Heroin has rapidly replaced prescription pain pills as the drug of choice in much of Northern Kentucky and Louisville, raising fears that a heroin scourge will soon ravage the state.
In Northern Kentucky, police are finding people passed out in cars at gas stations with needles poking from their arms. In Louisville, initial statistics suggest more than 50 people died of heroin overdoses in 2012.
"We've even found parents in the front seat with kids in the back seat in car seats, wondering what was going on," said Covington police Chief Spike Jones.
Police in Louisville and the Northern Kentucky suburbs of Cincinnati said they began seeing more heroin as early as four years ago, but it was in the last 12 months that heroin surpassed pain pills as the preferred drug of addicts.
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The resurgence of the dangerous street drug, which rose to prominence in the 1970s, has prompted one state lawmaker to draft a bill that would stiffen penalties for heroin traffickers and make it possible for prosecutors to charge dealers with murder if a person overdoses on heroin.
Concerned about the increased use of heroin, Attorney General Jack Conway launched public service announcements about heroin addiction this month and now incorporates heroin into his talks to teenagers about the dangers of prescription pill abuse.
Heroin has not found much of a toe-hold yet in Lexington and it's still rare in Eastern and Western Kentucky, but drug treatment counselors and police say they are beginning to see heroin abuse pop up across Kentucky.
"We are seeing more of it all over the state," Conway said.
If something isn't done soon, heroin addiction will spread statewide, said state Sen. Katie Stine, R-Southgate. She plans to file her proposed heroin legislation during the first week in February, when lawmakers return to Frankfort for the 2013 General Assembly.
"This is not just a Northern Kentucky problem," Stine said. "If we don't stop it now, the waters are going to be flowing over."
In Louisville, arrests for heroin possession have skyrocketed since 2008, Louisville Metro Police Department statistics show. Police logged 32 heroin-related arrests in 2008 but made 676 arrests in the first 11 months of 2012.
Overdoses involving heroin have also climbed. In 2009, the state medical examiner's office conducted no autopsies on heroin-related overdose victims in Kentucky. In 2011, there were 22.
In Louisville alone, there were believed to be 54 heroin-related overdose deaths in 2012, initial statistics show.
Police thought crack cocaine — which surfaced in the 1990s — took top honors as the worst and most addictive street drug available. Heroin is worse, said Jones, the Covington police chief.
"The heroin on the street now is so much more powerful than it was in the 1970s," Jones said. "I can tell you with confidence that what we are seeing with heroin, crack had nothing on."
How heroin spread
A key driver behind the uptick in heroin abuse was the reformulation of two widely abused prescription pain drugs, making them harder to crush and snort, said Van Ingram, executive director of the Kentucky Office of Drug Control Policy. Drug manufacturers reformulated OxyContin in 2010 and Opana in 2011.
The number of heroin samples analyzed by the Kentucky State Police crime lab has increased 211 percent since 2010. There were 433 samples analyzed in 2010, but that jumped to 1,349 samples last year.
"Any substance that's abused is influenced by four things: price, availability, perception of risk and public perception. When any of those four things change, so does how the substance is used," Ingram said.
Aside from pain pill reformulations, law enforcement has successfully cracked down on the flow of prescription pills into Kentucky from Florida and other southern states. Meanwhile, the legislature passed House Bill 1 last year, which put in place regulations to crack down on unscrupulous doctors and to make it more difficult for drug abusers to obtain prescription drugs.
But the uptick in heroin use started before House Bill 1 took effect, Ingram said.
Price is also driving the switch to heroin, police said.
Prescription pills are relatively expensive — anywhere from $40 to $100 per pill. An addict at the end stages of an opiate addiction will need to spend at least $600 a day on prescription pills just to function. The same heroin high would probably cost about $100, police said.
Even though Northern Kentucky and Louisville show the most arrests and seizures of heroin, those are not the only places heroin abusers live, police said.
Jones and Bill Mark, executive director of the Northern Kentucky Drug Strike Force, said they are increasingly finding more people who buy heroin in Northern Kentucky and then leave. Louisville police also report more "drug tourists" in the city.
Sherelle Roberts, a spokeswoman for Lexington police, said few heroin-related arrests or seizures have been made, but the number of heroin addicts is clearly on the rise.
"We are averaging about 12 overdose calls a month," Roberts said.
Heroin is still rare in much of Eastern Kentucky, where prescription pills and methamphetamine remain the drugs of choice, said Dan Smoot, law enforcement director of Operation UNITE, a 32-county drug task force.
Heroin habit hard to stop
Police and drug addiction specialists said heroin use is spreading among all age groups and all economic classes. Abusers are not the "junkies in an alley that you remember seeing in the 1970s," Ingram said.
Louisville Metro Police Lt. J.T. Duncan said his department has interviewed a 13-year-old heroin addict. In Northern Kentucky, heroin use has moved into wealthy suburbs and rural areas alike, Mark said.
"I know of two 16-year-olds who overdosed in Kenton County," Mark said.
Mac McArthur, executive director of Transitions Inc., said 90 percent of the company's drug treatment facilities in Northern Kentucky are filled by heroin addicts. There is a minimum six-month waiting list to get one of the company's 186 beds in the region.
"Our average age is between 18 and 25," McArthur said.
McArthur and other experts said the cravings created by heroin are much worse than those from prescription pain pills.
"Once you start heroin, it's very, very hard to stop," Duncan said.
Stine, the state lawmaker, said she also would like to see the state encourage more options for drug treatment. Some privately run drug treatment centers — such as the Healing Place in Louisville — have great outcomes and are able to provide treatment at relatively low costs, she said. Finding ways to replicate that model, which might ease a tremendous shortfall in drug treatment options in the state, should be explored, Stine said.
"You can't put handcuffs on addiction," Jones said. "It just doesn't work. There is a role for law enforcement in this. But we have to be advocates for treatment. We have to be advocates for education. It's a three-legged stool."