Monday, May 19, 2014

Increasingly common heroin addiction overwhelms agencies

Jails, treatment facilities, drug courts and hospitals are struggling to provide the necessary help as more Kentuckians become addicted to heroin, Chris Kenning writes for The Courier-Journal: "In a state that already had a shortage of drug-treatment options, the heroin problem is badly outstripping Kentucky's ability treat it." A Kentucky Health Issues Poll found that 9 percent of Kentuckians and 15 percent aged 18 to 29 reported awareness of a family member of friend struggling with heroin.

"We're just bursting at the seams," said Karyn Hascal, who is head of The Healing Place, a Louisville drug-treatment center. "I've been around 35 years, and I've never seen anything hit this fast and this hard." Though heroin users were few and far between several years ago, now they take up 90 percent of The Healing Place's detox beds.

The Louisville jail deals with 30 to 90 inmates every day. It has hired four around-the-clock detox nurses, started new detox dorm programs and added training officers since 2012, and "increased our inmate health-care budget by hundreds of thousands of dollars," said Metro Corrections director Mark Bolton.

Heroin may be "the most addicting drug there is," said Dr. Christopher Stewart, an addiction psychiatrist and medical director at the Jefferson Alcohol and Drug Abuse Center. Heroin crosses the blood-brain barrier and becomes morphine, "binding to opioid receptors in the brain and sparking an intense rush of pleasure and euphoria—one that's far more sharp and immediate than opiate pills," Kenning writes. People become immune to its effects and need to take more of it, and withdrawal symptoms include pain, vomiting, insomnia, spasms and cravings.

While longer-term treatment for severe addictions often includes patient resident programs including counseling, Kentucky lacks this kind of care. "There are not enough open-entry detox and treatment beds in this community—I'm talking non-insurance beds," Bolton said. Dr. Eric Fulcher, an emergency room doctor said that providing emergency treatment for heroin addicts has become "the new normal" at Sts. Mary and Elizabeth in the South End. "We're so used to it, we're almost numb to it."

Although the former director of the Office of National Drug Control Policy, Gil Kerlikowske, recommended the increased availability of naloxone, used to counteract heroin overdoses, the General Assembly didn't pass a bill "that in part would have made naloxone more widely available, along with other heroin-related measures," Kenning writes.

Jefferson District Judge Stephanie Pearce Burke said that "heroin use is present in more than three-quarters of her cases." Something has to be done. "People still have the idea that it's a drug from the '60s and homeless people in the park," she said. "But the face of heroin has changed. It's suburban teens and middle-class housewives, too." (Read more)

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