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POSTED: Sunday, Nov. 01, 2009

Heroin use may be on the rise in Whatcom County

Police and drug rehabilitation workers in Whatcom County fear they are seeing an increase in local heroin use.

It's difficult to get concrete numbers for something transported and used in secret. But those who work with people struggling with heroin addiction have reported increases in use and treatment for the drug in 2009.

"There's not a doubt in my mind that heroin use has increased," said Carole Wells, who owns Westcoast Counseling & Treatment Center in Bellingham. "Everybody sees this increase: nurses, teachers, police, the sheriff's office. I've been working in the county since 1980 in dependence counseling, and I've seen the increase. I saw it start to rise 10 years ago and skyrocket in the past few years."

The evidence for increased heroin use is all around:

• The demand for outpatient rehab for heroin has more than doubled. This year, 150 people are getting outpatient treatment for rehab compared to 70 last year, said Jackie Mitchell, Whatcom County substance abuse program specialist.

• Needle exchanges increased 36 percent for spring/summer compared to the same time last year at the county Needle Exchange Program. This program provides clean needles to heroin users to prevent the transmission of diseases such as HIV/AIDS, said Alice Simmons, public health nursing supervisor with the Whatcom County Health Department.

• The number of jail inmates going through heroin withdrawals has increased 7 to 10 percent, said Wendy Jones, chief of the Whatcom County Jail.

• Arrests for heroin use and sale have increased, according to Whatcom County Prosecutor Craig Chambers and Sheriff Bill Elfo.

• More people are entering rehab. Wells said up to 20 people are in treatment for heroin at her facility at any one time, double that of last year. Lex Rivers, with Catholic Community Services, also has seen an increase.

THEORIES BEHIND SPIKE IN USE

Local experts say several factors are behind the increase in heroin use: the drug doesn't have to be injected anymore, it's fairly easy to get, addicts are getting younger and, in a recession, it's cheaper than drugs that offer similar highs.

Heroin is no longer a drug of stereotypical addicts but something that grips hold of everyone from homeless youth to business professionals, Wells said. The quintessential image of a heroin addict - injection scars on the inside of the arm, a picture of gaunt, human decay - is no longer an accurate reflection of modern heroin users.

"People no longer say, "Oh look at him, he's a heroin addict," Wells said. Instead, people can seem normal before they've reached late-stage addiction. Heroin users won't necessarily have injection scars; the drug also can be snorted or cooked down with boiling water and inhaled.

Heroin is less taboo, and it's cheaper and easier to get than similar drugs, said Bellingham Police Sgt. Claudia Murphy.

OxyContin, a painkiller prescribed for conditions such as arthritis and cancer, gives a high similar to heroin when its time-release effect is thwarted by crushing the tablets and then snorting, injecting, swallowing or inserting them rectally. It's also highly addictive.

But OxyContin is difficult to obtain without a prescription and costs abusers about $1 a milligram, Murphy said. Although every user is different, Murphy said in her experience, it's not uncommon to find people who take five or six pills a day. Six 80-milligram pills could cost almost $500 a day on the street.

Depending on the quality, a gram of heroin is only $50 to $80, Murphy said. It's common for users to be satisfied on one to two grams of heroin a day, making it the cheaper choice compared to OxyContin.

Some experts think another factor is increasingly younger drug users.

Today, some heroin users are so young that they may still ride the yellow school bus. Addiction can start by rummaging through parents' and grandparents' medicine cabinets for prescription painkillers.

"The real surprise factor for me lately is talking to a large number of young folks addicted to heroin," said Murphy, who works with a special investigative unit that deals with prostitution and drugs.

A 17-year-old was the youngest person ever treated for heroin use by Dr. Anthony Gargano, who treats patients from Westcoast Counseling & Treatment Center. But he's been told by pediatricians that some users start as young as eighth grade.

Some teens start using painkillers with friends and at parties. When they graduate from high school, they may not be able to get the drugs from relatives' prescriptions anymore or afford them on their own. So they start using heroin, because it's cheaper and easy to get on the street, Gargano said.

