He’s a 20-something Kitsap man, and he’s not unlike most young adults in the county. He holds down a job. Spends his off-time with his friends.
And, like an increasing number of people in Kitsap County, he uses heroin.
He describes heroin as an old friend, like anyone in the area might have.
“It’s an old friend that I bump into now and again,” he said. “It’s easy enough in passing, just as you would bump into anybody you grew up with, you see them around.”
The Kitsap man — who spoke on condition of anonymity — shies away from describing himself, and his current relationship with the drug, as a “user” or an “addict,” especially after experiencing a few scares from the drug. His experience, however, is not unique in Kitsap. It’s reflective of countless others in the county who have become involved with the drug.
Heroin is not new to the region. Despite other drugs, such as methamphetamine, becoming popular over the past decade, heroin appears to be making a comeback, spanning the Puget Sound and thriving in Kitsap.
County officials — from law enforcement to health departments — are reporting a sharp rise in heroin use, crime and health-related impacts. The come-and-go trend of drugs is to be expected, officials say. However, what is shocking many is the relatively short period of time the comeback has occurred, and the individuals the drug is attracting.
“Cities have a personality for drug preferences,” said Steve Freng, a prevention treatment specialist with the Northwest division of the nation’s High Intensity Drug Trafficking Areas program. The program helps federal, state, local and tribal agencies tackle drug enforcement in highly trafficked regions.
“We’ve had a long steady love affair with heroin in this region and it’s come and gone depending on price and what’s competing for users’ attention,” he said.
The recent spike is distinct, however. Experts such as Freng report that the drug has crossed beyond old stereotypes and has not spared any class, age range or other group. The gateway to the drug has changed, too. Prescription pills are providing a new introduction to the heroin scene.
It has led to a new, surprising population of users — younger generations in particular — and avenues of access.
“You can go to any middle school or high school in this state and find heroin,” Freng said. “Or bump into somebody who knows somebody, and by the end of the school day you can lay your hands on someone with heroin.”
A rise in heroin use
Resources to draw data from are scarce. Therefore, gauging the comeback is difficult. But the signs are there.
“It’s not like every heroin user signs a registry,” said Scott Lindquist, director of the Kitsap Public Health District.
“There are some indirect measures that we see,” he said. “One is through death certificates. We are seeing the numbers of overdoses, and drug deaths that are poly-drug use, such as heroin and alcohol. We are also seeing a rise in the number of needles exchanged in the county.”
For example, in 2012 a needle exchange run by the Kitsap Public Health District turned over 620,582 needles, more than it has ever exchanged in the past. The program began in 2003 and at that time it exchanged roughly 175,000 needles.
The only other needle exchange available to the Kitsap region is a volunteer organization run by Monte Levine for the past 18 years. He too has noticed the jump.
“The spike started in the spring of 2011 and I believe it was in a reaction to the reformulation of pharmaceuticals,” Levine said. “Within a matter months the number people we served tripled.”
Pills and needles
Levine is not alone in his opinion about prescription pain medications.
“There was a change in the ’90s in this country and a bit of a head slap on how doctors had been under-medicating pain,” Freng said. “And the pendulum didn’t go to the middle, it went to the other side.”
Indications of that pendulum were realized in 2011 as news reports exploded over a survey by consulting firm IMS Health. The survey indicated prescriptions for the pain medication Vicodin alone had risen from 112 million doses in 2006 to 131 million in 2011. That number does not reflect doses of oxycontin or oxycodone, other common prescription opiates.
“It’s easy to develop a dependency with prescription opiates. It’s highly addictive,” Freng said. “One of the mechanisms is that you develop a tolerance for the drug quickly. You go home with a sprained elbow and a few pills every few hours won’t be enough.”
“There ain’t no free lunch in that equation,” he added. “Because a tolerance develops and they realize they can’t just stop.”
Prescription pills can be sold on the street, but prices are steep. The pills are crushed, then smoked allowing the user to obtain an immediate high, rather than the time-released effect many are designed for.
Manufacturers of the prescription drugs, however, have reacted to the street use and have altered its makeup, making it less smokable. Providers have become more guarded as well, and the pills are now more difficult to access.
The combination of factors have led some to switch from the pill to heroin for an opiate high.
“The segue to heroin is usually from prescription opiates,” the 20-something Kitsap man said. “I don’t know anybody who went straight to pick up heroin as a habit. It’s usually a result of a dependency from prescription drugs. People become dependent on pills, for whatever reason, and they become addicted. It’s easy to make that transition to heroin.”
And heroin, like the pills, can be smoked or swallowed in pill form.
The changing face of heroin
“One main misconception is that it’s this certain group or demographic of people that are using,” the Kitsap man said. “In my experience with the people that I have met, it touches on every level of society, old, young, wealthy and well-to-do people, it’s all encompassing.”
He added, “That’s a big surprise to people who get exposed to it. It’s everywhere, it’s right under your nose and you would never know it. It’s all around us.”
Like others who use the drug, the man took prescription pills before making the transition to heroin when he was 16.
“I took pills and I smoked pills before I ever tried heroin,” he said. “I didn’t use a needle until I was in my early 20s. That lasted a short while because it got to be way out of control and I had a couple friends pass away [from overdose] and that was motivation.”
The introduction to opiates through prescription medications is not new, but the recent intensity of the transition is. It has forged avenues to heroin for new populations, previously not expected to use the drug.
“It’s been at arms length, it was a population of people here or there,” Freng said. “But prescription opiates have brought it up close.”
“Kids have ready access to prescription opiates, and if it’s not in your parents’ medicine cabinet it’s in your friend’s parents’ medicine cabinet,” he added. “Everybody’s got an orange bottle with 10 Vicodins or a couple dozen oxys. Kids know that. It’s ubiquitous.”
A younger generation isn’t the only frontier of users.
“It’s much more significantly found with the middle class and younger kids,” Freng said. “When I came into this years ago, it was a grungy guy on Capitol Hill coming in with an addiction. Now it’s young, 20-somethings finding their way into ERs and clinics.”
Freng noted that perception of the drug, whether a prescription pill, or the method of using heroin itself could be a factor. It seems less threatening than a needle.
“Kids are brushing up against it now because you don’t have to inject it,” he said. “The assumption is that heroin means needles, but you can smoke it. A lot of kids don’t realize that smoking heroin is the same. It’s all the same to your brain.”
The experience at the top of enforcement echoes that of those on the ground.
“We are losing a generation,” Levine said. “I’ve seen kids that are really bright become involved with opiates and it’s very hard.”
Next week: Heroin, crime and lack of treatment in Kitsap.
