Pubdate: Sun, 20 Apr 2014
Source: Macomb Daily, The (MI)
Copyright: 2014 The Macomb Daily
Contact:  http://www.macombdaily.com/
Details: http://www.mapinc.org/media/2253
Author: Jameson Cook
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)
Page: 6

MACOMB LEADS STATE IN OVERDOSE DEATHS

First in a two-part series.

So many heroin abusers hop onto the No. 560 SMART bus to Detroit to 
buy drugs it's been dubbed "the heroin express."

"It's called the heroin express. There's not much we can do about 
it," said Roseville Police Chief James Berlin, whose city includes 
multiple popular Gratiot Avenue stops, after attempts to crack down 
on the practice.

"Yeah, the 560," sheriff's Lt. David Daniels, head of his 
department's drug unit, repeated in a tone of familiarity. "We've had 
them on that bus from Macomb Township and Chesterfield Township."

The 560's route  mostly on Gratiot from Macomb County across Eight 
Mile to Detroit -- has steered hundreds of young people down the path 
to a premature death.

Heroin and opiate prescription drug abuse has skyrocketed in the 
county in recent years, giving Macomb the dubious distinction of 
leading the state in fatal heroin overdoses over a three-year period.

Heroin began seeping into the county about 10 years ago. Its 
prevalence has progressed to the point where addiction, arrests and 
overdoses from heroin and other opiates are overwhelming.

"It's something that happening in every community," said Judge Linda 
Davis, president of the statewide organization, Fraser-based Families 
Against Narcotics (FAN), formed in 2007. "We've been screaming about 
it for the past seven years and nobody listened. Now kids are 
dropping like flies. They're not just addicted now, they're dying. We 
are getting so many calls from people wanting to get involved with us."

"I'm very concerned," said Macomb County Executive Mark Hackel, the 
former sheriff.

"It's devastating to the community," said Monique Stanton, CEO of 
CARE of Southeast Michigan. "It's disruptive to families, the school 
systems. It affects the spouse or the partner, siblings, friends, 
relatives. If the person is employed, it affects their job. It's 
affecting all aspects of the community."

Sheriff Anthony Wickersham said at least 70 percent of inmates at the 
county jail did drugs or committed a crime to fund a drug habit.

"The increase (in heroin) has been around for the past five years if 
not longer," Wickersham said. "That is a change from 10 years ago 
when powered cocaine and crack cocaine were our main focus."

Overdoses for relatively cheap heroin exceed those for the more costly cocaine.

"They are turning to heroin, which is relatively cheap. But it's also 
deadly," the sheriff said.

"It has a devastating effect on our mental health hospitals and court 
system," said Davis, a judge at 41B District Court in Clinton 
Township, where she runs the drug court.

Debby Winowiecki of Fraser, whose 20-something son is recovering from 
heroin addiction, said an addict can destroy a family and affect 
anyone who comes into contact with him or her.

"Your addict will often steal from you first and then go out and 
steal from other people," said Winowiecki, a FAN member and wife of 
the group's executive director, David Winowiecki. "They lie, they 
cheat, they steal.

"Unfortunately we have too many people who have lost loved ones. It's 
just heartbreaking."

Hundreds die from overdose

Death from heroin abuse has crushed hundreds of Macomb County 
families over the past 15 years. During the three-year period 
2010-2012, the county led Michigan in fatal heroin overdoses, with 
202, according to the state Department of Health, although the 
state's figure conflicts with the number provided by the county 
Medical Examiner's Office, which says 191 heroin overdoses took place 
over the same period.

The second most overdoses occurred in Wayne County, with 179, and the 
third most occurred in Genesee County, with 84. There were 16 in 
Oakland County.

Medical Examiner Daniel Spitz said officials are in the process of 
finalizing the 2013 overdose information. He said it appears the 
number will be consistent with prior recent years.

Since 1999, 477 people have overdosed on heroin in Macomb County, 
with gradually increasing numbers for each three-year period. Wayne 
County had the most, 807, in the past 15 years, with more than 200 in 
each three year period 2003-2005 and 2006-2008.

Renee Campion, the Fraser Public Safety Officer for schools and FAN 
treasurer, said FAN learned in late March that a handful of young 
people overdosed.

"We found that five or six kids in the area that passed (away) from 
heroin overdoses," Campion said. "Every meeting we have some parent 
that stands up and says they lost their child to heroin. It's sad. 
You think you're tackling the problem but it's still out there and 
it's still a big problem."

Macomb County Health Department Director Bill Ridella is concerned, too.

"It's a significant public health problem and a challenge to our 
community," he said. "As a health department, we are continuing to 
seek strategies to reverse this trend."

Pills-to-heroin progression

Most heroin addicts progress from popping pills such as the opiates 
OxyContin and Vicodin, officials said. They often start with Vicodin 
because it initially is the easiest to get; doctors routinely 
prescribe it for pain.

