In the first six months of 2013, there were 28 heroin overdose deaths in Lexington, six more than in all of 2012 and more than five times as many as two years ago.
City leaders and law enforcement officers have tried to get a handle on that trend. Officials formed a task force that has held closed-door meetings for months, trying to devise a strategy to overcome the punishing blows that heroin has laid on the city.
On Friday, Mayor Jim Gray — flanked by the Division of Police, the LFUCG Public Safety team and law enforcement partners — held a news conference to discuss their efforts in prosecution, treatment and prevention.
Already this year, heroin-related arrests are up 57 percent over all of last year. There have been 160 arrests from Jan. 1 through July 11, compared to 102 for 2012 and 8 in 2011.
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The task force, which has implemented several initiatives to stem the problem, wants to get the word out that Fayette County's heroin addicts have not resembled the 1970s stereotype — that "it's not the dirty addict in the corner."
Heroin does not discriminate, Lexington fire battalion chief Brian Wood said.
"We'll pick them up everywhere, from the street downtown to out in a very nice affluent subdivision," Wood said. "I've seen it across all spectrums."
Task force member Michele McCarthy — the government liaison for SelfRefind, a physician-owned outpatient treatment center — agreed.
"This is hitting everybody," McCarthy said. "It could be your neighbor. It could be your kid. It could be your spouse. It could be your co-worker. It's not just somebody else's problem."
At the news conference Friday, Chief Ronnie Bastin of the Lexington Police Department said heroin use resurfaced in October 2012.
"Prior to that, we hadn't seen it in a number of years," he said. "Forty years ago, it was an issue in the community, but it hadn't been for quite some time."
The spike in fatal heroin overdoses in 2013 prompted Fayette County officials to convene the task force, which includes representatives from the police and fire departments, the mayor's office and treatment specialists.
Public Safety Commissioner Clay Mason said the task force first met March 8, after a roughly two-week period when there was a spike in overdose deaths.
The task force's initiatives include:
■ Having emergency medical technicians who respond to overdoses hand out pamphlets to heroin users and their families suggesting ways to get help.
■ Viewing the causes of overdose death as potential homicides.
■ Training judges to understand that heroin is among the most difficult addictions to break.
Since that March 8 meeting, police have seized 1,179.5 grams of heroin, with an estimated street value of $235,000.
Kentucky's crackdown on prescription painkillers in 2012 was punctuated by the passage of a law that placed greater restrictions on access to prescription opioid medicines. When the pills became harder to get and therefore more expensive on the street, addicts turned to heroin as their drug of choice.
The vast majority of people who were addicted to prescription drugs are now looking for opiates, McCarthy said.
"We're seeing people who have never used heroin before. We're seeing use of it by teenagers and people in their early 20s. They're skipping straight to injection use of it," she said.
A single 80 milligram pill of the painkiller OxyContin can sell for $80 to $100, McCarthy said. With heroin, dealers offer "buy 10 bags, get one free," she said. A bag generally costs $9 or $10.
"The same amount they spent on one pill before, they can get an amount of heroin to keep them high for one day," she said.
Kentucky State Police Trooper Dave Roberts said the drug is so prevalent that an undercover narcotics officer can find it easier to buy heroin than marijuana.
The danger, Roberts said, is that heroin doesn't guarantee users the same purity that they get from painkillers made in laboratories.
As heroin passes through drug dealers on the street, he said, the dealers "cut it" — crushing up an additive, like vitamins, and mixing it with the heroin to dilute it. This makes the product weaker and gives the dealer more to sell, Roberts said.
Said Fayette County Coroner Gary Ginn: "People who use heroin have no way of knowing the strength of the heroin and play Russian roulette when administering heroin to themselves."
Roberts said if someone goes to one dealer repeatedly, and that dealer uses a 50 percent additive, the user will get used to that dose. If the user then switches dealers, the ratio could be different, and the user might inject more than he or she is used to, leading to an overdose.
Roberts said it's difficult for most addicts to stop using heroin because the withdrawal symptoms — severe aches all over the body, chills, sweating, vomiting and diarrhea — are so severe, they'll do anything to avoid them.
"When the opiate addict is at the point that they are using heroin to that degree, they, in a lot of cases, want to stop and can't," Roberts said.
Stemming the tide
Mason, the public safety commissioner, said police think a heroin pipeline has developed from Detroit to Lexington.
"Our investigative force is working very hard to try and stem the tide of incoming heroin here in this community," Mason said.
Statewide, there were 456 cases containing some type of heroin charge in circuit courts in 2011, according to Kentucky's Administrative Office of the Courts. That number rose to 921 in 2012. In district court, there were 679 heroin-related cases in 2011 and 1,784 in 2012.
In Lexington, local, state and federal law enforcement officials are meeting once a month and reviewing cases, Mason said.
"They've taken off with what they've been doing in terms of a number of different investigations, and arrests and seizures and searches," Mason said.
Fayette Commonwealth's Attorney Ray Larson, who said the heroin problem "snuck up" on Lexington, said he would recommend to the task force that "people have to begin to treat these drug overdose deaths initially as a potential crime scene."
Larson said representatives of every segment of the community that deals with users and dealers must work together if drug overdoses are to be prosecuted as homicides.
Under federal law, there is a mandatory minimum 20-year prison sentence, and a maximum sentence of life, when an overdose death is linked to a drug dealer.
Kerry B. Harvey, U.S. Attorney for the Eastern District of Kentucky, told the Herald-Leader recently that his office has committed to focus on overdose deaths.
Harvey said his office is working with other officials, including first-responders and coroners, "to detect these cases and to develop the proof necessary to obtain convictions."
In terms of other initiatives, one arm of the task force is composed of professionals focusing on prevention, education and treatment.
Task force members are working on a treatment directory that will be posted on the Mayor's Alliance on Substance Abuse website. Mason said there is a wide array of treatment options available in Lexington, including residential, outpatient and faith-based programs.
Treatment specialists are designing pocket resource cards for first-responders in the hope that addicts and their families will follow up after the emergency has passed.
Task force members are putting together a multi-pronged education effort that will feature public service announcements showing the range of people who have become addicts.
Jessica Cobb of the Lexington Fayette Health Department said that as a result of increased heroin use and deaths in Lexington, health officials want to begin surveillance of hepatitis C and HIV cases to see whether there is a link between the cases and heroin use.
Fayette County jail director Rodney Ballard said the jail division that conducts drug tests at the direction of the court is beginning to monitor specifically for heroin.
Mason said there will be a training session for circuit judges in July "to help them understand that opiate addiction is different."
"It is the most difficult addiction to break, and there are different types of treatment for different addicts," he said. "There isn't a one size fits all."
Meanwhile, Mason said, the task force will continue.
"What's been so impressive about this collaborative effort," said task force member Sharon Tankersley of the Fayette County Mayor's Alliance on Substance Abuse, "is that we've watched law enforcement really show that their concern truly in this thing has been for the hurting individuals and families that are being affected by the disease of addiction in this community."
Places to go for help, treatment options:
The Salvation Army, 736 West Main Street, (859)252-7706
Hope Center, 360 West Loudon Avenue (859) 252-7881
Hope Center Recovery Program for Women, 1524 Versailles Road, (859) 252-2002
George Privett Recovery Center for Men, 250 W. Loudon Avenue, (859) 225-4673
To find more treatment options, go to drugfreelex.com (local) or findtreatment.samhsa.gov, a national organization that can connect people with local options.