken out," said Dan Smoot, law enforcement director of Operation UNITE, which handles drug investigations in 29 eastern Kentucky counties where pain pill abuse had been rampant. "We didn't know it was going to be heroin. We knew something was going to replace pills."

Law enforcement officials in Kentucky and Ohio said the heroin, which is generally snorted or injected in powder form, is imported into the United States from Mexico and Central America. It's first going to Illinois, Michigan and Ohio, then migrating across the Ohio River into Kentucky.

Bill Mark, head of the Northern Kentucky Drug Strike Force in Burlington, was surprised the first time he encountered a heroin overdose.

"We were like, 'Heroin? Where did that come from?" Mark said.

Like most drugs, what is attracting users is availability and cost, police said.

Where a single oxycodone pill can run from $80 to $100, heroin can cost as little as $15 to $20 for a hit that will give the user the same high for 24 hours, said Van Ingram, executive director for the Kentucky Office of Drug Control Policy.

Northern Kentucky, particularly Boone, Campbell and Kenton counties that make up Cincinnati's southern suburbs, have become the epicenter of heroin's abuse in the Bluegrass State. But, across Kentucky, from Louisville in the north central region to Appalachia in the east and Lexington to the south, law enforcement agencies are reporting a dramatic rise in the number of arrests and seizures related to the sometimes deadly drug.

Kentucky State Police submitted 451 suspected heroin samples to its lab in 2010. By 2011, that number increased to 749. Through September 2012, state police had submitted 1,074 cases to the lab.

"I expected to see a 50 or 60 percent increase, but not double," Ingram told The Associated Press.

The trend in Kentucky mirrors what the Drug Enforcement Administration is seeing nationally. While seizures of marijuana, cocaine and methamphetamine have either held steady or dropped in the last three years, heroin has jumped from 619 kilograms confiscated in 2009 to 1,067 kilograms seized in 2011. Heroin didn't show up in federal drug seizure statistics until 2006, when 10 kilograms were seized.

The Kentucky State Police's drug enforcement branch for the eastern half of the state has seen a steady rise in the doses of opiates, including heroin, since 2008, when 11 doses were seized. By 2012, the number had risen to 395 doses seized, up 97 percent.

The seizure of pain pills, primarily oxycodone, hydromorphone and methadone, peaked in 2010, when the special unit seized 15,433. That number fell to 1,706 by 2012, an 89 percent drop.

Maysville Assistant Police Chief Lisa O'Hearn said heroine, which first surfaced in the city in large amounts earlier this year, is overtaking prescription pain pills as the drug of choice for addicts. O'Hearn suspects abusers are importing heroin from other parts of Kentucky and Cincinnati. Mark agreed.

"I'll bet it is traveling right down the double-A highway," Mark said, referring to the main road connecting Maysville to Covington.

Charlotte Wethington's son, Casey, died a decade ago, when heroin was rarely the drug of choice in the state.

Now, the abuse of the opiate "has taken over families," said Wethington of Fort Mitchell, who has become a drug counselor. "It's an equal opportunity disease. It does not discriminate."

The Kentucky All Schedule Prescription Electronic Reporting System tracks the number and types of controlled substances prescribed in the state. Since the system went into effect in 2005, the use of four common opiate drugs — codeine, hydrocodone, oxycodone and fentanyl — for non-medical purposes has leveled off, according to a 2010 report produced by the University of Kentucky's Institute for Pharmaceutical Outcomes and Policy.

The authors of the report, a group of pharmacists and psychologists at the university, attributed that in part to the closer monitoring under the tracking program, which slowed efforts by abusers to go from doctor to doctor and clinic to clinic trying to have prescriptions filled.

Enter heroin. The White House Office of National Drug Control Policy reported in a survey that 251, or 1.2 percent, of Kentucky's 20,266 drug and alcohol abusers admitted themselves into treatment for heroin in 2010, the last year available.

Also statewide, heroin and morphine (both opiates measured together by the Kentucky Medical Examiner's office) were responsible for 121 of the 684 reported overdose deaths — 17.9 percent — reported in 2011.

In 2010, the medical examiner reported 85 deaths because of morphine and heroin overdoses statewide.

Law enforcement officials describe users as people in their 20s who weren't around during the drug's last wave of popularity 40-plus years ago. In many cases, heroin, like pain pills dissolved in water, is being injected, snorted and smoked.

"Now, it's just the guy down the street using it," said Dr. Tracy Corey, the state's chief medical examiner. "It's a whole new demographic."

