HEROIN: The Addiction

SEPTEMBER 09, 2014 IN TIMES LEADER

Here is the second part of the series on heroin, which appeared in The Times Leader earlier this year. Do check out TylersLight.com. The videos are quite powerful.

HEROIN: The Addiction

By GLYNIS VALENTI Times Leader Staff Writer

 “We didn’t understand addiction and how to separate the person from the illness. We felt alone in our quest for help.” Wayne Campbell, father of a heroin overdose victim

 Heroin addiction is a no-win situation. A scant minority makes it into recovery, but for the rest of their lives they will be walking a tightrope. More often than not, using heroin is fatal. It is a daily game of Russian roulette pitting a $10 stamp bag against the rest of one’s life. This wretched scenario may have begun with friends sharing six packs of beer under the bleachers at football games or relaxing with joints around camping trip campfires or with a prescription for easing the pain from surgery, chronic pain or a sports injury.

           While the United States population is roughly five percent of the world population, Americans use 80 percent of the world’s prescription drugs and 70 percent of the world’s illegal drugs. In Ohio 11 young adults between ages 15 and 25 die every two days from overdoses. The human body doesn’t distinguish “dangerous.” It only takes in more and more of what makes it feel good. It builds up tolerance for opiates quickly and reacts violently when the intake isn’t enough.

                Heroin and other opiates are extremely dangerous because 1. they are highly addictive (it’s an almost certainty) and can happen with one fix; 2. as soon as the effects wear off, the body begins moving into withdrawl; 3. withdrawl is hard on the body and weakens it, making the drugs more attractive; 4. addicts need more doses more often, and there is no “regulation” dose. Dealers don’t care about safety, so there may be less heroin cut with more strychnine, or a higher grade of heroin in this shipment that they cut with laundry detergent, or a lesser grade cut with other more powerful drugs. Dealers do care about collecting $10 for a dose about the size of a crushed baby aspirin. There will always be addicts on which they prey.     

                Heroin can be swallowed, inhaled as fumes, “snorted” through a tube into the nasal passages, “mainlined” into a vein through injection or injected into muscle or fatty tissue, called “skin popping.” To liquefy the drug for inhalation or injection (the most common and potent means of ingestion) addicts will have a “kit” consisting of bent spoons, glass pipes, tin foil or bottle caps, a length of rubber banding or hose and syringes and hypodermic needles. The drug is detectable in urine for up to four days after using, but most addicts cannot wait that long before their next fix.

                Heroin (injected) initially produces a euphoric rush and a warm, fuzzy sensation. The user feels relaxed, drowsy and pain free as the world slows down and thoughts and memories slip away. The drug flows to parts of the brain that control blood pressure and breathing, but also to critical areas controlling pain and dependence, so as heroin is easing the physical pain the mind is welcoming that relief and creating the need for continuing. It is completely converted to morphine through chemical processes in the body. There is no “experimenting” with heroin; the body and mind are immediately drawn in.            

                The rush, of course, wears off, and the user begins coping with the aftermath: nausea and vomiting as the body tries to reject the heroin, dry mouth, confusion, slurred speech, muscle weakness and slow breathing. Some deaths are attributed to this stage when the addict loses consciousness and is asphyxiated by his own vomit.

                Aside from increased tolerance and addiction, regular use of heroin will manifest other harmful indications such as scars and bruises, depression (when not high,) appearing sedated, severe weight loss, decline of personal grooming and cleanliness, premature aging, irritability, mood swings and changes in sleeping patterns. Users are susceptible to pneumonia and infections of the heart and liver. Addicts who inject the drug run an extremely high risk of contracting HIV/AIDS and hepatitis from dirty needles, as well as skin infections, abscesses and collapsed veins. They may complain of a condition termed “itchy blood,” which causes them to scratch uncontrollably, leaving welts and sores.

             Psychologically, the addict’s life revolves around heroin, and he will lie to loved ones, co-workers and strangers about his addiction and actions connected with it. When his money runs out, the addict will use any means necessary to obtain drugs, including, but not limited to, manipulation, theft, gambling and prostitution.

