Skyrocketing heroin use in Central Oregon
Painkillers can be the gateway

Ian Wilson liked the way heroin made him feel the first time he tried it.

“It was like an instant warmth all over your body,” he recalls. “It just felt amazing.”

The Bend man had been buying prescription painkillers on the street for months, a gateway into a world of needles and blackened spoons.

“I started hanging out with the worst of crowds, I guess,” he said.

Despite several near fatal overdoses — including a trip to the emergency room — Wilson, 22, continued to use heroin for months. Then one last night in October 2012, alone at home, he shot up with heroin and knew immediately he was in trouble. The feeling was too intense. He grabbed his phone. It took two tries to text his friend a two-letter cry for help: OD.

“Are you ODing now?” his friend texted back.

Wilson never answered. And his friend never came to save him.

It was more than 13 hours before his older brother, Bryce, found him and called for help. Wilson had vomited, aspirating the vomit into his lungs. The heroin had slowed his breathing, cutting to a bare minimum the supply of oxygen to his brain. At the hospital, doctors told Wilson’s mother, Jain, they didn’t expect him to make it. Starved of oxygen, his brain had endured too much damage. The doctors were ready to turn off the ventilator keeping him alive.

“They told us he had zero chance of survival,” she said. “We had picked the date of death.”

But a simple test by a neurologist suggested Wilson still had a chance to recover. For more than four months, his mother watched her son make agonizingly slow progress, regaining feeling first in the tip of his finger, then his knuckle, then a hand and an arm.

More than a year later, Wilson is still battling to regain the use of his legs. He came as close as possible to a fatal heroin overdose without dying, narrowly avoiding adding his name to growing list of casualties that has gone largely unnoticed in Central Oregon.

“It’s horrible,” Wilson said. “Our generation is a horrible place to be because everybody is doing heroin.”

Heroin use has skyrocketed in Central Oregon over the past five years, fueled primarily by individuals addicted to prescription drugs looking for a cheaper, more readily available alternative. Local law enforcement, medical personnel and addiction specialists have all reported increasing incidents involving heroin, and overdose deaths continue to tick higher each year.

According to records from the Oregon State Medical Examiner, there were two heroin overdoses in Deschutes County over the five-year period from 2002 through 2006. From 2007 through 2012, there were 11 heroin deaths in Deschutes County and one in Crook County. Statewide, heroin overdoses increased from the 90 to 100 range 10 years ago, to more than 140 deaths both in 2011 and 2012.

“I would say it’s an epidemic, but it’s more like a plague,” said Crook County District Attorney Daina Vitolins.

Vitolins said there were at least two heroin overdoses in Crook County in the last month.

“Just last Saturday an 18-year-old was transported to Pioneer Memorial Hospital from a heroin overdose,” she said late last week. “It’s cheaper than prescription drugs and it’s easier to get.”

Both Vitolins and Deschutes County Deputy District Attorney Steve Gunnels say they’ve seen a significant increase in the number of heroin cases coming across their desks in the past five years.

“I used to never charge for heroin possession. It was maybe once every three years,” Gunnels said. “But we’re getting cases now because paramedics get called to an overdose and show up to find someone with a needle in their arm.”

Gunnels said he’s prosecuting more people for having a “substantial quantity” of heroin. According to Oregon statute, being in possession of more than five grams of heroin constitutes a substantial quantity.

“We’re seeing cases with half-ounce or ounce quantities now,” he said. “Typically, people from here go to Portland to buy quantity and then break it up to sell.”

Lt. Paul Kansky with the Central Oregon Drug Enforcement Team said the amount of heroin confiscated in 2013 was slightly less than in 2012, but agrees heroin use appears to be on the rise.

“We don’t have the amount here that somewhere like Portland will have, so it takes only one really large bust to skew those numbers,” he said. “Our 2013 numbers were lower, but it’s still on the rise and at a level that is concerning to us.”

Supply and demand

The current surge in heroin use may be the unintended consequence of steps taken to stem other forms of illicit drug use over the past decade. New initiatives to combat methamphetamine production and sales cut supply of the drug at the same time the medical community was making a conscious effort to treat chronic pain more effectively. That flooded the market with prescription opioid painkillers, which teens and young adults began to pilfer from their parents and grandparents for recreational use. When authorities began to crack down on rampant prescribing of opioids, many of those addicted turned to heroin instead.

Research from the federal Centers for Disease Control and Prevention shows that some 77 percent of heroin users report first using prescription opioids, and that 18- to 25-year-olds transitioned from opioid use to heroin use more than any other age group.

“It starts out with Vicodin, Percocet, Oxycontin, and kids that are 18, 19, 20 years old who don’t think there’s any problem with them taking prescription painkillers,” said Jason Koland, a 29-year-old former heroin addict. “Their body gets so physically dependent on those and it gets so expensive to buy the prescription drugs, so you go to the next best thing, which is heroin.”

Koland, 29, came to Bend to escape the surroundings in Lake Tahoe, Calif., that led to his heroin use. Sober for more than three years, he is now a program coordinator for the Central Oregon Men’s Center, a faith-based residential recovery program in Bend run by Teen Challenge Pacific Northwest. Four out of five students come to the center because of their heroin use.

Koland said it took only two to three weeks of using prescription opiates before he was hooked.

“It started as recreational use, and I liked the way it made me feel,” he said. “The next thing I knew I was fully addicted to it.”

Koland sold drugs to pay for his habit, but when the supply ran scarce and he realized heroin was 10 times cheaper, he made the switch.