Keith Mills, a drug counselor with WestCare, which offers addiction treatment in the Appalachian city of Pikeville, said the users he's seen have switched because of price and availability. While prescription pills are still a major problem in the Appalachians, heroin does pop up — and he expects to see more of it as use of the drug continues to spread south and east.

"It's still kind of rare here," Mills aid. "I'm sure it will become more common, though."

Indiana is also seeing a rise in heroin as oxycontin gets tougher and more expensive to acquire, said Indiana State Police Trooper Jerry Goodin.

"Heroin is much deadlier due to no controls on formulation or ingredients as in prescription pills," said Goodin, who did not have statistics available.

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  • Off topic but look at how many people in Frankfort that has been charged, arrested & locked up in the last week over drugs. Meth is evidently getting popular also & it is a different kind of drug. This is one drug that I think everybody can say is DANGEROUS! The before & after pictures of users tells me everything that I need to know of its side effects. Do we want to force druggies from perhaps a safer recreational drug to this. This is what is happening, the druggies are turning to drugs that have no control whatsoever in the process. Also (I hope that I am wrong) but it appears that the sheriff may have found a way around having to secure a search warrant by these suppose calls of other incidents such as wreckless driving & wellcare checks. What are they doing, going into houses now over a call that someone was speeding & are they arresting everybody in the house because one person is making or growing drugs. It appears that way. Young children of has been arrested & charged also because of their parents drugs. Folks I would never expect a 20 or 19 year old to report a drug crime that their parents may be guilty of & to charge them by a direct bloodline association is wrong. Several young people may have to go through the rest of their lives with a felony on their records just because they didn't tell on their parents. Come on sheriff!

  • Nothing has replaced pain pills...where did they get THAT idea? Pain pills will always be there and quite frankly, can be easily obtained by anyone with an on-line computer and a credit card. All illegalities aside, folks that are in pain (physical or emotional, it doesn't matter) are going to seek relief either from their doctors or the black market. Nobody who is happy and well-adjusted wants to feel drugged-down on opiates all the time. These drugs are NOT recreational, and for those that take them on a regular basis, it is a symptom of their problems, not THE problem. Until we as a society can get our heads around that concept, we are just spinning our wheels and wasting a lot of tax money. .................................................................................................................................................................................................................................................................................................................................................................................. bodeen, I think that you are buying into the police's talking points too much...maybe it is the way that they incorrectly use percent of increase instead of actual relative numbers. It is the oldest selling trick in the book used in advertising to give a false impression of what their price REALLY is. Like we have all heard something like, "President's Day SALE 50% OFF!". Of course, to make that mean anything, you should ask, "50% off of what?". When you give a percentage that is not relative to anything real, it gives a false impression. The police use that trick all the time to gin up support and sell their very expensive Drug War. But they have a decided conflict of interest here, so you should view their malarkey with a jaundiced eye. Maybe you should ask, does the person telling me this have anything to personally gain from doing so? If the answer is "yes", run the other way. ............................................................................................................................................................................................................................................................................................................................................................................................................................................................................. May I offer an analogy to illustrate my point? If my cat brings in one mouse a month and then next month he brings in two mice, that is a hundred percent increase...WOW, a 100% increase! I have to do something about that or the mice around here will go extinct! So, I go out and buy a $20,000 electronic collar to put on him that sends out a high frequency signal to warn the mice that he is stalking them. Of course, it is ridiculous to think that him bringing in two mice a month is having a real impact on the local mice population, even though the unrelated 100% increase statistic seems to indicate that it is. That is basically the same thing that the police and politicians (what is the difference?) are doing with these drug and heroin stats. Whether it is two mice a month or 121 deaths a year, RELATIVELY speaking, that still isn't much relative to the total population, the other real threats to that population, etc., and it is certainly NOT worth going out and hysterically spending a vast amount of money to try do something about it. ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................... Dan Smoot and the rest of law enforcement are HARDLY drug experts, and even though somehow society has ordained them that status, they are in fact probably the worst source of valid information. The police rely on FEAR to get your attention, and to not complain as they routinely fun roughshod over YOUR Bill of Rights and using your own tax dollars to do it. The police are experts in investigating and tracking down those who dare to use SOME drugs that have been demonized, and are therefore illegal. Your cigarette addiction is a classic example of a drug that they ignore, despite the carnage associated with its use. It is illogical to ignore it, but it is politically expedient. None of the police have any personal experience with the drugs that they are enforcing. They cannot relate to those who use drugs recreationally or for pain management, and look at those who do with disdain. This is ironic since plenty of them use the socially acceptable alcohol to excess, smoke, or take steroids to pump them up! This inability to relate is why they have bought into all of the myths about drugs that support their preconceived ideas and this insane drug war. This Drug War is actually a war on the people whom they are sworn to serve and protect. That is why they exhibit an obvious zeal when they do a big drug bust...I have personally witnessed it. They look like high school football players psyching themselves up before a big game! That is the mindset they have and why the first thing that they do when forcibly entering a home where drugs are suspected is to shoot the family dog (usually in front of the kids) as punishment and a deterrent warning that they are not fooling around with this stuff. YOU WILL NOT QUESTION THEIR AUTHORITY!

