Pubdate: Sat, 24 Jan 2015
Source: Chillicothe Gazette (OH)
Copyright: 2015 Chillicothe Gazette
Author: Caitlin Turner


CHILLICOTHE - For most parents, their worst nightmare is burying their child.

Marshall Frankel lives that nightmare daily. Frankel lost his 
daughter, Michelle Frankel, and his son, Benjamin Frankel, within 
months last year to overdoses involving heroin, with Michelle passing 
away in April and Benjamin in June.

"Even though it is happening, there's nothing you can do," Frankel 
said. "The biggest problem is that it is all over the U.S., not just 

Michelle, 26, and Benjamin, 32, join the list of 27 other people whom 
Ross County lost to drug overdoses in 2014. Of the overdoses, 19 
involved heroin - an increase almost five times that of 2013, when 22 
people died of overdoses and four involved heroin.

"Drug addiction isn't Darwinian," said Dr. John Gabis, Ross County 
coroner. "This isn't survival of the fittest. This is a disease."

Gabis' concerns are echoed by law enforcement. The steady growth of 
those dying from overdoses has dispatch taking about three possible 
overdose calls per week, Chillicothe police Capt. Keith Washburn said.

"Used to be you could take the map of Chillicothe and say, 'Where are 
the drug problems?' " Washburn said. "You could take a Sharpie with a 
fine point and point out the spots. If you took a map today and said, 
'Where's the drug problem?' you could take a can of paint and sling 
it on the map; that would be your drug problem. It's everywhere. 
There's no geographical boundaries; there's no socioeconomic boundaries."

The problem throughout the county is similar. Lt. Mike Preston, of 
the Ross County Sheriff's Office, said addiction knows no bounds and 
that the department has to do more to decrease the trend.

The progression to heroin as the drug of choice grew out of addiction 
to prescription opioids, Chillicothe police Capt. Larry Bamfield said.

"When I hired on in 1991, heroin had been pretty big in the '80s," 
Bamfield said. "In the '90s, we didn't see it. It was cocaine and 
crack all through the '90s, with some pills. Really, just in the last 
eight or nine years, it has come back. I think prescription pills 
based on Oxycontin with opiates, that's what has brought heroin back."

Frankel said Michelle became addicted to prescription pain pills 
after a car accident three years before her death. Frankel said he 
believes she started using heroin the year she died.

Before her death, Frankel said, Michelle graduated from vocational 
school and became certified in cosmetology. She was a mother to three 
children. Frankel's son, Benjamin, was a father to two. Frankel said 
his son was not an addict but had been going through a divorce near 
his death and "just let his guard down."

Benjamin died June 29, 2014 - 62 days after Michelle's death April 28.

"He was the best dad you've ever seen," Frankel said. "He was unreal. 
. I talked to him shortly before he died, and I told him he didn't 
sound too good."

What is being done

To fight the flow of drugs coming in from the major highways 
surrounding and running through Ross County, the sheriff's office, 
city police and the Ohio Highway Patrol have teamed up to help each 
other coordinate enforcement.

"It's like weeds, these drug houses," Washburn said. "This one 
springs up, you fix it. Another springs up, you fix that. We are 
keeping the garden presentable, but we've got a lot of weeds."

On the judicial side, Ross County Common Pleas Judge Michael Ater 
presides over the drug court, which was created as a 
court-supervised, treatment-focused diversion program for specific 
types of drug offenders.

The court allows offenders to plead guilty to offenses but have 
findings of guilt delayed for a year while they go through the 
court's program. Successful completion could result in cases being 
dismissed at the end of the year.

Jail inmates are kept free of drugs, Preston said, in preparation for 
an opportunity to go before the drug court. Sheriff George Lavender 
said $400,000 of his department's budget is used on medical costs for 
inmates in jail each year, with many related to complications brought 
forth from drug use.

Lifesaving drugs

When the city fire department arrives at a drug overdose scene, time 
is of the essence.

The drug of choice in bringing someone back from an overdose is 
naloxone, marketed under the label Narcan. Narcan can be administered 
either through an IV, a syringe or nasal spray and works to counter 
the effects of opioids.

"Usually, they come out pretty quick," Chillicothe fire Chief Jeffrey 
Creed said about overdose victims. "Sometimes they come out slow; 
sometimes they come out fighting."

During 2014, the city fire department administered 118 doses of 
Narcan. The number is almost twice that of 2013, when 68 doses were needed.

However, the fire department's numbers fall short of Adena Medical 
Center's emergency department, which administered 115 doses in 2013, 
210 in 2014 and 15 in the roughly three weeks since 2015 began.

Creed said some of the doses were used on calls of an unresponsive 
person, and emergency medical technicians and medics use Narcan in 
case the person is unresponsive because of an overdose.

