Heroin hits home • Examining the local response
He was already a bit of a controlled substance aficionado. He had been smoking marijuana since age 14, and eventually he dealt it, too; and he started taking opiate painkillers like Vicodin to deal with broken bones. In fact, he tried just about every controlled substance in the book – mushrooms, Ecstasy, Molly, alcohol, cocaine, hallucinogenic drugs and, accidentally, methamphetamine.
His is a story being repeated every day.
“I didn’t become addicted to drugs – the only thing I was addicted to was making money,” he said. “I always told myself that I would try everything once,” he said.
Once changed everything.
He was hanging out with a friend, a registered nurse from another state, who knew Smith sold drugs and asked him if he could find some Mexican black tar heroin. The friend had some, but wanted more. Then, the friend went out of the room and came back with hypodermic needle and a spoon of heroin. That’s when once happened – the friend shot Smith up.
“It was something like I never, never … you’ve heard the term ‘chasing the dragon,’ the first time you use, and especially with a needle because that’s unusual,” Smith said in an interview with Mid Rivers Newsmagazine. Now 21, he’s been off heroin for almost a year, but in the interview, he’s trying to explain why – why, when the potential consequences are so dire, do people use?
“It was just a rush that came over my body, total euphoria, a chill goes down your spine. The first time you use it, it’s not even about pain or relief or whatever the hell,” he said. “The feeling is better than sex; that’s how I can explain it.”
That first time, he had a hard time walking; he said he almost blacked out.
“I don’t know if I realized it at that point, but from that second I was hooked,” he said.
To Juan Wilson, a U.S. Drug Enforcement Agency task force officer assigned to St. Charles and St. Louis counties, Smith’s story is a familiar one. Tattooed and with a dark beard, Wilson now looks more like the former undercover cop he was rather than a former city of St. Charles police patrolman. In his current role, he works state and federal drug cases and assists local police.
“I get to see a little of everything,” Wilson said, sitting down for an interview at the St. Charles police station.
He said chasing that first high explains much of the rampant ongoing substance abuse taking place now. And heroin, an opioid drug synthesized from morphine and a natural substance extracted from the seed pod of the Asian opium poppy plant, lends itself to that chase like no other drug.
When heroin enters the brain it’s converted to morphine. “When the opiates hit those opiate receptors in the brain it breaks the barrier of pain, so you don’t feel pain anymore,” Wilson said. “Physical pain, it blocks that and emotional pain.”
The rise in heroin use in recent years has occurred alongside the increased availability of powerful and addictive opiate-based prescription painkillers such as OxyContin and Vicodin. The drugs are commonly abused themselves and can be a stepping stone to heroin.
A perfect storm
The coupling of cheap and potent heroin and prescription painkillers has led to a perfect storm. Authorities are calling opiate abuse a public health crisis that has swept much of the nation, particularly the St. Louis area. The term “heroin epidemic” is becoming commonplace.
“We’re seeing heroin overdoses in kids 16 to 17 years old,” said Brandon Costerison, a public awareness specialist with the National Council on Alcoholism & Drug Abuse – St. Louis [NCADA].
Between 2007 and 2015, 2,844 people died from heroin and opiate overdoses in the city of St. Louis; St. Louis, St. Charles, Jefferson and Franklin counties in Missouri; and Madison and St. Clair counties in Illinois, according to statistics gathered by NCADA.
For seven of those eight years, the death toll rose above the previous year. For example, 49 people in St. Louis County and 14 in St. Charles County had fatal heroin and opiate overdoses recorded in 2007. By 2014, that death toll had reached 151 in St. Louis County, and 40 in St. Charles County.
The death statistics don’t mention the number of heroin-related calls and overdoses that emergency responders handle each year. Since 2013, the St. Charles County Police Department alone responded to 323 heroin-related calls and 84 heroin overdoses – and that’s just one police department in one county.
