There’s a story you hear in small towns and big cities all over the country. It goes like this: a lot of people get addicted to prescription opioid pain killers like oxycodone. When they can’t get those anymore they turn to heroin because the experience is similar and heroin is cheaper and easier to get. Much of the United States is now experiencing what is widely being called a heroin epidemic.
In Idaho we have the first part of that story. Walter Bogucki is an inpatient counselor at Port of Hope, a drug treatment center in Nampa.
“About the last two years is when we’ve seen the opiates take off,” Bogucki says. “Right now opiates is our number one, even above methamphetamine.”
Port of Hope can have 35 outpatient clients at a time. It has a dozen beds for inpatients and three detox rooms, which look like the smallest motel rooms you’ve ever seen. Bogucki says it takes five or six days to detox from opiates.
“[Addicts] just come in and shake and bake,” he says. “They detox without medications. Opiates is one of the worst detoxes. You wish you would die.”
Where Idaho is now with heroin
Bogucki says while prescription opioids are now the drug of choice for the most Port of Hope patients, recently they’ve seen an increase in people coming in for heroin addiction. We spoke to several drug treatment facilities in southern Idaho and most said something similar.
But we don’t have a clear picture of what happens in drug treatment centers. The Idaho department of Health and Welfare only gets numbers from a handful of them that use some specific public funding sources. At those, people getting treatment primarily for heroin increased by more than 50 percent from 2014 to 2015.
Treasure Valley hospitals are also noticing an increase. A spokesman for St. Alphonsus Health Systems says they don’t have clear numbers but all their Treasure Valley emergency departments are seeing more heroin overdoses.
“We have seen a steady but modest increase . . . in the number of heroin overdoses and heroin-related problems in the last few years. One thing to point out that I have heard from multiple sources in both our Ada and Canyon County ERs is that methamphetamine is still a major issue, and continues to be one of the larger problems when it comes to drug overdoses and drug-related issues.” - Josh Schlaich, St. Al’s
Law enforcement agencies are also seeing more heroin activity. Bill Lutz is in charge of the DEA office that covers southern Idaho.
“Right now we’re blessed in this state that we don’t have the problems that some of the other states surrounding us have,” Lutz says. “Is there more heroin today in Idaho than there was six years ago when I came to this office? There is. There has been a measurable increase in both availability and use.”
But Lutz says the number of heroin seizures in Idaho and the amounts involved in those seizures are still small in comparison to those for other drugs. Meth, he says, remains the top concern for his office.
“When we look at the quantity of heroin involved in a typical case, it pales in comparison to Portland or Seattle or even Anchorage Alaska,” Lutz says. “Part of that is going to be demand. Part of it is also going to be cost. The heroin in those locations is significantly cheaper to buy than it is here.”
Lutz says this is a time when the Treasure Valley’s isolation is working in its favor. He says heroin here is among the most expensive in the country. But the cost is now not that much different from what someone without a prescription might pay for an equivalent amount of a prescription opioid.
Lutz says in Salt Lake City you can buy heroin on the street if you know the right part of town. He says in Boise it’s not sold on the street, but rather a buyer has to know the right people.
Why we should be concerned about heroin
When scientists ask what the most harmful drug is, the answer is usually alcohol both for society as a whole and for individual users. But heroin is often next. For example, a 2010 study in the British medical journal the Lancet ranks heroin the second most harmful drug overall. It’s “harm to users” is about the same as crack cocaine and methamphetamine, but it is by far the most likely drug to simply kill its users.
Some critics of America’s “War on Drugs” claim that heroin was far less harmful to society and far less likely to result in fatalities before it was made illegal.
There’s a striking map on the DEA website that shows heroin deaths in 2013. A lot of states have hundreds. Oregon and Utah have as many as 160 each. Washington has more than that. Then there is a block of states almost none: North and South Dakota, Montana, Wyoming and Idaho. According to the Idaho Department of Health and Welfare, five Idahoans died from heroin overdose that year, one the year before and 12 in 2014. They don’t have an estimate yet for 2015.
There is a place in Idaho where the heroin epidemic is a lot closer
Stewart Miller is a lieutenant for the Kootenai County Sheriff’s office. Miller says he’s seen a drug epidemic before. He says meth use reached that level about 15 years ago. It has subsided some, but remains a big problem today. Now Miller says heroin use has overtaken meth and even prescription drugs in Kootenai County. But he says it’s not an epidemic yet.
“Could it get there? Yeah," Miller says. “I mean it’s easier to obtain than a lot of the other drugs. Being so close to Washington, that large metropolitan area, I think gives us more of the heroin as well.”
According to the DEA, the Sinaloa drug cartel has a base of operations in Spokane. And while the administration says Sinaloa controls the meth trade in all of Idaho, it doesn’t have the same kind of permanent toe hold. It does have a base in Salt Lake though. Miller thinks heroin traffic will continue to expand south from Kootenai County and north from Utah.
“I think the southern part of the state has the same issues we do, maybe not to the level we do, but I think once they kind of meet in the middle that’s where it’s going to be a very large problem,” Miller says.
Is the heroin epidemic coming to southwest Idaho
Miller thinks it’s only a matter of time until the problem is as bad in southwest Idaho as it is in his part of the state. But Bill Lutz from the DEA office in Boise says he thinks that can prevented.
“When we look at the areas around Salt Lake City and the areas around Portland, you know we can’t think for a second that it couldn’t happen to us,” Lutz says. “But you know, as a state I feel like we’re doing a good job right now looking at addressing the issue.”
For example, Lutz says Idaho is taking action to reduce access to prescription opioids. But that’s where things get complicated. A lot of places experiencing the epidemic saw heroin use spike because they made prescription drugs harder to get. Elisha Figueroa, head of the Idaho Office of Drug Policy, says she doesn’t believe the state’s actions on prescription drugs are causing an increase in heroin use.
“We have those discussions of course,” Figueroa says. “I believe that if we can prevent someone from ever becoming dependent upon prescription drugs then they won’t have that graduation on to heroin.”
Walter Bogucki from Port of Hope supports the state’s efforts to reduce access to prescription opioids. He agrees with Figueroa that it’s essential to prevent people from becoming addicted. But already there are a lot of addicts and Bogucki says the state’s efforts are turning some of them to heroin.
“They’re going to find it,” Bogucki says. “Once they are addicted they’re going to do whatever they have to. They’re going to go to the heroin.”
Bogucki and his fellow Port of Hope drug counselor David Strong actually have a lot of specific policy ideas, like requiring drug companies that profit from prescription opioids to do more to help addicts. But on this they’re stumped. They say the state shouldn’t avoid attacking the prescription problem for fear of making the heroin problem worse, but that it will make the heroin problem worse. Strong thinks the epidemic is unavoidable.
“Suit up. It’s coming,” Strong says. “There’s a huge incentive for people to sell this. The profit margins are incredible. If you’re down in Arizona or New Mexico you are paying pennies on the dollar for what it’s going to sell for in Nampa Idaho. And it’s not going to be any worse or any better here than it is in New York City, Tampa Bay Florida or Los Angeles California.”
Find Adam Cotterell on Twitter @cotterelladam
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