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.