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Friday, September 19, 2014

Heroin Common In Scioto -- Closing the Pill Mills

“Since the pain clinics have been shut down in this area, the influx of heroin has pretty much exploded,” Portsmouth Police Department Operations Captain Lynn Brewer said. “It used to be that we saw heroin maybe two or three times a year on arrest, but now it’s quite common.”

(Frank Lewis. "Portman Introduces Bill to Fight Heroin."
Portsmouth Daily Times. September 8, 2014)

Many people do not understand why heroin, a highly addictive illegal substance, is now so common in Southern Ohio. Did a community do the wrong thing by waging all-out war on prescription drug abuse here? I have actually heard many blame those in the anti-prescription drug movement for the heroin outbreak.

To those unaware of the background of opiate drug addiction, heroin seems like a new, terrible scourge that has devastated our area. Nothing could be further from the truth: "heroin," in one form or another, has ravaged Scioto County for decades. Only the name and the formulation have changed.

In order to discern the reason for the present popularity of heroin, one must first take a brief history lesson.

First of all, one must understand a couple of basic definitions of two commonly abused substances. Oxycodone is a semi-synthetic opioid synthesized from poppy-devived thebaine, an opiate alkaloid.
It is a prescription drug used to treat moderate to severe pain.

On the other hand, heroin is a highly addictive drug that is processed from morphine, which comes from the seedpod of the opium Asian poppy plant. It is a highly addictive illegal narcotic.

Health Commissioner Aaron Adam’s public health emergency declaration - See more at: Commissioner Aaron Adam’s public health emergency declaration
Opioid pain pill addiction became so prevalent in Scioto County that the health commissioner in 2010 declared a public health emergency, something usually reserved for disease outbreaks. What else could he do when nearly one in 10 babies were born addicted to drugs, and rehab admissions for prescription painkiller addictions were five times the national average in 2009? These drugs had contributed to at least 117 overdose fatalities in the county between 2000 and 2008.
Rehab admissions for prescription painkiller addictions were five times the national average. In a rare step, the health commissioner declared a public health emergency, something usually reserved for disease outbreaks. - See more at:

In 2010 ten Pill Mills, or bogus pain clinics, in Scioto county were employing doctors that doled out prescription medications like OxyContin with little discretion. Thanks to groups like the Scioto County Drug Action Team, citizen support groups, and health officials, the last of the pill mills were shut down on December 20, 2011, when Ohio Attorney General Mike DeWine teamed with the Ohio Board of Pharmacy and Scioto County officials to raid the Greater Medical Advance office in the Wheelersburg clinic.

And, finally, in 2011, Ohio lawmakers unanimously passed Ohio House Bill 93 mandating the State Board of Pharmacy to license pain management clinics and, further, providing for clinics to be licensed as terminal distributors of dangerous drugs with a pain management clinic classification. Moreover, the law prohibited the operation of a pain clinic without such a license.

Ohio has since revoked medical licenses for 38 doctors and 13 pharmacists, and convicted 15 medical professionals of improperly prescribing or dispersing prescription pills. Scioto County prospers from the ousting of the Pill Mills.

Southern Ohio was the National Epicenter of this terrible prescription drug abuse before the reforms. OxyContin, widely known as “hillbilly heroin” because of its abuse in Appalachian communities like Scioto County, had emerged as a major drug of choice. It was the high content of oxycodone that made OxyContin popular on the street. Swarms of people from Ohio and neighboring states came to the county to purchase the product from evil owners and doctors of the mills.

One may wonder why such high abuse is connected with oxycodone? One opioid was particularly attractive to addicts and dealers. The drug OxyContin, like similar opioids, tends to induce feelings of euphoria, relaxation and reduced anxiety in its users. These effects, along with its addictive qualities and legal prohibition, made it one of the most commonly abused pharmaceutical drugs.  

At one time, opioids were readily available and relatively cheap. Easy to obtain, easy to distribute, and easy to conceal, users can take oxycodone orally or ingested through insufflation (inhaling). It can also be prepared for injection and administered intravenously, while some abusers will heat the pills on aluminum foil and inhale the smoke as a means of ingesting it. Other ways of abuse include intravenous injection of oral dosage forms.

Scioto County was among the first areas in the nation to address the widespread abuse of opioids. In fact, the county became a well-know model for other communities fighting their own rx abuse.

Prescription drug abuse is still a major problem throughout the country. In 2010 alone, 16,652 deaths were related to opioid overdose. In the United States, more than 12 million people abuse opioid drugs. Based on statistical estimates by the U.S. Department of Health and Human Services, about 11 million people in the US will consume at least one of dose of this opioid in a non-medical way. About 100,000 men or women per year are admitted to US hospitals due to misuse of this drug, making it the most widely abused opioid drug in America. 

("Policy Impact: Prescription Pain Killer Overdoses."  
Centers for Disease Control and Prevention. December, 2013)

Now, let's look at the answer for the great 
numbers of heroin users in the county.

As I hope I have established, prescription pain medications such as OxyContin, Opana, Percocet, and Vicodin can have effects similar to heroin when taken in doses or in ways other than prescribed, and they are currently among the most commonly abused drugs in the United States.

Let me make it easy to understand. Heroin is also an opioid drug; it's the illegal cousin. They are all made from the poppy plant, and they are all addictive. The similar high is the object of affection for drug abusers.

Research (The National Institute of Drug Abuse) now suggests 
that abuse of opioids opens the door to heroin abuse.

