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An unforeseen side-effect of the successful fight against abuse of prescription and over-the-counter medication has been a spike in the popularity of heroin — especially in Northern Kentucky.
That was the message delivered Friday to U.S. Sen. Mitch McConnell by local experts, law enforcement agencies and even one recovering heroin addict.
McConnell led the discussion, which was hosted by the Northern Kentucky Area Development District at its main office in Florence, Ky. Many Carroll County residents attended, including Judge-Executive Harold “Shorty” Tomlinson; County Attorney Nick Marsh; and President Leigh Ann Tomlinson Roberts and Coordinator Hayley Franklin of Champions for a Drug Free Carroll County.
In his opening comments, McConnell observed that restrictions on over-the-counter medications containing pseudoephedrine that helped stem the scourge of methamphetamine and a statewide system that tracks prescription narcotics making drugs like hydrocodone and oxycontin harder to obtain, officials say heroin is now taking over as the drug of choice in Boone and surrounding counties.
“It’s an epidemic our community is facing,” said Boone Judge-Executive Gary Moore. “We’ve held town hall meetings with advocacy groups made up of parents and relatives who have lost children to this drug; law enforcement; prosecutors; and local, state and federal officials. We already have a collective response, but this is just the beginning.”
McConnell, himself, said he is aware of the increasing problem, presenting statistics that show Kentucky had 33 heroin-related deaths in 2011, which doubled to 66 in 2012. He said Kentucky State Police sampled 2,382 confiscated samples of heroin for testing, up from 451 samples tested the prior year.
“Northern Kentucky is the hardest hit,” McConnell said, with Boone and Campbell counties, alone, accounting for 60 percent of heroin in the entire state,
He applauded efforts such as the Appalachian High Intensity Drug Trafficking Area task force, which includes 29 of Kentucky’s 120 counties and also involves portions of Tennessee, West Virginia and Virginia. McConnell said during a visit to Kentucky last year, then-U.S. Drug Czar Gil Kirlekowske encouraged Appalachian HIPTA to expand to include Jefferson and Hardin counties.
Through such interagency work, McConnell said, “There’s no limit to what we can achieve. ... [The heroin issue] is the result of fighting illegal sales of prescription medication. I’m sure we can take on this challenge as well.”
McConnell then opened the floor to the 10 panelists there to give their testimony on ways to address the increase in heroin abuse as well as ways to help those addicted and their families.
“The federal government has finite resources,” McConnell said. “I’m here ... to take your concerns back to Washington, D.C., to formulate legislation that would provide the maximum federal resources for the maximum return.”
Youth and young adults are at risk for a multitude of reasons, according to several panelists.
First, 33 percent of users are between the ages of 16 and 25, said Bonnie Hedrick, Ph.D., coordinator of the Northern Kentucky Agency for Substance Abuse Policy. “Adolescents are already dying from drug overdoses. We need to do everything we can to curtail use.”
According to the most recent data from the Centers for Disease Control and Prevention, in 2011, 7.7 percent of 12th-graders in Kentucky had used heroin compared with just 2.7 percent of all 12th-graders in the United States having used it.
“We need to fund adolescent treatment initiatives, from health promotion to intervention, to treatment and to aftercare,” Hedrick said. “We need safer homes and environments.”
Many young people are in homes where parents are using or selling drugs, or there is other dysfunction and crime, she said. Substance abuse often results as a coping mechanism against chronic stress in young people and “affects early neural development ... and contributes to long-term disease, disability and social problems.”
Preventing drug abuse starts with raising awareness in schools and with parents, and continuing programs to prevent underage drinking, often where young people start experimenting with substances, she said.
Kathy Bryant Reuterman, executive director of Student Services for Boone County Schools, agreed, adding that parental drug abuse also is a source of stress and difficulty for young people in the region, and it affects their ability to thrive in school.
She told of a woman who is raising her infant granddaughter, born drug-addicted to a mother who is still using, and of elementary school students who are “not getting sleep, not eating right,” because their parents are using.
“One 5-year-old told me he makes breakfast for his 3- and 4-year-old siblings. The district has large numbers of homeless children. In middle school, we have to address cutting and mental-health issues.”
In middle school and high school, she said, “60 percent of the student [expulsion] hearings are drug-related; that’s up from 30 percent” previously.
“One parent, when asked if her child was dealing drugs, said, ‘Oh, not at school,’ “ Reuterman continued, adding that it’s heartbreaking for her “when a child says to me, ‘I don’t want to go home. Can’t I stay at school longer?’ This is scary for us, as a school district. Children can’t be college and career ready under such circumstances.”
Lifelong Boone County resident Patrick Kenyon told McConnell of his life as a former addict — a life he was on track to lose, had it not been for the consequences of jail time and Drug Court.
“My childhood was normal. I had loving parents. All my needs were always met,” Kenyon said. Still, he started abusing substances at age 10. “A lot of it was just fitting in. My friends were older.”