Randy O'Brien, who treats addicts as director of the Macomb County 
Office of Substance Abuse (MCOSA), described a common scenario: A 
youth or young adult gains access to pill swiped from his or her 
parents or grandparents' medicine cabinet, or is prescribed pain 
pills for a sports injury or a procedure such as wisdom-teeth removal.

"They'll use that for a while go get their buzz," O'Brien said. "But 
that source will dry up and that start looking out the streets. ... 
They'll graduate to heroin. They start snorting it and before too 
long that start using needles for the better effect. It (injection) 
gives them an immediate high."

Data supports the rise in opiate abuse. Admissions to 
county-sponsored treatment programs for heroin and other opiates has 
more than doubled in 10 years, climbing from 1,126 in 2004, to 2,045 
in 2008 to 2,497 in 2013, according to MCOSA.

Drug counselor Larry McCarrick of St. John Providence Health System's 
Eastwood Clinics substance abuse facilities, said the addiction 
problem is so out of control that treatment programs can't keep up.

"The amount of opiate addiction is far outpacing our ability to treat 
it," he said.

Macomb County, the state's third most-populous county, last year had 
the fourth most total substance-abuse admissions, 4,350, behind 
Wayne, Oakland and Genesee counties, according to the Bureau of 
Substance Abuse and Addiction Services within the Michigan Department 
of Community Health.

For heroin addiction, Macomb had the second highest percentage of 
total admissions, 37.1 percent, behind Monroe County, at 44.6 percent.

But Macomb's rate of opiate addiction admissions last year was among 
the bottom half of the state's 83 counties at 13.8 percent.

McCarrick said minimal opiate use begets more opiate use.

"They get used to it and have to do more as their tolerance builds 
up," he said.

Once the dependency takes hold, the opiate addict will do anything to 
get more because the alternative is a painful withdrawal.

"It's like the worst flu you've ever had in your life," he said. 
"It's just so painful and dramatic, they will do anything to avoid 
it, and have to do more."

When the initial sources dries up, the addict must hit the streets.

"Pills are available on the street," Campion said. "They're not 
cheap. They are expensive. But they get them. They get them from wherever.

"The pills can go from $10 to $50, depending on the milligrams. 
They're just as addicting (as heroin). I call them, 'Heroin in a 
pill,' because that's what it is."

Heroin provides a discounted high.

A single "bindle" or hit, a fraction of a gram, can cost $5 to $15 
while a single prescription pill has a street value triple that or 
more. Addicts often buy heroin bindles in bulk to get a greater 
discount. A gram roughly costs about $100 to $120, according to First 
Lt. Darwin Scott, commander of the County of Macomb Enforcement Team (COMET).

Judge James Biernat Jr., one of two circuit Drug Court judges and 
former assistant prosecutor in the drug unit, said addicts climb a 
ladder of Vicodin (hydrocodone), Percocet (oxycodone/acetaminophen) 
and OxyContin (oxycodone), among others, to the top for "smack," 
"dope," "junk."

"It's like a ladder, and the first step is Vicodin," he said. "Once 
you get addicted to the prescription drugs, it all leads down one 
road, to heroin.

"Kids like to experiment with different things, but you can't 
experiment with these drugs. It's not like before when kids would go 
to a party and drink beer. These are dangerous drugs."

Carrie Ryan, a Clinton Township-base substance abuse counselor, 
discovered the existence of "pharm parties" from young clients. Each 
person brings a pill to the fathering and drops it into a bowl; 
party-goers make their selections.

Biernat said he has learned that drug dealers sometimes provide "free 
samples" of prescription drugs at parties to introduce youths to opiates.

Most of the current participants in circuit Drug Court in Mount 
Clemens are addicted to heroin or other opiates. Thirty of the 44 
participants (70 percent) are heroin addicts while five (12 percent) 
are addicted to other opiates, according to Chief of Specialty Courts 
Lisa Ellis. The remaining nine are addicted to cocaine, alcohol or 
marijuana, in descending order. That's a 10-percent increase from 
2011 when 62 percent of participants were addicted to heroin and 10 
percent were addicted to other opiates.

Nationally, heroin use has nearly doubled from 2007 to 2012, 
according to the Substance Abuse and Mental Health Services 
Administration. Fatal heroin overdoses increased 45 percent from 2006 
to 2010, according to the Drug Enforcement Administration.

United States Attorney Barbara L. McQuade said recently the number of 
fatal overdoses nationally from prescription drugs in 2013 was more 
than six times the number of "other illegal drugs combined."

In Macomb County, in three of the four years from 2009 to 2012, 
overdoses from other drugs, including other opiates, exceeded the 
heroin overdoses, according to the Medical Examiner's Office.

