Pubdate: Sat, 18 Jul 2015
Source: Orange County Register, The (CA)
Copyright: 2015 The Orange County Register
Author: Jenna Chandler


Seeking a cheaper, better high than they'd get from prescription 
pills, more women are using heroin in Orange County, mirroring a 
national trend recently reported by federal health officials.

Though women accounted for fewer than half of the 466 heroin 
poisonings last year in Orange County, they are beginning to catch up to men.

The number of women hospitalized with heroin poisoning from 2010 to 
2014 increased 2.5 times, to 119 from 48, while it doubled for men in 
that same period, according to county data provided by the Office of 
Statewide Health Planning and Development.

Across the country, the annual average rate of heroin use soared 100 
percent for women and 50 percent for men from 2002-04 and 2011-13, 
the two three-year periods studied.

It also shot up among all income groups -- 60 percent for households 
with yearly incomes above $50,000, according to a new Centers for 
Disease Control and Prevention report.

The figures are not surprising to local health officials and 
addiction specialists such as Jim O'Connell, who said they've been 
"screaming" about the problem for several years. They have noticed a 
leap in the number of people seeking treatment and fatally 
overdosing, and a shift in how heroin -- and who uses it -- is perceived.

"The percentage of adolescents with heroin addiction, it's shocking," 
said O'Connell, chief executive of Social Model Recovery Systems 
Inc., which has treatment programs in Orange and Los Angeles 
counties. "Twenty years ago, we almost never saw a kid addicted to 
heroin. That is absolutely not the case today."

The problem has grown to the point that Orange County sheriff's 
deputies, who often are the first to respond, soon will carry the 
antidote naloxone to revive people who have overdosed on opioids.

Last summer, U.S. Attorney General Eric Holder urged law enforcement 
agencies to equip officers with the antidote, saying he was confident 
it "has the potential to save the lives, families, and futures of 
countless people."

The county also is spending more money to help addicts of heroin and 
other drugs get treatment, allotting an additional $1.7 million over 
the next two years to rent more beds at detoxification and rehab centers.

Blame for the heroin boom is placed on a corresponding boom in the 
use of painkillers, often prescribed by doctors and promoted by the 
pharmaceutical industry.

In 2012, health care providers in the U.S. wrote 259 million 
prescriptions for painkillers, enough for every adult to have one 
bottle of pills, according to the CDC.

Women are more likely than men to be prescribed opioids. It's also 
harder for them to quit addictive substances, including heroin, and 
they are more susceptible to relapse, according to Harvard Health Publications.

Adults and children are so comfortable with prescription opioids, 
they have become blase about heroin too, experts say. It's no longer 
perceived as a "hard" drug, and teens talk as casually about it as 
they do marijuana. It has even been given pot's old street name, "dope."

In most cases, experts say, heroin has become a fallback for opiate 
addicts who can no longer afford, or find, prescriptions.

It offers a similar, and sometimes more euphoric, high at a cheaper price.

It can cost up to $100 a day to stay high on pills, while a balloon 
of heroin offering an eight-hour high is about $35, said Mike 
Darnold, who runs interventions with families and a 24/7 hotline for 
students at Dana Hills High School in Dana Point.

Several years ago, treatment specialists and law enforcement 
officials realized that the new face of heroin use in Orange County 
was a well-off white male living in the hills or along the beach. 
That was a shift from 20 years ago, when a heroin user was more 
likely to be from a lower-income neighborhood.

With more data to show heroin is finding a home in the suburbs 
nationwide, some in Orange County are hopeful that more might be done 
to try to change the culture around heroin, similar to the 
anti-tobacco campaigns of the 1990s.

"We need a concerted, committed societal effort to make the use of 
recreational psychoactive substances uncool," O'Connell said.

Darnold agrees, saying combating opioids cannot be done in emergency 
rooms or rehab.

"The only way to change or reduce this epidemic is to change the 
culture," he said.

Grass-roots efforts are underway to raise awareness about the 
prevalence of prescription drugs and the swell of heroin use in 
Orange County. But community forums, presentations and workshops, 
documentary screenings and classroom education are barely chipping 
away at the problem -- the number of opioid overdose deaths is going 
up, not down.

Opioid overdoses caused the deaths of 263 people in Orange County 
last year -- 90 of them a result of injecting morphine or heroin. In 
2013, 246 people died of opioid overdoses, including 59 who had 
injected morphine or heroin, according to data provided by the coroner.

 From 2011 to 2013 in Orange County, 70 percent of all overdose 
deaths investigated by the coroner involved opioids. Of those, more 
than half were caused by prescription drugs, 17 percent by heroin, 
and the remainder by some combination of the two and/or alcohol, 
according to the Orange County Health Care Agency.

Darnold agrees there needs to be a culture change. He said that 
although he has managed to do that at Dana Hills, not enough is being 
done elsewhere in the county.

"Our substance abuse incidents are way down," he said. "Our kids 
still smoke dope and do drugs. Just not at school."

In Dana Point, where Darnold works, more residents die per capita 
overdosing on drugs and alcohol than in any other city in the county: 
nearly 34 of every 100,000 residents, according to the Orange County 
Health Care Agency.

The 2012 death of 18-year-old Huntington Beach High School senior and 
varsity lacrosse player Tyler Macleod from a heroin overdose put the 
spotlight on Huntington Beach.

About 80 residents demanded the City Council tackle the problem, 
which they said had largely been ignored.

A Huntington Beach police unit made up of six undercover officers is 
working to dismantle distribution networks.

In August, an officer will start work full time with a countywide 
narcotics task force. Police also have collected thousands of pills 
dropped off voluntarily for destruction, said chief Robert Handy.

Officers responding to overdoses no longer treat the cases as 
strictly medical. They now try to find the source of the heroin, he said.

But, Handy said, he fears "the problem will become worse," because of 
Proposition 47, which downgraded the possession of heroin for 
personal use to a misdemeanor. There's little incentive for people to 
seek treatment because they're no longer facing serious consequences, he said.

"Treatment and prevention are the answer, not just arrest and 
enforcement, but that's a critical component," Handy said. "There 
have to be consequences, and people need incentives to get into treatment."

When it comes to prevention, Mitch Cherness, with the Orange County 
Health Care Agency, said it's tough reaching people who are not 
already aware there's a problem, he said.

"A lot of people who attend these forums are kind of aware already. 
The people that are not aware just stay unaware until it affects them 
personally," Cherness said. "A lot needs to be done, and change is slow."
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