                Withdrawl begins 6 to 24 hours after the last fix and can last up to 10 days. All of the above-mentioned downswing effects like nausea and muscle weakness progress into sweating, cold sweats and chills, anxiety and uneasiness, muscle spasms, insomnia, aching muscles and bones then cramping, diarrhea, excessive sneezing and discharge of mucous, watery eyes and yawning. Unless a user is in a rehabilitation facility, he or she is most likely to seek out a dealer for relief.

                The Campbells of Pickerington, outside of Columbus, are an all-American family, educated and hard-working. Their oldest son, Tyler, was well-liked and set his sights on playing Division I college football, earning a scholarship to the University of Akron. He made the starting team in his second year and found out how rough play could get. After games, doctors would be on hand in the locker rooms, checking players for injuries, pulled muscles, headaches, etc.

                Wayne Campbell, a Martins Ferry native and Tyler’s father, says he found out later that the doctors would give players pain killers to alleviate those aches and help them get through practices. Tyler told his parents everything was fine. Then he suffered a shoulder injury requiring surgery. The doctor gave Tyler 60 Percocet to help him recover.

             During Tyler’s junior year, however, his positive attitude deteriorated, his grades dropped, and his performance on the team declined. When he came home for the Christmas break, Campbell knew there was a health issue and took him to an OSU medical center where a doctor found the prescription drug addiction. Campbell sent Tyler to rehab after which Tyler returned to the University of Akron—and to drugs.

                His parents got him back into rehab, then into a smaller college. A dealer there introduced him to heroin. Campbell got a call from one of Tyler’s friends, and they admitted him into an exclusive Cleveland rehab facility where he was surrounded by doctors and lawyers with the same addiction.

                Upon his release, Tyler changed his major to counseling to help other young people get past addiction. On a visit home from school, Tyler suffered a fatal overdose.

                “We couldn’t help him,” Campbell recalls. “The addiction was the issue. It grabbed him, and he couldn’t shake it.”    

                Two weeks after Tyler’s death, friends and family met, and Tyler’s Light (TylersLight.com) was formed. Campbell travels to schools and organizations telling this story, talking with students and parents and making sure people know that speaking up could save a life. Campbell was surprised that the problem was so prevalent in their county and in Ohio. He does presentations often in Belmont County, especially since the Columbus drug task force commander told him heroin traffickers target suburban, rural teens rather than urban school districts.

                Campbell echoes law enforcement’s pleas to parents to monitor their children’s friends and activities. Even if mood swings and erratic sleep patterns seem like normal teen traits, changes in behavior, clothing, weight, grades and friends could signify problems, including involvement with drugs. Finding “kit” items or noticing missing money or valuables are red flags. Knowing the signs, paying attention and taking action are the only ways to help a loved one.

                “There are no do-overs,” Campbell adds. “You can’t ask them why.”

HEROIN: The Epidemic

AUGUST 11, 2014 IN TIMES LEADER

I live in Appalachia--coal mines, abandoned steel mills, barges traveling up and down the Ohio River, family farms--where Belmont County's population is around 70,000 and looks like a metropolis next to Monroe and Harrison Counties to the south and west, respectively.

As Chef Jamie Oliver has touted, health issues here are rampant and pervasive. Financial, nutrition and fitness poverties have become the way of life. Doctors prescribe medications that address symptoms rather than causes. And here we are.

I deliberated about posting this series because it isn't happy fare. This is a serious issue, and Belmont County and the state of Ohio are among the majority now with opiate and heroin problems--real problems. Police, anti-drug activists and health care workers have told me that they learned something from this series, so I've decided to post it here, the theory being that better education will lead to better decisions and, hopefully, something useful.

This is the first of three installments.

It doesn’t start out with deceit and theft. Nor does it begin with making your connection and injecting the fix as your children watch from the back seat of the car. In fact, most heroin addicts’ short journeys to darkness and desperation begin with a legitimate visit to a doctor.