“Certainly this is the biggest drug-related crisis we’ve had in our country – far more people are dying from heroin and other prescription opioids than ever died from crack or methamphetamine and the diversity of people it’s killing is far wider,” said Howard Weissman, executive director for NCADA in St. Louis. He said the heroin epidemic is so much a public health emergency that all federal health-related organizations are re-examining their responses to it.
“We’re 4.2 percent of the world’s population and we consume 80 percent of all opioids,” Weissman said. “Clearly America has an opioid and heroin problem.”
It’s a problem that has many complicated layers that don’t peel apart easily.
Heroin in the suburbs
How did this happen? That’s the question a great many people are asking. Some blame the medicine cabinet.
Opioids have been used for millennia to treat pain. In the mid 1990s, prescription painkiller use began to increase. Abuse of prescribed medications was high enough in recent years to prompt the federal Centers for Disease Control and Prevention [CDC] to recently issue prescription guidelines to physicians.
Pharmaceuticals can be a gateway to heroin. Eighty percent of the people who use heroin start with prescription pain pills because they’re so available … and pharmaceutical abuse is beginning at younger and younger ages, Costerison said.
Health care providers say they noted an increase a few years ago in “pharm parties” featuring pills raided from parents’ medicine cabinets and dumped into a bowl for sampling. While prescription opioid pain medications like OxyContin and Vicodin impact the brain similar to heroin, Wilson, Costerison and other authorities say heroin is cheaper and easier to get. Heroin also has a stronger effect on the brain than prescription pills. One thing easily can lead to the other. Still, the arrival of heroin in the suburbs in mass is recent.
“I think you could go back probably five years and if you talked to average people in our community and you asked them if our community had a heroin problem, I think most people would get a funny look on their faces,” said Tim Lohmar, the prosecuting attorney for St. Charles County.
Lohmar, Wilson and others say Mexican drug cartels began flooding the St. Louis area with large amounts of a purer, more potent heroin around 2008. Ironically, the effectiveness of drug enforcement efforts may have helped push the cartels into planting poppies. Seizures of shipments of cocaine and marijuana were up in the early part of that decade.
“The cartel, they’re business people, they provide a product, and they were providing cocaine into the United States,” Wilson said. “But once you lose a product, you just replace it with another.”
Methamphetamine, another drug scourge in recent years, can be locally manufactured – often a “mom-and-pop-type operation,” Lohmar said. “You can trace that it [heroin] is directly related to the Mexican cartels who use local gangs in the metropolitan area as their distribution networks,” he said.
Soon local medical examiners were seeing younger and younger people drawn to heroin.
“At first, the cause of death was ‘myocardial infarction’ but we started to see a lot of 18- to 25-year-olds dying from ‘heart attacks,’” Wilson said. “[Medical examiners] started to look into [it] a little more and they were finding heroin in their systems at levels that were lethal. They started classifying those deaths as heroin intoxication.”
The allure of heroin also is strong because it is cheap and pure. The drug is sold as “buttons” or “beans” for as little as $5 to $10 each. The low cost is leading to the surge in overdoses and crime. Ten years ago, street heroin had a 6- to 10-percent purity. The new stuff is 50-percent to as high as 80-percent or more pure – so potent that authorities say fatal overdoses can occur if heroin is used just once. Users afraid of hypodermic needles can snort, smoke or swallow it.
Because the addiction is so strong, people often do almost anything to get the drug.
“Your tolerance builds so quickly that the little baggie you got [one week], a week from then you’re going to need two of them, two weeks three or four,” Smith said.
“The statistics vary but I would venture to guess that 75 to 80 percent of our property crime cases – burglaries, stealing, forgeries and stuff like that – involve someone addicted to controlled substances, and most of the time it’s heroin,” Lohmar said.
Wilson tells the story of a heroin addict arrested three times in 24 hours in St. Charles for stealing things to trade or sell to a dealer. She was caught at a Radio Shack and released, and a few hours later at a Walmart where she was stealing baby clothes to trade with her dealer. Ten hours later she was picked up at a Schnucks supermarket.
