By CRAIG FREILICH
The number of people treated for heroin addiction in St. Lawrence County is skyrocketing, heroin seizures in the county nearly quadrupled in one year, and the drug trade has some communities wondering how to protect their children.
Adam Bullock, director of Canton-Potsdam Hospital’s drug treatment programs, says the number of heroin users getting help there has doubled each year since 2011, and that’s just the people who can get into the programs. “Epidemic proportions,” he says.
Heroin seizures or recoveries in St. Lawrence County jumped from 15 in 2012 to 57 in 2013, according to Sen. Patricia Ritchie, who was recently named to the Senate Task Force on Heroin and Opioid Addiction.
“There used to be a stigma to heroin. But with the availability now, more and more people are trying it, and it’s easy to get hooked,” said St. Lawrence County Sheriff Kevin Wells.
Heroin use has risen as prescription narcotic pain relievers such as hydrocodone and similar painkillers have become harder to obtain and as manufacturers have changed the formulations to make it harder to get the high abusers seek, Wells says. And heroin is now more available and relatively cheap.
In Massena, hoping to reduce the spread of disease, Police Chief Timmy Currier is investigating what it would take to begin a needle exchange program for heroin users in the community. And with 61 reports of hypodermic syringes found in public areas in Massena since January 2013, the Massena Drug Free Coalition was to have swept village parks last Saturday looking for more discarded needles.
St. Lawrence County Interim Director of Public Health Loraine Kourofsky says it is an epidemic that is having an effect on “public health” around the county.
The statistics speak for themselves:
• In the CPH detoxification program in 2011, heroin users as primary and secondary diagnosis patients accounted for 11 percent of the unit’s patients; in 2012 it was 20 percent; in 2013, they made up 38 percent of patients. Detox is the first step in recovery – getting the drug out of the system, and getting the body used to it.
• In the CPH drug rehabilitation program, heroin users were 9 percent of patients in 2011; in 2012, they were 13.6 percent; in 2013, the number had risen to 31 percent. This is the education and reinforcement stage of recovery.
• In the CPH outpatient drug treatment program, heroin users were one percent of patients in 2011; in 2012, they made up 2.2 percent; by 2013, the number had risen to 9 percent.
And the trend is continuing. Bullock has compiled the statistics for just the first quarter of 2014, January through March: detox patients, 45 percent of the total; rehab, now more than half at 53 percent.
“We clearly have an epidemic of heroin abuse,” Bullock says, “but patients can’t access an appropriate level of care because of insurers. The issue is ability to access care.”
At the moment, the patient spaces in the programs at Canton-Potsdam Hospital are not all filled, but “the phone is ringing off the hook,” Bullock says. There are still available slots in his programs, and he believes they would be filled easily if insurers would cover more cases.
From a public health standpoint, Kourofsky says heroin use has serious effects on people other than the users. For instance, a user might be a parent.
“Children may be forced into foster care. If a woman is pregnant or becomes pregnant they may not be taking care of issues they should be. And not only is the mom addicted, the baby can be too. Neurologically, such babies frequently don’t do well.” That adds up financial and psychological expense for the family and community, Kourofsky said.
“Substance abusers who share needles are more at risk for hepatitis C. They may not see the symptoms, but they’re just not feeling well, and they don’t know they have it until a test shows it. Among people with hepatitis C, 75 percent become chronic, with serious liver disease. They’re not able to work, and the new drugs to treat it are way expensive and not usually covered by insurance.”
There are similar issues with HIV infection. Kourofsky said her department might be able to offer hepatitis C screening soon, but that is helpful only after infection.
Heroin More Available
“It all comes down to what’s available, and heroin is more available than any of the pills,” said Sheriff Wells. “So heroin moves in, not just here, but all across the country.”
Wells says the distribution to the North Country is not through urban gangs, as had been the case with cocaine.
“There is no consistent gang tie. They are entrepreneurs. It’s coming out of New York City or Troy or Poughkeepsie and up the Northway, or from Syracuse, Rochester and Buffalo, no one city in particular. It’s just showing up, from people who are just dealers by choice, to make a few dollars at someone else’s expense.”
“How do we fix it, how do we make it better, how do keep families together?” Kourofsky asks out loud, and offers some possible answers.
“Education in the community. We’re working with schools, providing materials, and to see how else we can help. We’re working with the Seaway Prevention Council and all the hospitals. I know this is a concern for hospitals because it affects emergency rooms and clinics. We need to try to fix the things that are broken.”
Bullock says the number of people in his programs abusing prescription opioids, which had been rising fast, has stabilized, and he believes they will be seeing a drop-off.
“We’ve not seen a great increase or decrease” lately, he says, but he says he has seen little evidence so far that there has been a great switch from the prescription drugs to heroin.
“It’s the new folks. Some of them are still abusing prescription drugs, but heroin is so available new people are joining in.”
He sees the people in treatment as coming from “across all social and economic boundaries. It’s like a cold. Anyone can catch it.”