Area township fire departments also carry the medication.

"The first time that I'd seen Narcan used, we had to force entry into 
a house around midnight," Washburn said. "This guy was dead, and they 
tried to find a vein on him and they couldn't find a vein. So they 
hit him intermuscular, and they brought him back. ... One of the 
things about it is, you think this person has scraped up enough money 
to get that last high, that's all they live for. Their body has to 
have it, and you're taking that away from them."

The Ross County Health District offers Narcan training to anyone 
interested through Project DAWN. The training takes five to 10 
minutes, said Kathy Wakefield, director of nursing and communication 
health services.

"We give each person trained two doses of Narcan," Wakefield said. 
"We don't have that many people coming in for the kit, unfortunately. 
Mostly, it is friends and family of someone who has an opioid addiction."

Since the training program began in February 2014, Wakefield said, 
the department has given out 60 kits. There are 200 kits available, 
and more can be ordered upon request.

When it comes to recovery, the health district offers its Vivitrol 
program. Wakefield said Vivitrol is a non-narcotic medication taken 
every 28 days that blocks the high from heroin or other opioids from 
reaching the brain. Two-thirds of the patients come to the program 
through the drug court.

The program began in March 2014 and has 40 patients who receive the 
monthly shot. Wakefield said patients are recommended to get the 
shots for one year and must take part in counseling throughout the process.

"The patient must be free of opioids or heroin for 10 days before 
stopping treatment or it will throw you into withdrawal," Wakefield 
said. "We require the counseling because, if the person does not 
change their environment, they are not as successful. Just the 
Vivitrol isn't enough."

The Ross County Jail can help inmates become drug-free before going 
in front of the drug court and then being eligible to receive Vivitrol.

Looking forward

Ross County is being considered as the pilot county for the state's 
Heroin Partnership Program, which could provide state funding and 
expertise to better track, treat and curve opioid addiction downward.

While the county proceeds with the application process, law 
enforcement continues to work with the U.S. 23 Pipeline Task Force to 
share resources such as undercover officers and investigators between 
Ross, Highland, Pickaway, Pike and Fayette counties, Preston said.

Preston said doctors and law enforcement have made efforts to monitor 
prescription pill use and the laws surrounding prescribing because 
they can spawn opioid addiction, which can lead to heroin addiction 
because it is cheaper than prescription medication.

"It used to be that heroin was a drug you worked up to," Preston 
said. "Now, it's a drug people start with."

Efforts continue to be made by law enforcement, the court system and 
treatment centers to collaborate on getting treatment to addicts faster.

"We cannot arrest away the drug problem," Washburn said. "That is not 
the answer. Law enforcement's role should be somewhat of a deterrent. 
You need a collaboration of treatment, support agencies, family. This 
whole community, everything has to come together to get rid of this."

The problem, Kathy Wakefield said, is a generational one.

"We have a whole generation who is growing up raised by their 
grandparents because they lost their parents to drug problems," Wakefield said.

Frankel is among the grandparents raising their grandchildren. He 
said he has guardianship over Michelle's three children.

"It's awful for any parent to think that it's the police's job to 
keep our kids clean," Frankel said. "The morning she died, Michelle 
called me at 7 a.m. and asked for money. I said, 'Honey no, I don't 
have any money.' I know she'd never call me at 7 a.m. because she was 
hungry. The drugs are more powerful than me or anyone can realize."

Drug deaths in Ross County

2005: 12

2006: 11

2007: 20

2008: 10

2009: 18

2010: 19 (3) heroin

2011:21 (5) heroin

2012: 18 (9) heroin

2013: 22 (4) heroin

2014: 29 (19) heroin

Note: Heroin numbers could be provided only since 2010 and are 
included in each year's total number of deaths.

Source: Ross County Coroner's Office

Naloxone, an anti-overdose drug, administered by the Chillicothe Fire 

2012: 73

2013: 68

2014: 118

Note: Numbers represent doses administered by emergency medical 
technicians and paramedics only.

Source: Chillicothe Fire Department

Naloxone Usage in Adena Medical Center Emergency Room

2012: 193 doses

2013: 115 doses

2014: 210 doses

2015 so far: 15 doses

Project DAWN and Vivitrol Program

Project DAWN is a program dedicated to training addicts, their 
friends and family members on how to administer naloxone. The 
Vivitrol program offers a drug that addicts can have injected into 
muscle once a month, and it blocks the areas of the brain that react 
to drugs, making it impossible get the feeling of being high. Both 
programs are run out of the Ross County Health District.

Project DAWN (number of those trained and carrying naloxone since it 
began in Feb. 2014): 60 kits given with 2 doses/kit

Vivitrol program (number of patients since it began in March 2014): 
40 patients currently on the monthly injection
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MAP posted-by: Jay Bergstrom