Kid next door, soccer moms

The drug's resurgence from its "junkie" status among users in the 
1960s and 1970s has cut across all demographics and age groups, officials said.

Officials say many heroin-addicted youths were considered good 
students who were involved in sports and other extracurricular activities.

"The average kid we see is an honor student, an athlete, the kid that 
lives next door," Davis said. "Kids who you would never think would 
become a heroin addict."

Dr. Kevin Brody, one of several emergency room doctors at Henry Ford 
Macomb Hospital in Clinton Township, said he sees several overdose 
patients each month.

"They're getting younger and younger, in their late teens and early 
20s," he said.

Biernat recalled his first heroin case as an assistant prosecutor 
around 2004. The defendants were high school athletes and cheerleaders.

"When I thought of heroin addicts, I thought of Keith Richards," 
Biernat said. "I didn't think of cheerleaders and football players."

Biernat said studies show that a continued heroin addiction leads to 
two outcomes  prison or death.

Among five addicts who related their experiences, all started 
drinking alcohol in high school and some also smoked marijuana. They 
progressed to opiate prescription pills, and four of the five 
progressed to heroin.

Andrew Fortunato of Fraser, was an athlete and well-spoken high 
schooler who became an alcoholic and advanced to opiate prescription 
addiction following a prescription for an injury suffered in a 
bicycle accident. But he stopped short of heroin. He has become a 
speaker for FAN, ran a "recovery house" for a year and is a mental 
health technician at a hospital.

"(Opiate addiction) is usually a very gradual process," Fortunato 
said. "Nobody wakes up and says, 'I think I want to become a heroin 
addict today.' It's a slow and steady slide to the gateway of hell."

Matt, who didn't use his last name, said he started drinking alcohol 
in high school because, in his mind, "It made me bigger, stronger and 
more outgoing."

He was an avid hockey player but injured his knee his junior year for 
which he was prescribed Vicodin.

He lost his passion for hockey.

"Opiates was my first love," he said.

By his senior year, he began using heroin.

Now in his mid-20s, he has spent years in and out of rehabilitation 
centers but believes he has turned the corner.

"As soon as I lose my sobriety, I lose who I am," he said.

Another addict, "Chad" started doing prescription drugs a dozen years 
ago due to a "broken heart" when he lived in Warren.

The 29-year-old drug of choice at different times alternated between 
heroin and methamphetamine; that required him to "commit crimes" to 
fund a $100 per day habit.

He overdosed several times.

"I learned to shoot heroin while I was in treatment," Chad said. "I 
was in and out of jail in my 20s."

Chad is now in recovery, participating in the circuit Drug Court.

Officials also are seeing more middle-aged and senior-citizen heroin 
addicts who, like their youth counterparts, graduate from drugs such 
as Vicodin and OxyContin, typically prescribed for pain.

"We've arrested people in their 50's, 46-47-year-olds," said Warren 
Deputy Police Commissioner Louis Galasso said. "It's a whole new 
heroin world out there."

"This is totally difference from when you think about the junkie from 
days of old," Ryan said. "There's a whole new dynamic. There's no 
boundaries. There's soccer moms, car-pool moms, executives."

The three largest age groups for overdoses deaths in Michigan from 
2010 to 2012 were 30-34, with 115; and 25-29, with 111; and 20-24, 
with 99, according to MDCH. The next largest age groups were 45-49, 
with 90 deaths and 50-54, with 84 deaths.

Many overdoses occur when the user resumes using following a 
relatively long abstinence during a stay in a rehabilitation facility 
or prison or jail, said Dr. Tony Bonfiglio, medical director of the 
county Medical Control Authority and chief of the emergency room at 
St. John Macomb Hospital in Warren. He said users believe they can 
still handle the same amount of heroin or other opiate that they were 
taking before their time of absentia.

"But their body isn't used to it," he said.

Once snorted or inhaled, the drug doesn't confine itself to the lungs 
or blood system. Heroin and other opiates often attach to the brain.

"Too much (opiate) will make your brain forget to do things like 
breathe," Bonfiglio said.

Brody of Henry Ford said he is shocked that users are so careless in 
using "dirty needles." The addict not only can contract HIV or 
Hepatitis B and C, but is at risk for bacterial infections. The 
infection can be at the site of the injection and can become very 
serious if it reaches the heart muscle or heart valve, he said. An 
infected valve will spread the infection to other organs.

Lt. Daniels, commander of the Sheriff's Selective Enforcement Team, 
said stronger versions of heroin contribute to overdoses. Drug 
dealers try to improve their product's quality by increasing its 
purity, mixing it with a lower percentage of the "cutting agent," 
such as baking soda or powdered milk.

"The dealers want users to buy products, and they if they provide 
more potency and a better high, the users will come back," he said.

When drug dealers several years ago mixed heroin with another 
prescription drug, fentanyl, disaster resulted. Dozens of users in 
Detroit overdosed.

