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Though drug-related deaths are down in Oregon, heroin overdoses are on the rise. According to numbers (pdf) released by the state medical examiner's office this week, there were 127 documented fatal heroin overdoses in the state last year. That was the most since 2000, when heroin accounted for 131 deaths in Oregon, and it means that heroin killed more Oregonians in 2009 than cocaine and methamphetamine combined. Two of those deaths were linked to a pair of heroin dealers who were recently indicted in federal court.
Local state and federal law enforcement have been getting more aggressive in the past few years in their attempts to hold dealers accountable for overdose deaths. Federal prosecutors can seek a sentence of at least 20 years for dealers linked to a drug-related death, using the federal Len Bias law (named for the University of Maryland basketball star who died of a drug overdose). Prosecutors depend on police and other first responders to help collect key evidence. Police in Multnomah and Marion counties have changed their protocols to treat an overdose death as a crime scene.
Have you used heroin? Have you dealt it? Has someone you love been affected by the drug? What's the best way to combat heroin use? What's the best way to respond to overdoses?
GUESTS:
- Christopher Young: Forensic pathologist and deputy state medical examiner for the state of Oregon
- Mark McDonnell: Multnomah County senior deputy district attorney in charge of the drug unit
- Scott Nowning: Detective with the Salem Police
Tagged as: drugs · heroin · law
Photo credit: CGehlen / Creative Commons
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I used heroin in my late 20s, eventually using it up to 5 times a day for a year.
But thanks to methadone maintenance treatment (MMT), I've been clean for 15 years.
Before MMT, I tried quitting on my own, but after the detox period, I always returned to heroin.
The detox period is the week portrayed in many movies, when addicts suffer extreme withdrawal symptoms. Unfortunately, those movies imply that, once the withdrawal symptoms go, so does the addiction.
In reality, 90% of heroin addicts who detox will return to heroin.
Decades ago, this was mistakenly called "psychological addiction." Now scientists know that this, too, is physical addiction because the brain is a physical organ, physically changed by heroin.So a heroin addict develops cravings for heroin comparable to the cravings that any person might feel for sleep, food, water, or sex. And the cravings for heroin persist, perhaps for life.
But methadone, in sufficient doses, all but eliminates cravings for heroin.
Some say methadone is just another addiction. Yet heroin addicts treated with methadone never crave methadone. If the methadone wears off, they just crave heroin.
Methadone does create a dependency, but dependency itself is not addiction. Addiction is a dependency characterized by an ever-worsening quality of life. In contrast, MMT improves one's quality of life. Studies show that the longer addicts receive MMT, the better their quality of life.
Ten years ago, prominent U.S. scientists in the field of addiction treatment held a national press conference announcing that MMT is a cure for heroin addiction -- and one far more effective than any other treatment for any other addiction.But, they said, methadone is poorly administered in the U.S. via expensive, stigmatized clinics, where absurd restrictions are imposed and doses are often prescribed below therapeutic levels.
So the scientists called for legal reforms to permit regular doctors to treat heroin addiction with MMT outside specialized clinics.Sadly, the scientists' suggestions have yet to be implemented in the U.S.
The time has come to consider heroin as a health issue, not a criminal issue.
So the question is, when will we give treatment a real chance?Steve
SE Portland -
Well said, Steve! It really is a health issue. I'm glad you are here to share your story and insight.
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good comment Steve. we tend to ignore the effectiveness of methadone clinics.
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Steve,
Glad things are working well for you.
So, I was always under the impression that methadone was more of a way to taper off and remove the heroin addiction.
Are you saying that the damage done by heroin is permanent so that methadone is a dependency in the same way levothyroxine is a dependency for people that have had their thyroids removed?
Or, is the length of time MMT is required proportional the heroin usage? For instance, if someone were lucky enough to get on MMT after maybe a couple of weeks of using every other day, would they only need a year of MMT? (numbers are completely arbitrary)
Or, is just totally dependent on the person?
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I don't know what the chain of cause-and-effect is exactly, but it seems that as long as we as a nation are propping up a narco-state (afghanistan) that is the biggest producer of opium poppies, there is going to be an ample supply of heroin.