                Society’s dependence on prescription drugs—especially pain killers and muscle relaxers—has created what Ohio Attorney General Michael DeWine calls “an epidemic” where a solid 70 percent of drug busts in the state are now opioid-related. According to a report citing information from the DEA and other federal and state agencies, in 2010 alone 692 million doses of opiates like Hydrocodone, Oxycodone, methadone, morphine, codeine, hydromorphone, buprenorphine, fentanyl base and meperidine were distributed to retail pharmacies. Common names for some of these include Vicodan, OxyContin, Percocet and Demerol.

                The report puts that large number in perspective. This is enough for 60 doses per every person living in Ohio; 1.8 million doses per day; 79,000 doses per hour; 1,316 doses per minute. Every second 22 people are taking one of the above-mentioned pills. These numbers are for assumedly legitimate prescriptions ordered by doctors.

                When patients have recovered from their illnesses or surgeries and can no longer get the medications to which their bodies have become accustomed (and addicted,) they seek out other sources—dealers, who peddle stolen and illegally manufactured pharmaceuticals, and “pill mills,” often operating under the guise of pain management clinics that have relaxed prescription policies. A Google search of “pill mills Ohio” brings up more than 100 locations in the Columbus area alone. DeWine says that eliminating pill mills is crucial to crippling the growing heroin problem and adds that surrounding states are facing the same issues.

                As the physical addiction takes hold, the body requires more drugs more often. This is the nature of opiates. Prescription drugs, however, are comparatively expensive, especially since the demand has been increasing steadily during the past decade. Enter, heroin, a morphine-based Schedule I narcotic readily supplied by Mexican drug cartels.

Pure heroin is dealt as powder or gravel rocks and sells for $4,000 to $5,000 per ounce. This bag came to Belmont County from Cleveland, and, had it not been confiscated, would have been “cut” with baking soda, baby powder, household cleanser or powdered drugs to maximize the financial gains of local dealers.  

  Although opium poppies were cultivated in Mesopotamia more than 5,000 years ago, Diacetylmorphine (heroin) was first derived from the opium poppy only about 100 years ago, first by a British chemist in 1874 and then by a German chemist in 1897. Both were looking for morphine alternatives. C.R. Alder Wright’s experiments in the UK yielded a drug that had severe effects on test animals: fear, quickened respiration then irregular heartbeat, salivation and loss of muscle control. He did not pursue its development.

                Felix Hoffmann worked for the German pharmacology company that was the predecessor to today’s Bayer and was directed to develop codeine by synthesizing opium. The company sought a milder, less addictive alternative to morphine. Instead, what he created was actually stronger and twice as addictive. It metabolized into morphine when ingested, but the company didn’t realize this when they marketed it as a cough suppressant, morphine substitute and cure for morphine addiction. The name “Heroin” came from a German word for heroic or strong because soldiers using it charged at enemy lines even as those enemies attacked.

               From 1898 to 1910 the drug was sold for general consumer use. By 1924, as governments and companies became aware of heroin’s potency and adverse effects, the drug was banned from manufacture or sale in the United States. The Controlled Substance Act of 1970 made heroin a Schedule I narcotic that is illegal to possess without special licensing from the DEA. The United Kingdom still uses heroin for medical treatment.

              Traditionally Afghanistan has been the world’s leading producer and exporter of heroin with an estimated 87 percent market share in 2004. However, a fungus destroyed the opium crops there in 2009, and India is now the top producer--and consumer—of heroin, a $1.4 billion industry.

               Heroin in the Ohio Valley generally originates in Mexico according to Martins Ferry Police Chief and Commander of the Belmont County Drug Task Force John McFarland. This area sees the standard white type of the drug, also, rather than the more exotic brown and “black tar” varieties. Some of the nicknames for heroin hark back to the 1960’s and ‘70’s such as “smack,” “H” and “horse,” but McFarland adds that, because of the accessibility of information and evidence on cell phones and computers, dealers will use their own code words when talking with buyers, words that may not have anything to do with the drug’s real name. Parents should be aware of this.   