Of the people who tried heroin between 2008 and 2010, more than eighty percent had previously abused prescription drugs, according to a study done by the Federal Substance Abuse and Mental Health Services Administration.

Experts say the problem can be traced back to the aggressive prescribing of opioid drugs for pain about 15 years ago. It is easy to trace the Scioto heroin problems to the pens of those evil doctors as they signed prescription pads for opioid drugs.
"When you talk to people who use heroin today, almost all of them will tell you that their opioid addiction began with exposure to painkillers, says Dr. Andrew Kolodny, chief medical officer for the Phoenix House Foundation and president of Physicians for Responsible Opioid Prescribing.

  (Laura Sullivan. NPR. February 04, 2014)

And, the young are currently victims of the trend.

"Nearly half of young people who inject heroin surveyed in three recent studies reported abusing prescription opioids before starting to use heroin. Some individuals reported taking up heroin because it is cheaper and easier to obtain than prescription opioids.

"Many of these young people also report that crushing prescription opioid pills to snort or inject the powder provided their initiation into these methods of drug administration."

(Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. CBHSQ Data Review. Associations of Nonmedical Pain Reliever Use and Initiation of Heroin Use in the United States. Rockville, MD, August 2013) 

As the number of prescription pill overdose deaths in Ohio flat-lined and slowly began to wane, the number of heroin overdose deaths skyrocketed.

The numbers may not show a direct causal link, but Steven Dettelbach, U.S. attorney for the Northern District of Ohio, said, "there's definitely a progression from people using opioid pills to using heroin."

Experts also suggest the switch from prescription pills to heroin may have something to do with the black-market economy of both narcotics. Heroin is now a cheaper alternative and many people that have become addicted to pain killers are abusing the highly addictive drug now.

"Heroin is cheaper than pills," said Deborah Naiman, a supervising prosecutor with the Cuyahoga County Major Drug Offenders Unit. "You have everything from people using it who actually have legitimate physical ailments that cannot be conquered... to young people trying drugs just to try drugs, to not so young people who are enmeshed in the drug culture, taking heroin because it's cheap and it's everywhere."

So, naturally, when the U.S. saw thousands of opiate addicts switch to heroin, Mexican drug cartels saw the opportunities. Heroin suppliers stepped in to fill the void. Today heroin is a much sought after drug on the streets since prescription painkillers aren't as easy to come by anymore.

Mexico's heroin production has quadrupled since 2006, making the country's neighbor to the south the second largest exporter of heroin, outdone only by Afghanistan. Mexican cartels boosted their production of heroin, but some of what they traffic into the U.S. originates oceans away.

Dettelbach said some of the heroin that enters the states via Mexico comes from Asia and Africa.

"The Mexican cartels are multibillion-dollar global, criminal enterprises," Dettelbach said. "They present a serious law enforcement and public safety risk."

(Brandon Blackwell. "The Heroin Epidemic: Death Toll from Drug Continues to Soar in Cuyahoga County." Plain Dealer Publishing Company. September 03, 2013)

The bottom line for drug abuse crusaders is that heroin is a sore problem for enforcement. As the press cites all poppy growth in areas out of the country -- Afghanistan, Mexico, other places in Asia and in Africa -- the need is evident for a national change. The thought successful heroin dealers transporting their drugs while making the journey of many thousands of miles to sell them in rural Southern Ohio is almost unbelievable.

The fact is greed and the tremendous money associated with such well-planned operations feeds those willing to risk the consequences of being apprehended and convicted. In addition, crooked, evil officials all across America thrive on the illegal drug trade. A major network of corruption is supported with big money, power, and influence. Consumption drives the market, and Southern Ohio has a particularly large opioid-consuming population.

It reminds me of the fantasy-drama movie Field of Dreams and the Iowa corn farmer who heeded a mysterious voice advising him: "If you build it (a baseball field), he will come." The farmer built the diamond, and Shoeless Joe Jackson with the seven other players banned in the 1919 Major League Black Sox scandal appeared.

Here, whispers of constructing another kind of edifice convinced not a farmer, but instead the criminal element to act. In Scioto County, they built The Killing Fields. Look who showed up to reap the riches of rampant opioid addiction. Outsiders love taking money and making misery in a place with low esteem and high addiction. Scioto County was ripe for those selling a quick high. The architects have not gone away. They still prosper even though the product has changed.

We have gone through the long era of indifference and inaction; we have survived the time of the Pill Mills; and now we are in the middle of Heroin Hopelessness. Heroin in Scioto County has nothing to do with those who helped close the prescription drug Pill Mills. They knew it would come and be the only substitute substance strong enough to satisfy prescription drug addicts.

Heroin is an illegal killer, a substance that the Federal Government, the DEA, the State Government, the local government, and the law enforcement controls. It is evident it is going to be here for a long time, that is, unless strategies can be created to keep the veins of users closed to that substance of the foreign poppy. Those who choose to play in The Killing Fields, like Shoeless Joe, risk their own permanent ban -- absence from the sweet reality of breathing life-sustaining air here on Planet Earth.

DOJ National Drug Threat Assessment 2011

Today heroin is a much sought after drug on the streets since prescription painkillers aren't as easy to come by anymore, this has caused the price of illegally obtained pain medications to increase as well. Heroin is an opiate also, and produces similar effects opioid pain relievers do when they're abused. Heroin is now a cheaper alternative and many people that have become addicted to pain killers like Vicodin, Opana, Percocet and OxyContin are abusing the highly addictive drug now. - See more at:
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