How complicit is our foreign policy in supporting the international heroin supply?
What is the source of Portland's street heroin?
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I am a psychologist with about two decades of work experience. My experience is that heroin addiction is the most difficult drug to beat that there is. In fact for a while I quit taking clients with this problem because of the lack of success I had with them. They would finish therapy, be clean, and six months later be back on the drug. It is a siren song.
There is a new drug out that can be substituted for H quite successfully. The theory is that the person gets a legal (very expensive drug) that blocks the H receptors and then will be weaned off the drug.
Frustratingly, I think a lot of people are getting dependent on the sugstitute and because it is legal, there is not the push to get off the drug. This is a very expensive cost to the health/insurance system. However, I have had a couple of clients who appear to have successfully moved off the drug who are not back to using H.
I have a client in the waiting room and will not be able to follow the discussion.
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Ruth, It may not be until we get an emergency room physician who has seen some of this train wreck up close and personal into the governor's mansion... And smarmy mental health and drug and alcohol treatment groups like Cascadia BHC. How about some over sight of Department of Corrections which conducts its own outcome studies on the drug dependent inmates selected for their treatment programs? We need institutions that will tell the truth about the efficacy of the programs that they administer. We need to pay the primary counselors who work in many of these MMT clinics better than the union janitors who clean the place up at night. And finally we need early full scale (every grade age appropriate presentations), thouroughly integrated education in our public school system.
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Here's an LA Times article about a newish model for drug trafficking that we'll be talking about shortly:
http://articles.latimes.com/2010/feb/14/local/la-me-blacktar14-2010feb14
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Our son died of a heroin overdose 8 months ago, to the day. He had been at a 3 week in- patient rehab program in Eugene, and was released just two days before.
What would have made the difference?
1. I strongly feel that enough is not done to ensure patients are "safe" when they are discharged. We need more "transition" homes before patients are released to their old environment.
2. Our son was on Suboxone to help him with his heroin addiction ;in retrospect ; he should have stayed on it.
Cracking down on sellers?
The police did little in our sons case to track down his supplier. Numbers on his cell phone were evidence, but nothing was done....
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Recreational drug use should be treated just like alcohol. Consenting adults should be allowed to use them at their discretion, but there should be severe penalties for those who injure or endanger others while intoxicated. Drugs can also then be taxed, the proceeds of which should be dedicated to drug/alcohol education and treatment.
Legalization achieves several things:
- Removes the incentive for criminal organizations to traffic in drugs. Should put a big dent in gang activity.
- Removes the fear of imprisonment for those who wish to seek help to break their addiction, making it easier for them to get help.
- Provides tax revenue (though, again, these revenues should be dedicated toward drug/alcohol education and treatment).
To avoid the obvious assumptions, I say this as someone who has never engaged in recreational use of drugs or alcohol. I believe these activities to be among the dumbest things you can do, but I believe I have a Constitutional duty to not tell others that they can't engage in them, as long as they keep it to themselves (ie., don't drug and drive).
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Last June both of my younger brothers in their mid 20's told me they were addicted to heroin and came to me for help. I immediately tried to get them into treatment but found it diffiuclt to get them into the system. It is exspensive about $330 a month for methadone.
It would be nice if you could say some more about the physical addiction that heroin causes. There are actual biochemical changes that take place. The body makes more opiate receptors in response to drug use over time, this is why tolerance occurs.
I also had a good friend from childhood die from a heroin overdose a couple years ago. This made the situation with my brothers a lot more difficult and scarry.
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Mark McDonnell
If 200 deaths per year were a serious problem, will you comment about how this compares with deaths by alcohol?
The criminalization of heroin is an industry, just as the sale and distribution of it is an industry. Please say on the air what amount of federal money you recieve from the federal government.
Nate
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Oh my God. I can't believe you had a heroin addict on the phone and no one did anything to send him in a direction to get help. As I write this the prosecutor is saying, "We don't want to send anyone to jail". Then put your money where your mouth is and help these people instead of arresting them.