Oxycontin pills sell on the street for about $1 per milligram, $80 for an 80 mg pill, $40 for a 40 mg pill. Taking two to three pills a day, as Koland did, can add up quickly. Heroin, on the other hand, sells for $20 for a tenth of a gram, or a point.

“It’s just a matter of time before somebody offers you the heroin or you know where you can get it,” said Barrett Hamilton, a recovery mentor at Best Care Treatment Centers in Redmond. “And even though you may have already said, ‘I’ll never do heroin,’ when you get sick from not having the pills, it’s just a natural progression. It’s cheaper, it gets you high, and it works better than the pills. And it’s easier to get for the most part.”

Hamilton, a recovering heroin addict himself, said at least two-thirds of the clients coming through Best Care have heroin addictions. Most are younger than 30, men and women generally from middle-class or higher-income families who would otherwise be in school or starting a career but stumble down the pathway of addiction.

“They become so helpless. Once their whole life depends on the heroin, they’ll do anything,” he said. “You find people hitting their bottoms a lot quicker. You can keep a meth addiction going for a long time before things get as bad as a heroin addiction will take you in a short amount of time.”

Fatal attraction

Heroin is as addictive as cigarettes, says Best Care director Rick Treleaven. “There’s not a lot of people doing heroin recreationally for very long,” he said.

Moreover, addicts quickly build up tolerance to heroin, and require larger or more frequent doses to satisfy their cravings. It makes for a hellish withdrawal experience, and relapse is a constant worry.

Heroin, he says, also has a much higher risk for overdosing than many other illegal drugs.

For one, there is tremendous variability in the potency of heroin sold on the street. Sellers often mix additives into it to increase the amount they have to sell. That makes it difficult for addicts to tell how much actual heroin they’re injecting. Addicts taking an 80 mg Oxycontin pill know they’re getting 80 mg of the drug. But those taking a tenth of a gram of heroin can’t always be sure of how much of the drug is in there.

In other cases, the additives themselves can be fatal. Officials in Maryland, Michigan and Pennsylvania are currently investigating more than 50 deaths linked to heroin laced with the powerful painkiller Fentanyl.

Hospital emergency rooms are often the first to know when a more potent product comes into the region.

“My experience is it comes in waves. It will be like three, four cases in a row,” said Dr. Bill Reed, an emergency room physician at St. Charles Bend. “So then you kind of know there is something new in town.”

But most often, addicts get into trouble when they relapse after treatment or being in jail, and don’t adjust their doses.

“If they’re clean for 30 days and their tolerance level goes down, and then they go back out on the street and they try to use at the same level as when they went in, that will kill them,” Treleaven said.

Oregon state officials are preparing to release a new report on overdose deaths in March or April that shows while the number of opioid deaths is dropping, heroin deaths have not declined.

“For heroin, you can see a significant difference in rates for fatal versus nonfatal overdose,” said Tom Beran, program coordinator for the Oregon Prescription Drug Monitoring Program. “People tend to die versus get hospitalized for heroin overdose.”

It’s easier for health officials to intervene with prescription drug abuse because they can regulate physicians’ prescribing and pharmacies’ dispensing. But focusing solely on shutting down the supply without considering what will happen to those addicted to drugs may be what’s driving the increased use of heroin.

Beran said officials are wary of pushing prescription drug abusers to trade one addiction for another. The solution may lie in moving further upstream and preventing individuals from becoming addicted to opiates in the first place.

“The whole point is not to create a population of people with addiction dependencies,” he said.

Dr. Christopher Jones, an addiction researcher with the CDC, said health officials must realize that the prescription opioid and heroin problems are related when trying to address them.

“The inappropriate prescribing of opioids is what has created and is driving the problem. Over the long term, you’ve got to change that,” he said. “But there is a cohort of people who are dependent and addicted to prescription opioids, and simply not prescribing to them is not going to change their addictive behavior. You have to make sure you have systems in place for addressing that population.”

Many believe that must start even earlier, intervening with potential addicts before they start experimenting with any drugs.

“If you’re getting into prescription drugs and heroin you started somewhere before that,” said Laurie Wilmot, a licensed clinical social worker in Bend. “You’ve got to get used to getting high. You’ve got to get pretty confident. You don’t just try heroin when you go to your weed dealer the first time.”

Jain Wilson said she was surprised how the widespread heroin use in Central Oregon seems to fly under the radar. After her son’s overdose, she began to meet more and more people with a family member who had used the drug.

“Everywhere I went, I would hear a story,” she said. “I was amazed, because nobody is talking about it.”

Bend’s heroin problem certainly doesn’t rise to the level of that of a major city. Former addicts say most of the local supply is coming from Portland. Dealers can buy a gram of heroin there for $50, and resell it for $200 in Central Oregon, financing their own drug habit in the process.

“You can’t walk down the street in Bend and buy drugs like you can in Portland. That is a big difference,” Koland, the Men’s Center program coordinator, said. “But any person who has an addictive personality, they’re going to find the drugs regardless of the town.”

Locals say those transporting heroin often avoid the Interstate 5 corridor, which has a higher police presence. That makes Bend a routine stop along the route from Los Angeles to Seattle, bringing more product into the region.

“The average normal person has no idea of the extent of the heroin here in Central Oregon,” Hamilton, the Best Care mentor said. “The parents of teens or people in their early 20s, they have no idea that this is going on. It’s going on right under their nose.”

—Reporter: 541-617-7814, mhawryluk@bendbulletin.com

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