"You never know what you're going to get," Daniels said.

Where are they getting it?

Heroin's heightened popularity followed about 25 years of near 
dormancy, said O'Brien, of MCOSA. After an increase in the 1960s and 
1970s, it remained in Macomb County but waned in popularity in the 
1980s and 1990s as cocaine and crack cocaine took over. Ecstasy was 
popular for a stretch in the 1990s and early 2000s, when heroin began 
its resurgence.

"The heroin and opiate trade has really taken over," O'Brien said.

Scott, of COMET, the countywide drug unit, said heroin has increased 
its attraction by improving its status as a "dirty drug" years ago to 
a flexible drug today. It can be smoked, snorted or injected. "Black 
tar" heroin hasn't been seen a lot in the Detroit area, officials said.

"There's so many different ways to use it, it's cheaper, and the high 
is pretty long lasting," Scott said.

"Heroin reinvented itself and in around 2005, 2006, 2007 started to 
capture a new audience," Galasso said.

Scott said most Macomb heroin addicts purchase the drug in Detroit. 
But some heroin is sold here in "mostly street level buys," he said.

He said COMET, which consists of state police and local police 
officers, have been to crack down on Macomb's low-level dealers.

In 2011, COMET made 53 heroin arrests of 233 total arrests and 
confiscated 337 grams of heroin.

The next year, the law enforcement team made 187 heroin arrests of 
424 total and seized 147 grams of heroin.

In 2013, there were 110 heroin arrests of 299 total and confiscated 
385 grams of heroin.

The largest seizures were 206 grams of heroin in Warren, 31 grams in 
another Warren case, 11 grams in Chesterfield Township, and 35 grams 
in Detroit from a Macomb County probe, Scott said.

Ryan, the therapist, said she learned from her clients that "Detroit 
is a huge hub, but they can get it here." Clients have mentioned 
buying heroin in Mount Clemens, Warren, Eastpointe and Chesterfield 
Township, she said.

Despite the 560 bus route's multiple stops in Roseville, Chief Berlin 
said heroin hasn't been a huge problem in his city.

Still, he said, his department has surveilled the bus and made arrests.

"We do watch the buses and attempt to interdict when we can," Berlin said.

The 560 provides addicts a cheap ride to and from their seller on 
Detroit's east side, without risking a traffic stop by police, 
although they risk personal safety going into crime-ridden areas.

"I've known people that have gotten robbed and beat up," said 
Christina Szymanski, a recovering heroin addict who rode the 560 bus 
many times. "There's so many different houses" where to buy and use 
heroin, she said. "They'll meet you on the corner. They see a white 
person down there and they'll come up to you."

Addicts typically ingest heroin in Detroit moments after their 
purchase, often in an abandoned home. They often carry more hits back 
to Macomb County to "last them through the night or to the next day," 
a police officer said.

Still, many heroin users drive or ride to Detroit in a personal 
vehicle. In Warren, the number of heroin arrests resulting from 
traffic stops increased 69 percent, 209 to 354, from 2012 to 2013, 
according to Galasso.

"A lot of them (heroin dealers) open up shop just across Eight Mile 
because some addicts don't want to go too deep into Detroit," he 
said. "Our officers certainly have been proactive in identifying 
people who are higher risk. If you're driving a half-mile out of 
Detroit at 2 a.m. and your license plate shows you're from Armada, 
you're putting a target on your back.

"It's pretty easy to spot (on a person). The pupils are like pins. 
That's a sign of opiates."

Warren undercover officers also made a substantial more number of 
heroin arrests, from 51 in 2012 to 78 in 2013.

"These typically are street sales," Galasso said.

Daniels of SET, which investigates drug cases in the communities 
served by the sheriff's office, said his investigators have only 
located users and perhaps small-time dealers here.

Metro-Detroit's heroin supply comes mostly from Mexico, which is 
providing less cocaine and more heroin as opiate-addiction takes hold 
in the United States, according to Rich Isaacson, special agent for 
the Detroit office of the DEA.

"The majority of illegal drugs consumed in Southeast Michigan is 
controlled by the Mexican drug cartels, and they do control the 
majority of heroin trafficking here," Isaacson said. "These are 
poly-drug organizations. Drug trafficking is always evolving."

Heroin use is widespread, he said.

"I have no doubt that there is not a community in this area that has 
not been affected by the opiate-abuse problem," he Isaacson said. "A 
lot of people have the outdated belief that heroin is used only in 
the inner-city. That is outdated thinking. The overdose deaths of 
teens and young adults have occurred in every community."

Tributes to 15 people who have died as the result of drug overdose 
can be found on "memoriam" at the FAN website, familiesagainstnarcotics.org.

Coming Monday: College dropout who stole from her grandmother on the 
road to recovery from decade-long addiction.
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MAP posted-by: Jay Bergstrom