Courier-Journal wrote:MANCHESTER, Ky. - Growing up in the hardscrabble hills of Appalachia, Bobby Vaughn began popping painkillers at 15-years-old, sneaking them from his injured coal miner dad. That was the start of a three-decade-long addiction to any drug available: OxyContin, cocaine, meth – and beginning a year ago, heroin.
“A friend had some. It was stronger, more intense than anything I ever did,” said Vaughn, a 47-year-old Harlan County resident now staying at Chad’s Hope recovery center. “It scared me.”
Fears are rising across rural Eastern Kentucky as heroin seeps into a region already marred by social forces that threaten to give it a strong foothold: poverty, unemployment, rampant addiction and hopelessness. Until recently in Kentucky, heroin has largely been an urban scourge. Now, it's a mountain malady too.
It’s showing up as the drug of choice among a rapidly-growing number of addicts in treatment, historically a reliable indicator of emerging drug trends. At one women’s treatment center in Prestonsburg, for example, 61 percent of clients are hooked on heroin.
That's one of many signs of the drug's incursion. Over the past year, police in the region have started making a trickle of heroin-related arrests. Area emergency rooms are treating more heroin overdose victims than ever before. And the Eastern Kentucky anti-drug organization Operation UNITE reports recent upticks in calls from heroin users to its treatment referral line.
“Heroin is definitely quickly making inroads in Southern and Eastern Kentucky,” said Nancy Hale, Operation UNITE’s president and CEO.
One reason, she said, is that the drug provides a relatively cheap high. A hit of heroin in Appalachia costs about $5, compared with around $30 for one pain pill.
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That begs the question: Why didn’t heroin take hold in the poorest part of the state years ago? Law enforcement officials say it’s all about supply and demand and ease of distribution, meaning heroin has been concentrated in places like Louisville, Lexington and Northern Kentucky.
Now that it’s in Appalachia, Vaughn worries it “will wipe out” the struggling place he calls home.
Pills set the stage
Since the early 2000s, this region of mist-covered hills, green-and-gold fields and winding forest roads has been drowning in a sea of pills.
A recent state report showed that five of the six Kentucky counties with the highest drug overdose rates last year were in Eastern Kentucky, where pills were mostly to blame.
Vaughn’s journey from pills to heroin is a typical one in other areas of the state and now is becoming more common in Eastern Kentucky.
Recovering addict James Faulkner of Whitley County followed nearly the same path as Vaughn. Faulker, 32, said he started abusing his dad’s Percocet at 17 after his mom died. He soon graduated to OxyContin, which led to illegal drugs: cocaine, methamphetamine and heroin. He even got hooked on Suboxone, the medication-assisted addiction treatment he was given to help him kick his habit.
Recently, Faulkner said, “black tar” heroin became much easier for addicts to get in his area.
“There’s a lot of it in Whitley County,” he said. “It’s bad.”
Vaughn said the same is true in Harlan County.
“Anywhere you go, (dealers) will offer it to you,” he said. “It’s right there.”
In other areas of the state and nation, heroin rushed in to fill the gap soon after authorities began cracking down on pill-pushing doctors and street dealers of prescription drugs several years ago. But Van Ingram, executive director of the Kentucky Office of Drug Control Policy, said it took a while for this scenario to play out in Appalachia.
That’s because heroin trafficking patterns cut through major cities first. A 2014 Courier-Journal series found that heroin sold in Louisville generally comes from Mexican and Colombian cartels and arrives in Atlanta or Chicago, two “distribution centers” with cartel operatives at the crossroads of major transportation networks.
RELATED: Heroin surges as Kentucky cracks down on pain pills
From there, officials said, it goes to other large cities such as Detroit or Cincinnati, making its way into the hands of local or regional crime rings or dealers. Down the line, the level of dealer gets smaller and smaller and the drug makes its way to more and more remote areas. Addicts get hooked and want more.
“It comes down to basic economic principles of supply and demand,” said Richard Barrett, who works in the public information office for the Detroit Division of the Drug Enforcement Administration. “There’s a supply of OxyContin in the (Eastern Kentucky) area. Now, there are pockets of heroin coming in.”
Places seeing the most are near highways such as Interstate 75 and the Eastern Kentucky Parkway, Barrett said. Next come the larger cities and towns in the region, such as Hazard.
Minor Allen, chief of police in Hazard, said pills are still the biggest drug issue in his city, with “mom and pop dealers” the most frequent sellers. But as state and local crackdowns on prescription pills have reduced the supply somewhat, he and his team have seen heroin creep in along with meth.
“I’ve seen more heroin these past 12 months than I have over the last five years,” Police Major James East said.
Allen said the handful of arrests his department made this year are a sign “heroin is coming this way.” And he said that means a potential spike in diseases linked to dirty needles, such as hepatitis and HIV, among residents and first responders. A recent federal report showed that 220 U.S. counties are at high risk for the spread of these drug-fueled diseases, and 54 of them are in Kentucky.