“The last time she shoved a turkey underneath her shirt because she was going to trade the turkey with her dealer for heroin,” Wilson said. It was close to Thanksgiving.
The statistics don’t mention other victims – namely the survivors. Wilson has been meeting and working with overdose victims and families since 2010. He also meets with families of people who weren’t so lucky.
“After someone overdoses and dies from heroin or drugs that person is dead and there really is nothing that you can do for them,” Wilson said. “But the family that’s left in the wake of that destruction and addiction, they need help.”
Many of those introduced to opioids aren’t bad people, he added. Many times they simply made a bad or inadvertent choice.
One overdose victim he interviewed was a union worker who hurt his back hauling concrete with a wheelbarrow and who had to take six prescription pain pills each day.
“A buddy of his said ‘I’ve got a medication for you that you only have to take once a day,’” Wilson said. He took the pill. “It was heroin. His buddy never told him.”
The long road to recovery
Smith was never afraid of needles. He paid attention to how the registered nurse used a tourniquet, heated the drug in a spoon and found a vein. Taking the drug intravenously gave him a better high, he said. He thought those sniffing the drug were wasting their money.
Then, the unraveling began.
“At that point, everything in my life started falling apart – and quick,” Smith said. A good student and athlete, he soon lost his job and girlfriend, left community college and was arrested for driving while intoxicated. He pretended to be a friend long enough to get a dealer’s telephone number.
At first, he had money in the bank and heroin wasn’t expensive. When that changed he stole from his mother’s purse and his dad’s wallet. He never pawned his possessions. Sometimes he and other users would steal something from a Lowe’s or Target store, return it, get a gift card, and sell the card in the parking lot. He became a liar.
“We knew he was doing drugs, [but] when we would ask him he would deny it,” his mother said. They couldn’t prove it.
“It kind of became a matter of waiting – waiting for him to be in the hospital, for him to die, for him to get in trouble with the law,” she said.
At one point, deep into his addiction, Smith had a striking epiphany.
“I remember one time I was in my room and I was cooking up the dope,” he said. “I was crying and I remember a tear dropping into the dope.” He paused for a moment.
“It was really tough because to be honest I didn’t want this,” he said. He was only doing it to avoid the painful symptoms of withdrawal that would sicken him without a new fix. “I was using …” He stopped. His mother, sitting next to him in the interview finished his sentence. “… so I could function,” she said.
Stints in rehab cleared the poison out of his system only for him to relapse once he was outside. Eventually, that also ended.
“It was just … you wake up and you get tired of feeling sick every freaking morning,” Smith said. He said he got tired of the hassle that had become his everyday life – waking up sick, calling up lots of people, finding a ride and trying to find a dealer. “Not a second of your day goes by until you get your fix,” he said.
Smith is now back at community college studying for his business degree.
“I can sit in class without shaking uncontrollably, without people looking at me and thinking ‘what’s this kid on,’” he said. “It does get better, it does get easier, and you don’t have the cravings. It’s something I will have to deal with the rest of my life.”
He said he didn’t like some of his earlier rehab counselors, but a support group like Alcoholics Anonymous has helped because he can talk to people who have had a similar experience. He’s cut himself off from past friends who were part of his earlier life.
For his mother, getting help hasn’t been an easy journey. Having health insurance helps but treatment can cost thousands of dollars. She and his father say they have made peace with these issues, because drug addiction is a disease. “If he had cancer, we would do anything. If he had diabetes, we would do anything. How is this any different?” she asked. “The gift of a child is a gift, so treasure it, protect it and try to help.”
She said her family was blessed that Smith’s story didn’t end like so many others.
“But we know every day he has to wake up and he has to make a choice,” she said. “And we’ve made a choice to be there and walk with him through this.”
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This is the first in a multi-part series on the local response to the heroin epidemic. Watch future Mid Rivers Newsmagazine editions for the continuing story.