After a 15-year cycle of treatment facilities and jails and battling “what I felt internally, I still wouldn’t quit. I went through four treatment programs and used through three of them. I thought I was slick.”
Stints in jail would help him clear his head “to see maybe another way,” but eventually he started to believe he would die as a heroin addict. “Once I found heroin, 99 percent of my effort went to that. I did whatever I had to do to get it. ... I was OD’ing, my friends were OD’ing. It became normal ... A lot of people die in that process. I lost friends.”
By the time he was sent to Drug Court, he said he was tired. During his fourth time in treatment, he found Narcotics Anonymous and has been clean for four years and 10 months. “I just got a college degree. I’ve been able to do all kinds of things with my life.”
Both U.S. Attorney Kerry Harvey and Commonwealth Attorney Ron Sanders said their offices have seen heroin-related crimes skyrocketing in the region.
“Several years ago, [heroin] was a disturbing uptick,” Harvey told McConnell. “Now it’s an explosion, taking over large segments of our district.”
Harvey said most of the heroin in the region comes from Detroit via Cincinnati. He said that “mules” used to transport the drug used to come and go from Detroit on Greyhound buses. “Over the past year or so, Detroiters have rented apartments and houses or bought houses [in Northern Kentucky] to set up permanent distribution centers.
“Northern Kentucky is the gateway to the south for heroin,” he continued. “If we could contain the flow across the border (from Cincinnati), we could stem the flow throughout the commonwealth.”
The federal Drug Enforcement Agency has been working with state and local law enforcement agencies. Through the Northern Kentucky Heroin Initiative, guidelines for federal prosecution have been relaxed from requiring arrests involving 100 grams of heroin to as little as 10 grams.
“We are targeting repeat offenders who use firearms or are involved with minors” for cases accepted for federal prosecution, Harvey said.
With two federal prosecutors assigned to the initiative, 49 people have been indicted so far; 15 have been convicted and are serving sentences ranging from 24 to 252 months. There have been no acquittals.
Sanders said that while awareness is up, “the problem is getting worse. ... there is no limit to the crime wave that is caused by heroin,” including property crimes, robberies, burglaries, prostitution, murders between dealers, and an “endless number of children being abused or neglected.”
In fact, 80-90 percent of all cases prosecuted in the region “are almost all heroin addicts trying to get that next high,” Sanders said.
State Sen. Katie Stine told McConnell that the impact of the drug problem is also having a negative impact on the region’s economic development.
“We used to be strong for economic development, but employers are having problems finding people who can pass a drug test,” she said. “The problem is pervasive ... Our resources are stretched to the maximum.”
Treatment is the third essential prong in the region’s approach to fighting the heroin epidemic,” she said.
She cited The Healing Place as a model for treatment. Addicts at the facility not only reside there, but they also participate in operations, she said. They minister to each other and take care of everything, including janitorial services.
“It’s a good use of funds,” she said. “Recovery Kentucky was modeled on this system.”
She said she believes Medicaid should be able to pay for drug treatment.
Jeremy Engle, M.D., a family physician based at St. Elizabeth’s Hospital, has taken the fight against drug abuse as his primary cause. He said the best way to fight the drug cartels is to put “everyone on heroin into medical treatment.”
It’s essential to remove the stigma of treatment, he continued. “We have to take the shackles off of addicts and put treatment and prevention first, not as a punishment.”
Mac McArthur, executive director of Transitions Inc. of Northern Kentucky, a 196-bed residential treatment facility, agrees. He also believes that the public must stop seeing addiction as a “moral failing, weakness or character flaw” and see it for what it is: a disease of brain chemistry.
He said the biggest hurdle to solving this problem is a lack of physicians and counselors certified in treating addiction and a “gigantic lack of residential beds.”
McArthur said recovery from opiate addiction takes far longer “than four or five days of managed care” provided for alcoholism and other addictions. “We have fewer beds than Louisville or Lexington. We’ve been underfunded for 15 years.”
McArthur said Northern Kentucky is short at least 300 beds for adults and 32 beds for adolescents. At present, the waiting list for addicts to get a bed in a residential treatment facility is two to six months.
Responding to a question from McConnell, who was wondering if treatment is more important than incarceration, U.S. Attorney Harvey said it’s a myth that jails are filled with small-time drug offenders that should be in treatment. “Most have done other crimes, too. Many have been given numerous chances before the judge sentences them to prison.”
He said his office mostly is prosecuting traffickers at the federal level, and dealers are not the same as addicted drug offenders. “They make money off death and destruction,” he said, adding that dealers very rarely are addicts, themselves. “They are making money off others based on cold-blooded greed.”
Asked for his opinion, Mike Kalfas, a family physician and addiction specialist who was in the audience, said he agrees that “jail does have a place for the treatment of society’s ills. Some people only respond to that threat,” he said. “But many wouldn’t fall into such a deep hole if they had had treatment before ... I would rather see more treatment beds than jail cells.”