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HEROIN: IT'S HERE, AND THERE ARE CONSEQUENCES

Today, heroin is cheaper and, being illegal, easier for addicts to obtain than prescription painkillers.  The consequences - a dramatic nationwide rise in overdose deaths since last year, increased thefts and related crimes, crowded jails, overtaxed social services - are not just making headlines across the country and in the neighboring counties and cities of Virginia's Piedmont.  They're here.  "It would be a mistake to think Rappahannock County is somehow immune," said Virginia State Police Captain Gary Settle, a Rappahannock native who heads the VSP's Bureau of Criminal Investigations at its Culpeper Division headquarters, at a roundtable discussion and interview last week with the Rappahannock News - a forum attended by Rappahannock County Sheriff Connie C.  Smith and other state police special agents and investigators who lead VSP's drug-enforcement efforts in the region.

Two months ago, Culpeper County Sheriff Scott Jenkins reported 20 heroin-related deaths since the start of 2013, and more than 100 overdose cases.  In the northern Shenandoah Valley counties and towns covered by VSP's Northwest Virginia Drug Task Force, task force coordinator Special Agent Jay Perry said last week that his region recorded 21 overdose deaths in 2013 and more than 100 cases in which the heroin-neutralizing drug naloxone, more commonly known as Narcan, had to be administered.  ( "Otherwise that number of deaths would have been much higher," he added.  )

He added there have already been 14 overdose deaths and 24 injuries in the northern Shenandoah region in 2014.  "And those are just the cases reported to us," said Perry, who estimates that authorities are made aware of "maybe two-thirds" of drug emergencies.

Blue Ridge Drug Task Force coordinator Tom Murphy, the VSP special agent whose undercover team covers the area that includes Rappahannock, says the Piedmont region has had five overdose deaths so far this year.

Changes over the last five years to prescription painkiller laws and the pills' formulations have made them more difficult to obtain and use, according to both Perry and Murphy.

"Heroin is also less expensive," said Murphy.  "An eight-milligram pain pill can run $80.  For $20 or $25, you can get a six-or seven-hour high on heroin."

"We had a pill problem," Perry said.  "We shifted from a pill problem to a heroin problem in late 2012."

Sheriff Smith ( who dropped out of participating in the VSP's Blue Ridge task force several years ago for budget and personnel-related reasons ) has said there have been no overdose-related deaths over the last two years in Rappahannock.  But she noted that tracking such incidents is difficult.

As an example, she cited a very recent "unconscious person" call, to which she and other deputies responded.  When EMTs and deputies arrived, Smith said, family members were already present; it was clear that the scene had already been cleared of any evidence of drug use before anyone called 911.  Such scenarios have become more commonplace over the last two or three years, Smith said.

There are no hospitals in Rappahannock, either.  But even in jurisdictions where hospitals are treating overdose cases, Perry said, federal HIPAA privacy regulations inhibit EMTs and emergency room medical personnel from reaching out to law enforcement.

Though HIPAA rules specifically exempt law enforcement personnel, there is no requirement in Virginia for law-enforcement notification by medical authorities dealing with the consequences of illegal drug use.  Settle said several of the area's state legislators are aware of the issue, and hopes the laws can be changed during the General Assembly's 2015 session.

Other local consequences of increasing drug use, according to Rappahannock County Commonwealth's Attorney Art Goff: Over the last three and half years, he says, half of the removals in the county - actions by social services to remove children from their homes and place them into foster care - can be attributed to heroin and other drug abuse by the parents.

Last week Goff proposed a late addition to the county budget to pay for a part-time member of the Blue Ridge Drug Task Force who'd work for the commonwealth's attorney office.  The request was opposed at a county supervisors' work session last week by the sheriff - who is struggling with her own department's downsizing, and likely restructuring, with this July's opening of the Rappahannock Shenandoah Warren Regional Jail - and is not a likely addition to the 2015 budget.  But Goff believes outside help is necessary.

"Can we handle it locally? Most of the time, yes, the sheriff's office can handle the war on drugs," Goff said.  "But the equipment, surveillance and otherwise, for the modern day drug war is expensive.  And technical assistance, the kind that can analyze a seized computer on scene for example, is even harder to come by."

In many ways, the same national economic realities that are causing Rappahannock and other jurisdictions to engage in repeated belt-tightening exercises in recent years, according to Settle and his special agents, are also the cause of the increase in overdoses and heroin deaths.

Heroin is a money-maker, Perry said, and many dealers ( almost none of whom use heroin, he notes ) have gotten into the illicit business in the past several years looking for a quick fortune - and are "making it up as they go along," as he put it.

Thus heroin is arriving in the Piedmont and Northern Shenandoah - primarily from Washington, D.C., and Baltimore, respectively - with widely varying levels of purity, some of it cut with such intensifying additives such as fentanyl, a drug commonly used in hospitals to treat post-surgery pain.  The purity of the heroin ranges from 15 percent to more than 40 percent, Perry said - "and if you're used to 15 percent, and you take the same hit of a 40-percent pure product, you're going to be in trouble."

Murphy said the heroin arriving in his region, coming largely from Washington, is generally less pure than what arrives in Perry's Northwest region from Baltimore - which, unlike Washington, is a "primary distribution center." Addicts and dealers often make multiple daily trips to and from Baltimore from the northern Shenandoah to buy at the city's "wide open" street markets, Perry said.

Goff has said he believes the majority of Rappahannock's drug traffic, quiet though it seems, is coming from the north, "from Warren County and Shenandoah County and Winchester."

In Winchester, in fact, the Northern Virginia Daily published an interview this week with a 25-year-old recovered heroin addict who will graduate next week from a year-long rehabilitation program at Shenandoah Valley Teen Challenge Women's Center in Mount Jackson.  The woman, who nearly died of an overdose at Warren Memorial Hospital in Front Royal last year, attended high school in Rappahannock County, and served three months at Rappahannock's jail after pleading guilty in 2012 to breaking into and stealing from a Chester Gap home to pay for her habit.

As she told the interviewer, the drug education effort she and many others received in high school didn't leave much of an impression, admitting that she knew "absolutely nothing" about illegal prescription drugs when she tried her first one.  Within a year she was using heroin, she said.

Settle thinks the first step local communities can take is to recognize and understand the problem, and he and his task force members have organized several regional "stakeholder" meetings over the last year, inviting representatives from local, state and federal law enforcement, as well as medical and social service professionals.

"This is not just a law enforcement problem," Settle said.  "This is a societal problem, and all of us need to be working together to solve it."