TREATMENT MAY NOT MEAN USAGE SPIKE

Not everyone is convinced heroin use is spreading locally, but again there is no solid evidence.

"Our community is simply seeing more people getting help and seeking treatment," Gargano said. The economic recession has encouraged more people to check into rehab, since it's often cheaper than paying for drugs.

When financing addiction becomes impossible, checking into rehab is easier than going through nauseating heroin withdrawals.

And withdrawals are the worst. If an addict misses his or her next fix: "Imagine the flu on steroids: vomiting, diarrhea, chills, shakes," Murphy said.

It takes as little as a one-time use to become addicted to heroin. And if that person continues to use heroin, after six months, his or her life is fully entrenched in the drug, Murphy said.

Gargano said he is one of only three doctors in Whatcom County licensed by the government to prescribe Suboxone, a drug that, when coupled with therapy, can help beat addiction. Because of the high demand for treatment, the county could use about 10 more doctors who can prescribe Suboxone, Gargano said.

"I'm completely booked," he said. "I have to turn people away every day."

Chuck Fuller, one of Gargano's patients, has been beating his off-and-on, 20-year heroin addiction with Suboxone. Fuller, who now holds a job and goes to school, said the drug "saved my life."

Simmons, nursing supervisor with the Needle Exchange Program, said she's also noticed an increase in people seeking help for heroin addiction but believes there aren't enough treatment facilities and resources available.

Although the needle exchange had, at one point, a 36 percent increase in needle exchanges this year, the increase could be because more people know about the program. That doesn't necessarily mean more people are using heroin, she said.

The Drug Enforcement Administration has not seized more heroin this year than in past years, said Agent Jodie Underwood. And the number of heroin-related deaths has not gone up in Whatcom County, said Gary Goldfogel, county medical examiner.

ABUSE COSTS EVERYONE

Regardless of whether heroin use has increased, local rehabilitation experts and law enforcement agree that any use of the drug can have a devastating affect on Whatcom County communities.

In many cases, heroin users turn to crime to finance their habit. They break into homes and cars to steal items that can be sold or traded for drugs, Murphy said. Some deal drugs themselves. Others forge checks, create counterfeit money or turn to identity theft.

It's common for people who use heroin to not pay rent and lose their homes. Parents high on heroin often neglect their children. It can cost users their jobs, health and hundreds of dollars a day.

But users and their direct crime victims aren't the only ones paying for heroin addiction. If someone is arrested for using or selling heroin or committing a crime to finance that drug habit, the $65 a day it takes to keep the person in jail comes right out of taxpayers' pockets, said Jones, with the Whatcom County Jail. And there's no saying how long someone could remain in jail, especially when people are booked on multiple charges.

After a week in jail for a heroin-related crime, taxpayers would have spent $455 just to keep someone behind bars.

In comparison, a week in outpatient treatment at Westcoast Counseling & Treatment Center would be $150 for group therapy, plus medical fees for some. And these fees can be minimal or paid with other funds, such as Medicaid.

But jail or treatment may not solve the problem. Treatment facilities have a hard time getting people to come in for help consistently. It's difficult to quit; relapse is common.

Each time a person uses, the chemicals are in control, working directly with the part of the brain that feels rewarded by the drug. It's a sense of happiness and satisfaction that's often absent in a person's life without heroin, Wells said.

With a substance that powerful, the chances of successful recovery go down. The chances of more drug use, crime, jail time and failing health go up.

"Heroin is a destination drug," Murphy said. "As far as a normal life goes, you're done."

WHERE TO GO FOR HELP

There are several public and private treatment services in Whatcom County for people coping with substance abuse. Good contacts to begin the search for help include:

• Whatcom County Health Department: 676-4593.

• 24 Hour Care Crisis: (800) 584-3578.

• Alcohol Drug 24-hour Help Line: (800) 562-1240.

• Cocaine Anonymous: (800) 723-1923.

• Narcotics Anonymous: 647-3234.

• Lummi CARE: 384-2330.

• Nooksack Tribe Genesis II: 966-7704.