As a child, James Sutherland wanted to become a soccer player or a golfer. He loved life, was full of energy, adored his family and loved going to church. But as a teenager, things got more complicated, his mother, Elly Sutherland, recalled.
After 23 years together, James Sutherland's parents divorced. In 2004, when James was 15, his older sister Rachel died in a car crash. He struggled to recover emotionally.
James began numbing the emotional pain with pills and alcohol. That progressed to cocaine, more pills and eventually heroin. Elly Sutherland said she noticed money was being taken out of her bank account, and "he (James) admitted to this and told me that it was for drugs.
"No child is born with the thought of becoming a drug addict," she said. "He looked forward to a normal, productive and happy life."
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James Sutherland, 25, started to use heroin last fall and quickly got addicted. He died in February from a deadly dose of fentanyl, a powerful synthetic opiate. Toxicology screening determined he had taken only fentanyl; no heroin was detected.
Sutherland's death is unusual in that regard. Throughout the country, heroin users have begun using heroin laced with fentanyl because it is more powerful.
But it's also more deadly.
Earlier this year, the Associated Press reported 80 people nationwide had died after injecting heroin laced with fentanyl, which is typically administered to people in chronic pain, including patients fighting cancer.
Locally, the Fayette County coroner's office said the more potent combination of fentanyl and heroin hasn't mainstreamed in Lexington. Still, officials continue to see potent batches of heroin with purity of 50 percent to 60 percent. Dealers typically sell doses that have been cut to stretch their supply.
From January to May 2014 there were 21 heroin overdose deaths, seven fewer than this time last year. Lexington finished 2013 with 44 heroin-related overdose deaths. There were 22 in 2012 and five in 2011, according to data from the coroner.
Concerns heighten because the use has grown so steadily. The coroner did not report any heroin deaths from 2002 to 2006. But, from 2007 to 2012, there were one to five heroin overdoses per year.
Like James Sutherland, many users and dealers switched from prescription pain pills a few years ago after legislatures passed House Bill 1, restricting access to prescription opioid medicines. When the pills became harder — and more expensive — to obtain, addicts turned to heroin as their drug of choice, officials have said.
Things got so bad that county officials banded together in 2013 to form a heroin task force, which would work together to crack down on dealers, keep the public informed and seek the stiffest penalties for those convicted.
City officials say the recent drop in heroin overdose deaths stems from a combination of media coverage, policing, awareness and medical and legislative efforts.
"We feel like some of our investigative efforts have deterred some of the importation of additional heroin, we've shown the community that we're serious in going after these predatory dealers and that we are intent on trying to keep as much of that activity out of the community as we can," Public Safety Commissioner Clay Mason told the Herald-Leader. Mason added that thousands of grams and hundreds of thousands dollars have been confiscated.
In a report given to the Health Department earlier this year, the task force said that of overdose deaths in Fayette County, 78 percent were men, and 22 percent were women. Broken down by ethnicity, heroin fatalities were about 93 percent white, 5 percent black and 2 percent Hispanic, according to figures released by the task force.
The use of Narcan, an antidote that can reverse the effects of opiate drug overdoses, has also contributed to the dip in heroin overdose deaths, officials say.
Last year, the Lexington fire department administered 843 Narcan shots.
Fire Lt. Chris Martin said paramedics give about two dosages of Narcan a day. The department operates on an unconscious/unknown protocol, allowing emergency crews to give the shot to those who are passed out, breathing and have a pulse.
Fayette Coroner Gary Ginn said the decline in heroin deaths is a result of educating the public and efforts by police.
"They're not just looking for people who are actually taking heroin, but they're actually looking for the dealers," Ginn said. "People realize heroin is a drug that's very addictive; it's very hard to get off of once you start on it. And most people who are on heroin are going to die."
'There is great risk'
James Sutherland battled his drug addiction for 10 years. He had remained sober for three years, but he struggled with drugs again shortly before his death. He sought treatment but was released from his treatment center after just two weeks. Two weeks was the allotted amount his insurance company would cover, Elly Sutherland said.
On Feb. 24, 2014, James Sutherland was found dead in his apartment near Tates Creek Road of an overdose of fentanyl.
Elly Sutherland said she does not think her son knew he was buying fentanyl, but thought instead it was heroin.
"I know that there is great risk in buying street drugs, but to buy something that is not what you believe it to be and is, in fact, a very powerful and dangerous drug, seems very wrong," Elly Sutherland said. "I feel like someone killed him, really."
James Sutherland died quickly, his mother said.
He didn't receive a Narcan shot, because "no one was with him to call 911" and "the amount of fentanyl in his system was large and would have killed him very quickly," Elly Sutherland said.
No one has been charged in James Sutherland's death.
Generally speaking, investigators have had some success going after drug dealers whose products have killed their customers.
Kerry B. Harvey, U.S. Attorney for the Eastern District of Kentucky, said dealers should be held accountable when their products kill someone.
Harvey said his office is working to convict those who sell drugs that result in death. Under federal law, if a person buys drugs and dies from an overdose, he said, the dealer can be sentenced to a minimum of 20 years to life in prison. However, these cases can be difficult to prosecute because law enforcement must prove that the person actually ingested the drugs from the dealer.
To make convictions stick, investigations must start immediately.
"A real key is when you have an overdose death, that that scene be treated by law enforcement and first responders as a crime scene, opposed to an accident scene," Harvey said, "because cases can be a bit more complex and difficult."
In order to get a handle on the heroin epidemic, both Harvey and Mason said it will take a collective effort from officials to educate and prevention.
"We're not going to arrest ourselves out of this problem," Mason said.