  • Dan Smoot, the law enforcement director of Operation UNITE, which handles drug investigations in 29 eastern Kentucky counties where pain pill abuse had been rampant, said that "We didn't know it was going to be heroin. We knew something was going to replace pills." ........... Now this is where there is a MAJOR problem, this man is suppose to know about drugs & pain pills specifically. Just what the heck did they think that would replace it. Pain pill abuse became more rampant when they targeted the heroin hard in the first place because heroin & opiate are all the same. They are derived from the same plant (POPPY), Heroin, Morphine, Codeine ect; are all the same except that poppy is processed more to make morphine & then further to make heroin. Just like a distiller that will keep distilling liquor further & further to make a more potent alcohol, that is how heroin is made. I would hope that the head man of unite would know his job better or at least be knowledgeable in what he is fighting! ..........1713 I think that I used the CORRECT TERM EXPLOSION in describing the heroin comeback from where it was 1 or 2 years ago.

  • Hugh, what I was referring to was LSD, and I said, "It is a completely different drug that is taken in micrograms, doses so tiny that they could never hurt anybody." That is a true statement. LSD must be done in a controlled setting, as people do tend to freak out if they do not respect that and think that it is a party drug. Done in a controlled setting with an experienced "guide", it can be as Jobs pointed out in his biography, “Taking LSD was a profound experience, one of the most important things in my life. LSD shows you that there’s another side to the coin, and you can’t remember it when it wears off, but you know it. It reinforced my sense of what was important—creating great things instead of making money, putting things back into the stream of history and of human consciousness as much as I could.”

  • I feel dumb after Hughs last paragraph :-(........1713, I probably shouldn't had included the LSD in the dangerous drugs & the reason I did was from my very limited experience of seeing a couple people on it when I was younger. That drug made them both freak out & paranoid. I've only heard & not really read much about it but I can see where it isn't a drug that I would want people around me using it & I can also see where dangerous things can happen to the people on it & those around them. When I said that I wish that they would ban tobacco, I meant nobody ever growing the plant again & that will never happen. Also 1713, when I said that I somewhat knew how addicts feel, I was refering to the overwhelming desire to use a drug even though I know what it is doing to me. Of course I don't have to worry about where my next fix is coming from or other things that illicit drug users go through. It was just the being ADDICTED part & the need. I'm just awful glad that the man doesn't send a small army of law enforcers with enough lethal weapons to take out a small army to come & get me because they didn't get their cut.

  • 1713 is right about your addiction, bodeen. Outlawing will not force you to quit. You will find a way to continue. You have to want to quit, just like with any addiction. If you do not, you will go out of your way to procure what you need. ........................................................................................................................................................................................................................................ Your last comment related to dosages is flawed though, 1713. A drug's potency has to be factored in. One of the drugs mentioned in this article, fentanyl, is usually given in 25,50, and 100 microgram patches that a patient wears for 72 hours. If one of these patches is given to someone without a built tolerance, they will die of an overdose. Patients have also died from putting heating pads on top of them or sitting in hot chairs, causing a more rapid release of the medication. It's potency is about 80 times stronger than morphine. There is also an opiate used in veterinary medicine (elephants) with a potency 10,000 times that of morphine. So, it is possible NANOGRAMS of that medication could kill someone that wasn't tolerant. What really matters (and determines potency) is the shape of the molecule and how it fits into affected receptors, its affinity (attraction) to those receptors, and its bio-availability and half-life (resistance to metabolism/being 'broken down')

