Pubdate: Tue, 8 Jul 2008 Source: Milwaukee Journal Sentinel (WI) Copyright: 2008 Journal Sentinel Inc. Contact: http://www.jsonline.com/news/editorials/submit.asp Website: http://www.jsonline.com/ Details: http://www.mapinc.org/media/265 Authors: Jacqui Seibel and Dan Benson PAINKILLERS MAY BE FUELING HEROIN BOOM, OFFICIALS SAY The spike in people addicted to prescription painkillers has evolved into an alarming new trend: increasing heroin use. The Waukesha County medical examiner reports more heroin overdose deaths so far in 2008 than in any recent year, and law enforcement officials throughout the Milwaukee area say heroin use is on the rise, an increase they attribute to people addicted to oxycodone or hydrocodone graduating to the stronger opiate. Waukesha County Deputy Medical Examiner Kris Klenz said that the most heroin deaths recorded in the county came in 2006, when there were three. But this year, there already had been four by June 30. Two of those victims were 19; the others were 22 and 28. Milwaukee County has had three heroin deaths through June 30, according to figures released from the medical examiner's office. Those who died were 21, 24 and 40. Klenz cautioned that the number of heroin-related deaths is likely under-reported in some cases because heroin metabolizes quickly in the blood. The drug can appear as an overdose of morphine in some autopsies, she said. Unless a specific metabolite is found in the body, the most a medical examiner can do is rule that the death was caused by an opiate, she said. "We are limited by science," Klenz said. Law enforcement, however, can link heroin to a death investigation by other factors, such as the presence of the drug or witnesses at the scene. Capt. Charles Wood, who heads the Waukesha County Metro Drug Unit, expects to see more Len Bias cases, referring to the law that enables authorities to prosecute people who supply drugs that contribute to an overdose death. The law is named after a University of Maryland basketball player who died of a drug overdose in 1986. Luke J. Bandkowski, 28, of Genesee was charged in April in Waukesha County Circuit Court with first-degree reckless homicide in the death of Joshua J. Carroll, 26. According to a criminal complaint, Bandkowski is accused of supplying heroin to Carroll in December. An autopsy showed that Carroll died of "opiate intoxication." Wisconsin mirrors nation What southeast Wisconsin is experiencing now mirrors a national trend in which users of highly addictive prescription painkillers turn to heroin when the "oxy" pill is not available, Wood said. The difference between drug users today and those of years past is that users a decade ago may have started with marijuana, then progressed to more addictive and dangerous drugs, such as cocaine, before trying heroin -- a process that may take years. Today, users start with prescription painkillers, then move on to heroin, which is cheaper than oxycodone or hydrocodone, Wood said. Oxycontin, which is a brand of oxycodone, costs about $1 per milligram, making a 40-milligram dose worth $40. Heroin, on the other hand, costs $10 to $20 per dose, according to law enforcement authorities. Drug overdoses overall have increased in southeast Wisconsin, doubling in Washington, Ozaukee and Waukesha counties from 2003 to 2007, according to figures released by medical examiner's offices. The increase of heroin use has not diminished the use of marijuana and cocaine, Wood said. What is frightening is that "heroin is an end game," Wood said. There are few options for someone addicted to heroin -- the result is death or a difficult rehabilitation with a lifetime of potential physical problems. Ozaukee County was hit by a series of highly publicized heroin-related deaths, including that of 17-year-old Angela Raettig of Cedarburg in 2005, that helped lead to the arrests of Benjamin Stibbe and his mother, Teri Stibbe, and several others. . The Stibbes were cited in a federal case as being the primary conduit for delivery of heroin to users in Ozaukee County. Dave Spakowicz, a special agent with the state Department of Justice who heads the federally funded Milwaukee High Intensity Drug Trafficking Area Heroin Initiative, said heroin use in the area dropped for a time after the Stibbes' case, especially in Ozaukee County, but only for a short time. "That shook a lot of kids and led to some introspection by some of these kids like, 'I don't want to end up on a slab or (in prison) like Ben Stibbe.' Unfortunately, there has been a significant increase in heroin use and heroin-related incidents in the last nine months," Spakowicz said. Spakowicz said officials can only estimate the number of heroin users in the five-county area. One estimate says the number of heroin users is typically four times the number of those in methadone treatment. Methadone is a synthetic opiate used to help recovering addicts fight withdrawal symptoms. Spakowicz said there are as many as 1,800 people in methadone treatment programs in southeast Wisconsin, which would put the estimate at more than 7,000 heroin users. Ozaukee sheriff's Detective Jeff Taylor, who is assigned to the Ozaukee County Anti-Drug Task Force, said the Stibbes have been replaced by several people. "As unfortunate as it sounds, I wouldn't doubt that we wouldn't experience an overdose (death) again. The heroin, OxyContin and prescription pills are readily available in the county and being used by a number of younger persons in the county," Taylor said. "I don't know why we still have kids experimenting with heroin. I think they have the same 'it's not going to happen to me' attitude." - --- MAP posted-by: Richard Lake