When the addict was on the line host asked the prosecutor to address the comments made by the addict. The prosecutor avoided talking to the addict. Instead he talked ABOUT addicts. Talking about someone as if he is not there is dehumanizing. Law enforcement dehumanizes the problem. These addicts are human beings. We need to treat them as such.
Adrian
recovering alchoholic
Portland, OR.
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I don't have direct (usage) experience, but I have heard a few addict's stories...
Heroin is a sledgehammer of a drug; people who use it are self-medicating so they can knock their brain out for a few hours. Whatever they are experiencing, it's not just enhanced perception or feeling good: they are knocked out. People in abusive situations, people with mental illness and demons they can't cope with, are drawn to use this drug after alcohol or lesser drugs fail to give them relief from living in the real world. It is tragic.
It would be interesting to hear from the VA about their efforts to treat drug adiction in the VA system.
Methodone: a friend was a drug conselor in the 1980's or earlier in a methodone clinic in CA. Her take on it was it was an ineffective, cruel program, that client recividism rates were very large (like 80%), that it was simply substiuting a state-sponsored addictive drug for a black-market one; that withdrawl from methodone was as bad or worse as withdrawl from heroin; that "clients" at clinics all game the system, fake their UAs, and that there is a street / black-market in methodone as well so dosing is really not in control of the clinic.
Also, these clinics are far and few between; treatment is rarely available in rural areas, there are states that have no clinics or only clinics in one major population center. What do these clinics cost? Are they run not-for-profit? How do poor and desparate addicts afford to pay for clinic, counselling?
Is drug use the symptom of other problems at large that could be addressed before the addict turns to heroin? Law enforcement has a difficult task; really they see the tail end of the problem: the officer is here cleaning up a mess that was long in the making. Would society paying for mental health treatment and crisis intervention be better off, and reduce the stream of people who feel they have to medicate with the sledgehammer to cope with life?
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Methadone treatment like ANY treatment will only give what you put into it. So if someone chooses to play the system instead of reconstruct their life that's what will happen. There are both for and not for profit clinics. Counseling at various clinics is widely different. Bear in mind that most black market Methadone does not come from treatment clinics but private prescriptions. Our clinic runs on a sliding scale with most patients paying 300 a month or less for treatment. This breaks down roughly to $10.00 a day. It is true that there are not many rural clinics. That is truly frustrating. Clinics are all different so I can’t say why your friend though her’s was cruel. But even if you choose to think of them as state sponsored addition just remember that a properly run clinic isn’t getting patients high or handing them “hot doses” that could kill them or perpetuating the spread of blood born illnesses with the use of dirty needles. It’s far from a fix all but I hope this helps you see what Methadone clinics do to help.
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I have lost 5 friends in England since 2000 due to Heroin overdoses. These have not been homeless people, my friends were married with houses and had families.
The cost per gram of H in England seems to have dropped to half since the late 90's and the purity has doubled. Pretty much tracking the market forces at work with the computer chip: half the price and twice as fast.
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Another angle that bares examination is the number of "traditional" suicides that have direct heroin links. I had a co-worker and friend who had wrestled with heroin abuse before I had met him and had relapsed into using. He was fired from our company, and his fiance left him due to his heroin use. He was then involved in a hit and run accident and was looking at jail time and committed suicide by carbon monoxide poisoning. By the time many heroin addicts hit bottom their natural chemistry is burnt out. They can no longer feel happiness, pride, or satisfaction and end up taking their lives through one method or another. It's too bad these can't be linked and accounted for, so the true cost of heroin abuse can be accurately measured.
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I lost my father in 1996 when I was 18 to an overdose. He had been through treatment so many times, was a felon and could not vote so I know he went through the criminal justice system. He had his life back together, new truck, great job as a supervisior. He just could never totally quit and it finally killed him at age 45. He loved me and our family so much but the drug would not let go. He would have loved to meet his twin grand-duaghters born in 2005. They have his thick and beautiful hair. I miss him and his talents every day. I often think, man dad we needed your help on this project today or I wish I could get something welded up. Such an empty place that he left in our lives. I love you dad and miss you everyday.
Thank you for this topic.