  • In a state with 4,300,000 people, 121 deaths a year an "explosion" does not make. Come on, Kentucky had 6,000 deaths from drug poisonings from 1999-2009, including accidental, intentional/suicide, and unknown reasons. We lose 8,000 a year from tobacco alone. Considering that Kentucky is one of the nation's most "medicated states", with a per capita of 15.8 retail prescriptions for each and every one of us, is it any wonder that there are these accidental poisonings? If we really are serious about reducing accidental prescription drug poisonings, shouldn't we first look at our doctors who are prescribing all of those 15.8 prescriptions for each of our citizens (per capita)? ...................................................................................................................................................................................................................................................................................................................................................................................................................................................................... I don't care how you slice it, dice it or julienne it, there is no way to stop these very few people from doing drugs if they want to. What do you want Larry Cleveland to do, "Cut off their fingers?" (I LOVE that one, Larry!) They can't even keep drugs out of the most locked-down, security rich places on earth...our prisons. Are prison conditions what you people who think that this Drug War is a good idea want to live in? That is where we are heading. ................................................................................................................................................................................................................................................................................................................................................................................... bodeen, I feel for you man, but banning cigarettes will not help you, because all that would do is create another layer of organized crime to supply you with you drug. We don't have to imagine what this would be like, as all that you have to do is go to Bhutan (bordered by China and India), where it has been illegal since 2004. There is a mafia type underworld smuggling cigarettes into the country, and all of the associated violence. That is NOT the answer. .............................................................................................................................................................................................................................................................................................................................................................................................................................................................................. Being addicted to cigarettes is nothing like what a heroin addict goes through, because you can get your fix at Speedway, Walmart or just about any place. Having to scrounge every day for enough money to buy your drugs on the undependable black market presents a whole other level of pain for these folks. No, you don't know what it is like. But you obviously know what addiction is, and until you and some good therapist figure out WHY you want to knowingly ingest a lethal, carcinogenic drug that kills 2/3 of those who use it exactly as intended, you will continue to be addicted. I don't know what you think that you are taking, but it is the twin of Meth. The chemical formula for Nicotine is: C10 H14 N2. .................................................................................................................................................................................. The chemical formula for Methamphetamine is: C10 H15 N. They are in the same drug family. ................................................................................................................................................................................................................................................................................................................................................................................................................................................................................ You addiction has very little to do with availability and much more to do with what is likely a deep-seeded emotional problem. I have assisted many people in their quest to stop, but it entailed a complete lifestyle change which included really cleaning up their diet and exercise...lots of exercise,, like running every day. And quitting alcohol in most cases. Some weren't up to it because their emotional problem didn't really allow them to want to feel better about themselves, and in fact they didn't even like themselves. I don't pretend to know what was going on in their heads about that, but I suspect that there were issues of the bi-polar nature involved. I don't pretend to know what is going on in your head either, but I have noted the similarities of those that I have helped help themselves with doing things that build self-esteem. Smoking cigarettes is somewhat like those girls who keep a little kit containing a razor blade in it, and they take it out and make little cuts on their upper thigh when things get too hard to deal with and the self-loathing sets in...hundreds or thousands of little cuts and scars over the years. Reminds me of cigarettes...slow suicide. .................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... I am curious why you lump LSD in with heroin, cocaine and meth, and say that it kills lots of people? It is a completely different drug that is taken in micrograms, doses so tiny that they could never hurt anybody. You are aware that Steve Jobs and others have said that LSD was one of the most profound experiences of their lifetimes...and Jobs had some doozies.

  • Steve, Hugh, 1713, A lot of people including me, said look out for the explosion of heroin when our Gov. signed that order making pain pills harder to get. The only people it hurt were the ones that really needs it. Yeah that's right, the law abiding citizens. They will not stop an addict if they threw another 100 billion a year into this token war. It looks good on the surface but when innocent women & children & man for that matters, gets caught in the crossfire from our overbearing law enforcers & our prisons bursting out the seams with addicts & dealers, who is it really hurting? I am a cigarette smoker & I wish like h*ll that they would outright ban this altogether because even though I know it is harming me & shortening my life, I continue to use. I want to quit & quit bad but I haven't been successful. Me being addicted to cigarettes gives me all the idea of what a drug addict goes through. I am of the opinion that the only reason a lot of illicit drugs are illegal is because the Gov. isn't getting their cut through taxes & other fees. I do think that a lot of drugs should be illegal, like Chrystal Meth, Heroin, LSD, Cocaine ect. (no control in the processing) because these drugs do kill a lot of people & ruin a lot of lives. Hugh & 1713 has great points & in my opinion, great inside thoughts on right & wrong.

  • Heroin does not cause cancer, emphysema, heart disease, kill brain cells and the host of other physical maladies associated with tobacco and alcohol use. If the police were really that concerned with public health, then they would lobby for those things that kill the vast majority of people, not what makes them feel good. And they would stop eating all of those donuts.