Chief John McFarland, commander of the Belmont County Drug Task Force, is concerned about how the influx of heroin is affecting Ohio Valley families and on a mission to cut the supply and access of opiates and educate children about the danger of addiction.

 Part of the problem and danger with heroin, as with many drugs, is that the potency is inconsistent. It is generally cut, or mixed, with other substances to stretch the pure drug and make more money. Additional substances can include lesser drugs like aspirin, products like powdered cleanser or, as in the cause of 23 deaths in Pittsburgh earlier this year, fentanyl. Fentanyl is another opiate that is 10 to 100 times stronger than morphine. Addicts have no idea what they are buying, how strong the drug is or if this will be their last fix.

               McFarland says that marijuana is definitely a gateway drug or precursor to heroin, but in most instances prescription drug addiction is the doorway. Barnesville Police Chief David Norris notes that until about two years ago there were few arrests for heroin and prescription drugs. He says the growth of the local market brought in out-of-towners from Cleveland and Pittsburgh who set up shop in and around small towns in rural Belmont County.

              “We’ve seen cases of other drugs here and there in the past,” says Norris. “But this is different. This trend is up over the last couple of years, and it doesn’t take long to see the results.”

              Aside from the physical effects of addiction and deaths from overdoses, “the results” Norris mentions are other undesirable increases: domestic violence, prostitution, theft and child neglect. The Belmont County Drug Task Force seized more than $30,000 during the past year in cash and stolen goods.

             “Five years ago almost all local drug arrests were for coke and crack [both cocaine.] Now almost all of them have ties to people out of the area,” explains McFarland. “I’ve seen young women and mothers get involved with prostitution to get heroin. Abuse is up. Child protective services have been a gigantic help, but they are overwhelmed from the cases related to drugs.”

              Both McFarland and Norris stress the importance of reaching youth about the dangers of heroin before they become addicted and the importance of vigilance on the parents’ parts to watch for any signs of changing behavior.

              “I’ve seen a 17 year old with track marks on his arms. Watch every move your child makes,” says McFarland. “I’m a parent, and I do it. I look around their rooms, ask them questions. If they think I’m mean, so be it. Look for the signs: missing items, change in behavior and appearance; know who he’s with.”

“Stamp bags” of heroin ready for sale to users are identified with catchy names by dealers. The drug task force seized 137 of these single doses with a street value of $1,370 to $4,110 as evidence in a case against the local Grim Reapers Motorcycle Club.  

 Punishment for possession is a felony. A first offense with no criminal record may involve drug court, treatment and probation. McFarland says that the charge may be expunged from the perpetrator’s record if drug tests are continuously clean. Otherwise, the sentence depends on the quantity of opiates found in possession. It could result in a maximum sentence of 20 to 25 years in federal prison.

              To keep drugs off the streets and to dispose of them properly, the Drug Task Force has installed “no questions asked” drop boxes at four police stations. These the specially designed lock-boxes are sponsored by the Belmont County Sheriff’s Department, Martins Ferry Police Department, Barnesville Hospital, Morristown Pharmacy, East Ohio Regional Hospital, Riesbeck’s Market and Chirpas Auto Body and are built by students at Belmont College. The program netted 300 pounds of prescription and over the counter drugs in four months. Boxes are currently located at the police departments in Barnesville, Bethesda, St. Clairsville and Bridgeport. On April 26, sites in Ohio collected more than 14 tons (28,466 pounds) of drugs on National Prescription Drug Take-Back Day.

                   Local police forces have boosted their manpower, training and attention toward anti-drug efforts, and Norris wants to assure dealers that their activities are on the radar and that their selling days are numbered.

                   His advice to buyers is, “Don’t even think about trying heroin. Once you do, you’re life is ruined. You’ll never be cured. If you live, you’ll be in and out of rehab the rest of your life.”

                  “The worst part is losing everything. With drugs you lose your family, your house, your job, everything in your life,” adds McFarland. “Eventually you lose your life.”