Sarah in Portland
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The solution is most definitely NOT cracking down on and punishing dealers. Drug use is unfortunate, but no one is to blame for it exactly, no one needs to be punished. Perhaps, few people really need saving. Or, perhaps, we save people more for ourselves then for them.
I feel so terrible for the families that loose people to drugs, it is harder then other losses, because in many ways it seems so unexplainable, or that it could have been prevented. But can it really? If addiction is really an illness, then it is an illness that effects our decision making processes. It is not just that we are addicted, it is also that our mind and ability to make choices, and in many ways to be a responsible person, are also infected. Perhaps, this is a good question to ask: when does the illness begin? Before or after the addiction starts? I think part of the added confusion we feel towards addiction, is that we believe the initial act to partake, to begin the process of addiction is a choice, and, well is it? I am not really sure! But, I think it plays an important role in how we view addiction.
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I apologize if this is redundant but as I’ve stated before I work in a methadone clinic. While I can’t plug my specific clinic here I would like to offer some phone numbers.
Crisis Line: 503-988-4888
24 hour resource line 1-800-723-3638
Hooper Detox 503-238-2067
The first 2 can help those who want to stop using find resources. It might be worth noting that it is a state statistic that for every dollar spend in MMT five dollars is saved in the judicial system. It has always confused me that this is the case and yet more attention is not given by government to help treat addiction. I greatly appreciate the Think Out Loud team addressing this topic.
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I just about fell out of my chair when I heard the comment that putting addicts in jail was the answer to this problem. Not my situation , I was in the county jail for a petty crime and used drugs occasionally. I met my heroin connection while in jail and went from drug user to drug addict. It wasn't until I went to a methadone clinic and received help that i was able to get a my life back. I went to the clinic on my own, specifically to stay out of jail. I knew that to maintain my addiction I would have to turn to crime. Many addicts cannot get treatment because they do not have health insurance to help pay for it. Access to treatment is the answer to heroin addiction.
Patrick
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I can't believe with all the resources in Portland for substance treatment that the Dave and Emily don't have anybody representing the recovery side of this issue.
When you have callers who would like to stop using and Emily Harris tells them "good luck to you". Couldn't you have researched ahead of time and had an actual resource to give them.
What a lost opportunity to reach out to people!
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I am a middle aged native Oregonian with liberal leanings and a life-long opponent of capital punishment. Nevertheless, I do wonder how a few executions of heroin dealers would deter their heinous and remorseless crimes. The Feds have the death penalty, and wouldn't waste time dithering like our state. These vermin kill others -- maybe a few less of them would save some addict lives (and the terrible consequences on so many others.)
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I know two families whom have had one son each addicted to heroin and it is devastating to the family structure of the family unit, why, because those sons will commit theft of any valuables the family owns to sale and procure heroin. These addicts will steal anything outside of the the family unit too in order to purchase heroin. The amount of money California and the state of Washington spends on heroin treatment is astronomical. Today a little less than 5% of the treatment is successful. What would I do? I would give the death penalty or life in prison to any person dealing in heroin or any type of drug no matter if it is a first time offense regardless if a death was caused by an overdose. Drug dealers do not care about sex or the age of the person they are dealing with. They prey on those of weak or no character - they believe in nothing except for making large amounts of money for themselves.
According to Joseph Calafano (book High Society) Americans use two thirds of the worlds illegal drugs. I find this shocking in a society that claims of much freedom, yet is willing to legalize the use of marijuana in order to pay for deficits. According to said mentioned book, marijuana is 33% for powerful than the marijuana that was used in the sixties. Perhaps we should also jail the legislatures along with the drug dealers
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You can't put pot in the same league as heroin. If you think pot is going to be the biggest problem, you'd have to say the same for our "legal" drug of choice, alcohol.
I haven't read the Calafano book. Does he count the pills sold illegally as "illegal drug" use, too?
Heck, in the USA we're proud of our pill industry being the best, right? Feeling a little down, feeling anxious, we have a pill to fix you up, just ask your doctor if it's right for you. I find this shocking.