“I’m definitely scared about heroin. We already have syringes laying around in playgrounds and neighborhoods” from those who melt down and shoot up pills, Allen said. “Anything that deals with shooting up is scary.”
Other Eastern Kentucky police chiefs and sheriffs say they are noticing the same trend with heroin. Although they haven’t yet handled major cases involving the drug, Hale said they are arresting more people for small-time heroin offenses and hearing from ERs treating overdose victims.
Area treatment centers, meanwhile, are serving more people seeking to kick heroin and break the cycle of addiction. At Hope in the Mountains, a women’s recovery facility in Prestonsburg, 22 of 36 clients are heroin addicts. At Louisa-based Addiction Recovery Care, 225 of 967 clients – almost a quarter – say heroin is their main drug of choice. At Prestonsburg-based Mountain Center for Recovery and Hope, 45 of 120 clients, or 38 percent, are heroin addicts. And at Chad’s Hope, about half of the clients have used heroin at one time or another.
“It’s here, and it’s going to become more prevalent,” said Wendell Carmack, executive director at Chad’s Hope. “And as it becomes more available, it’s going to be used more and more.”
A road leads into the Eastern Kentucky mountains fromBuy Photo
(Photo: Laura Ungar, The Courier-Journal)
Hale agrees. Since January, Operation UNITE has seen a 7 percent increase in calls to its treatment referral line from addicts whose drug of choice is heroin, and an 11 percent increase in calls from those who use heroin along with other drugs.
RELATED: Heroin Resource Guide: Local places to get help
Operation UNITE is teaching young people about the dangers of heroin through its clubs and camp in the hopes of keeping them safe.
“We’re trying to be proactive and make people very aware,” Hale said. “We have a tremendous job to do. We’re not going to stop fighting. We are making inroads, but we can’t let up.”
Recovering heroin addicts say they can’t either.
Vaughn and Faulkner, both fathers of three, said they’ve made great strides at Chad’s Hope, which provides a long-term residential program based on Christian principles.
“When it’s all said and done,” Vaughn said, “God prevails and he works things out.”
For Faulkner, staying sober and learning to live without drugs is excruciatingly difficult sometimes. But he said that’s true of any worthwhile goal. Sustaining him on his journey are faith, hope and an eye toward service.
Five years from now, he said, “hopefully I’ll be clean and sober and helping other people.”
Reporter Laura Ungar, who also reports for USA TODAY, can be reached at 502-582-7190 or firstname.lastname@example.org.
Heroin in the Mountains: By the numbers
61 percent – Portion of clients at Hope in the Mountains who are hooked on heroin.
38 percent – Portion of clients at Mountain Center for Recovery and Hope who are heroin addicts.
$5 – Cost for a hit of heroin in Appalachia, compared with $30 for a prescription painkiller.
7 percent – Rise in calls to Operation UNITE’s treatment referral line, since January, from addicts whose drug of choice is heroin.
11 percent – Rise in calls from addicts who use heroin and other drugs.
54 – Number of Kentucky counties among the 220 counties nationwide at high risk for the spread of drug-fueled HIV and hepatitis C.
Highest rates of drug overdose deaths
Rate of drug overdose deaths per 100,000 people in the top eight Ky. counties from 2012-2015
Leslie County: 68.6
Bell County: 61.2
Gallatin County: 52.6
Knott County: 48.7
Wolfe County: 48.4
Floyd County: 47.6
Campbell County: 47.2
Kenton County: 46.3
Source: Kentucky Office of Drug Control Policy, 2015 Overdose Fatality Report
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Drug use is an issue.. I wonder what can be done to help fix it?
I wonder about the state of Kentucky about the state of drug use in the United States. Sure this area had issues with pills, but never this.
I know that when we lived in Southern Indiana, my mom got any damn pain pill that she wanted. It was to the point she was on methadone for pain, not for drug withdraw. She was not a happy camper either, she just wanted a doctor to help her with her nerve endings, but since she had Medicaid and Medicare, it was easier to drug her up. It required her to see the doctor once a month, more money for the doctor. I think that this has happened here, get them hooked on drugs, then the state started to crack down on the docs-in-a-box, and the folks addicted, still need their high, either for trying to forget that the area that they live in almost has no jobs or for the pain caused by back-breaking work. I remember my papal telling me stories of working in the Coal Mines, he started when he was in the second grade (well he dropped out of school in the second grade). Then there is the issue of educational level, a lot of families do not have a single person who has a high school degree.
There is a drug problem in the United States, and with the DEA failing to with the classification of marijuana and allowing for a lesser classification, this only keeps that whole, War on Drugs alive. I do not think that there needs to be a war on drugs, but I do not think that all drugs need to be taken off of the DEA list, but there should be more help with the drug problem.