Pubdate: Thu, 03 Jan 2013
Source: Miami Herald (FL)
Copyright: 2013 Miami Herald Media Co.
Contact:  http://www.miamiherald.com/
Details: http://www.mapinc.org/media/262
Author: Meredith Rutland

HEROIN DEATHS CREEP UP STATEWIDE AS OTHER OPIATES BECOME TOO EXPENSIVE

Every time her son, Tod, relapsed, Maureen Barrett sat with him all
day at a rehab facility, hoping she could save him.

Tod died last spring, after years of abusing opiates - everything from
heroin to oxycodone. His death left Barrett, of Davie, to mourn the
third child she lost to drugs.

Years earlier, Palm Beach County resident Karen Perry sent her son off
to college, not knowing he'd gotten hooked first on oxycodone, and
then something cheaper and stronger: heroin.

"At some point, it became expensive to buy prescription pills, so he
started buying heroin," she said, reflecting on her son's fatal overdose.

Following a statewide war against prescription drug abuse, there are
early signs of growing heroin use as an alternative to opiate pills,
which are becoming harder and more expensive to get.

In an analysis of drug-related deaths for 2011, the Florida Department
of Law Enforcement flagged heroin as one of the year's most harmful
drugs. Heroin deaths statewide increased by 18.8 percent to 62.

Fifteen of those heroin-related deaths happened in Miami - the
second-highest number in the state, according to the FDLE report.
Orlando was the first with 18 deaths. Fort Lauderdale had three.

Historically, heroin deaths statewide are lower than they have been in
the past two decades. Deaths from the drug have been declining since a
high of roughly 270 in 2001, according to FDLE data.

Still, experts say the recent increase is worrisome. Miami-Dade drug
rehabilitation experts said they have seen a small but definite
increase in patients who have switched from oxycodone or other
prescription drugs to heroin within the past year.

"When I ask my patients, they say, 'Yeah, I couldn't get oxycodone,
and now I'm using heroin, four or five bags,' " said Dr. Patricia
Junquera, a University of Miami assistant professor of psychiatry and
a doctor at Jackson Memorial Hospital's detox unit. "I think more
people are switching to heroin."

The change could mean big problems for Miami-Dade, which some doctors
say is desperately lacking in detoxification facilities for the rich
and poor alike.

There are only a handful of facilities in Miami-Dade County that
provide detox services, both inpatient and outpatient, said Dr. Juan
Oms, medical director of Miami Outpatient Detox, and the need is growing.

"I think it's desperate at this point," Oms said. "There is so much
opiates and heroin out there."

The trend is the result of changes to state law and crackdowns by law
enforcement in recent years, in an effort to rid South Florida of its
status as the pill-mill capital of America.

After the Florida Legislature realized the state was the focal point
of a national prescription drug abuse epidemic, Gov. Rick Scott signed
HB 7095 in June 2011, which put strict restrictions on prescription
drug distribution.

The bill drastically cut back on who could dispense narcotics and
expanded penalties for pill-mill operators.

If Florida was the focus of the pill-mill problem, Broward County was
epicenter.

In 2007, the county had four pill mills. By 2009, that count had
jumped to 130, Broward Sheriff Al Lamberti said. BSO mounted an effort
to get rid of the pill mills, and three years later there were about
50 left, Lamberti said.

With some suppliers run out of business and laws preventing new mills
from opening up, the price of pills jumped. Oms said the price of 30
milligrams of oxycodone jumped from about $10 to about $30 in 2012.

Some types of heroin are as cheap as $10 a hit, and addicts are going
to pick the cheaper option without worrying about the painful detox
process, said John Schmidt, founder of the Miami-based drug
rehabilitation clinic Marvin's Corner.

Dr. Paul Adams, attending emergency physician at Jackson Memorial
Hospital, said drug trends are all about economics.

"When there's no supply," he said, "then all of the sudden you will
fall back to other drugs, heroin being the standby."

JMH detox specialist Junquera said she saw the number of heroin
patients increase by about 50 percent at her clinic during the first
six months or so of 2012. She said she sees about 25 people a week for
inpatient heroin detox.

Schmidt said he has seen a steadily increasing stream of heroin
addicts at his center. He expects the problem, growing slowly now, to
"avalanche" into a large-scale drug problem much like the nationwide
prescription drug abuse epidemic.

For Barrett, she hopes people will take notice so addicts can get help
before it's too late, as it was for her two sons and
daughter-in-law.

"The need for help for the addicts, in terms of detox and recovery,
has just risen tremendously, and of course we don't have the funds,"
she said. "I tried everything. Everything. I can't tell you how many
times my kids were in detox and rehab." 
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