  • Steve, short answer is NO. It is the ol' gagging on a gnat and swallowing the camel routine, with the gnat being the 121 deaths from heroin overdoses and the camel being the 8,000 deaths from tobacco products. I particularly have a problem with law enforcement lobbying for public sentiment in questions like these...law enforcement has a decided and obvious conflict of interest on this issue and therefore, should not be setting drug policy or trying to scare people into making them think it is a bigger problem than it is. Rather, law enforcement should be doing its job in enforcing that policy. Policy setting is the prime directive of the legislature and the people, not the police.

  • I don't know where they get their information that a dose of heroin keeps the user high for 24 hours. Not according to shows I've seen such as 'Intervention'. If it did, those addicts probably wouldn't spend their entire days looking for their next 'fix'. Also don't understand why this is surprising to the police if they know this drug is chemically related to most pain relievers. Seems like the most logical replacement to me, that's how I figured it would come to this, unfortunately. I have been seeing stories in the paper telling me the latest legislative efforts could be hurting legitimate patients and now I am reading stories telling me that addicts are still getting high. We could have been better off the way things were, folks.

  • Oh, how I wish I knew exactly which story I commented on a year ago or more where I predicted this would happen. It was a story praising a big pill bust. It's my understanding, Steve, the DEA 'goes after' this drug every day, especially in cities that are considered our 'ports of entry'. Drugs are a big problem, but Drug War opponents do make a few good points. You simply cannot legislate against human behavior and expect to win. Just because laws made something harder to get doesn't mean addicts will simply throw their hands in the air in defeat and say, "well, we just can't do that anymore". Pills are made in licensed facilities, sold to licensed distributors (pharmacies), prescribed by licensed doctors, and given to authorized patients. They are easy to track from raw material to end-user. It is easy to surmise about how much is on the street at any given time. You can't do this with illicit drugs. All I can tell by looking at that photo is that Mexican tar heroin has made its way here. I'm no expert, but I believe tar heroin cannot be 'snorted'. Now, we could have the added scourge of dummies out there trying to give themselves shots, sharing shots, and spreading disease. Also, because they made pain reliever acquisition harder for legitimate patients, I could picture pain patients buying heroin off the street for pain relief and that's sad. ........................................................................................................................................................................................................................................We need a new approach to the Drug War. Our whole way of doing things needs to be reviewed, preferably by people with degrees in areas such as sociology that understand human behavior, the nature of addiction, the benefits of treatment, and the economics of it all.

  • So, 1713, do you think the police (DEA, state, sheriff, whoever) should "go after" heroin?

  • Kentucky officials (read: police) will get rid of the pain pill abuse when it gets rid of pain. Or people. They are more likely to do the latter. For some reason, the police think that if they can just stop the supply that the problem will go away. The conventional wisdom is that these drugs are "bad" and "highly addictive". They are considered so much so, that if a normal, happy, well-adjusted person were to use one or the other (or both) that they would be hopelessly addicted in short order. That is the stuff of myths. Drugs do not MAKE the addict, the addicts make the drugs. Addicts almost always have serious pre-existing problems with self-esteem and clinical depression. To deny this fact is to try to minimize peoples' emotional state out of the equation. If this were not true, then you could not get addicted to gambling, sex, food or any other of the many things where this malady exists without a chemical precursor. ......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... Well, they have been spending $40,000,000,000 a year for 40 years on the drug war in this country and what have they accomplished? Well, we imprison more of our citizens per capita than any other country in the world. If drugs could really destroy people's lives, then everybody who did them would have their live's "destroyed". Our laws are based on protecting the weakest and most susceptible members of society from themselves. That approach is very expensive and counterproductive. But the police need a boogie man like heroin to throw out there every so often to keep us all skeered and to justify all the dang tax money that they are spending. ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... In a nation where 430,000 folks die each year from legal tobacco products, talking about what a threat heroin is ridiculous. There was 121 deaths from overdoses of heroin in 2010...compare that to the 8,000 deaths from tobacco. Tobacco use continues to be the leading cause of preventable death, disease, and excess health care costs across Kentucky. The detrimental effect of tobacco use on an individual’s health cannot be denied. The use of tobacco, and the chronic diseases related to its use, is killing our family members, friends and neighbors; over 8,000 Kentuckians die annually from tobacco-related illnesses. 8,000 vs 121...you tell me where the real health problem lies.