If you feel as you do about pot, you'd better outlaw alcohol too, it's a scourge. Oh wait, they tried that, amendment, prohibition. How'd that work out? Rise in crime and crime bosses, and almost no change in consumption. We'd have to find a source of state revenue to replace alcohol taxes. And gambling, I hear that's addictive...
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When I think about it it seems to me that our political and economic system is pretty much set up and financed by providing things to people that are bad for them, alcohol and tobacco taxes, casino and lottery funded schools, unregulated ads and standards for fast foods, etc. So that prevailing attitude is what gets applied to problems like heroin, acceptance instead of prevention.
In a way it's like ants farming aphids for their milk, only it's vice peddlers farming US citizens for their money and infesting the government to the financial core to keep it going.
We have a very strange system in our "Free Market".
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I was a heroin addict for11 years, and have been free from it now for 8 1/2. It is hard to describe the nature of heroin addiction to anyone who hasn't been there. It acts at the same level as hunger for food, or survival itself.
I was a "middle-class" guy - good family, a marriage I wanted very much to stay in, my own business, a house , and many other things supporting those. Over a period of 2-3 years, I lost all of the above. I ended up just like any other "street junkie", in a craven, degrading existence. I overdosed many times, and would certainly have died at least 3 of those times had not someone been around to revive me. I went through withdrawals probably 50-60 times. Of all the people I knew as a user, I've seen only a very few since. The rest I've never seen again, or know are dead.
What I know about being free from it is this: That it is easier to get "clean" than to stay clean -- and that's difficult enough. I could absolutely not stay free from it on my own. I was introduced to NA and AA through my first treatment center, and those methods and fellowships have helped me stay clean. From the first time I really tried, and wanted, to get free of addiction, it took me 7 years of treatment, withdrawals, meetings, "home" groups, reading/studying, mentors, family interventions, support, and more. I have never met or heard of anyone who just quit heroin and walked away by themselves. But for those of you out there still using, know that it can be done, with help from others.
For the problem as a whole, as long as people want badly enough to try anything to feel better, or just get caught up in it, there will be a ready market for drugs. Personally, I've never known anyone to stop using, or selling, drugs because of fear of consequences. There is no solution on a broad scale that I can see, short of getting everyone so content there is no market left. But... the massive funds we spend on interdiction and punishment have clearly had no effect whatsoever. I can't help but believe that if detox and treatment were free and consistently available a great number of current addicts would be there, as often as it took, to get free. We have the money and resources to deal with this...
Thanks for letting me share.
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Thanks for very substantial information regarding the fatal effects of heroin. The government need tot intervene in this issue and make some prohibition on it. Mergers, mergers, mergers, it is one thing we are hearing weekly in our unstable economy. Well, here is the next one; Hertz Car Rentals is getting out Dollar Thrifty Automotive Group. This Hertz Dollar Thrifty Merge is costing Hertz about $1.2 billion in cash and stock. However, the merger is anticipated to pull Hertz out of the declining slum they are experiencing for the last two years by supplying them a much larger share of the market. Hertz is also marketing to other age groups like university students, which is not traditional of auto rental companies. They are doing this to take over even a lot more of the market and possible build a clientele in places where other rental companies will not go.
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Comments are now closed.
This is such a sad situation. We lost our 38 year old son last year to heroin. The thing that causes the most anger is that there is so much information out there. Our son was a textbook case. We were textbook parents and family. Yet, everything we and his friends did to break the cycle or chain were impotent. We are statistics and that just breaks my heart.
Were the illegal stigmas removed to drug use perhaps this plague could be brought into the open and make it possible for those hiding in the dark corners of society to seek help. Often these people have no access to effective long term addiction programs and health care, other than the coroner.
As long as this business is lucrative, I believe it will continue. Legalizing, controlling, taxing the hell out of this substance and prosecuting bad behavior while under the influence (as we do with alcohol) might be a start. This idea leaves a bad taste in my mouth. I don't know of any other way to take it out of the hands of those cartels that have wounded our family.
I urge those interested in the subject to read the recent articles in the Oregonian by Maxine Bernstein and Dwight Holton, and the LA Times by Sam Quinones.