As heroin problem spreads, focus is on treatment and community efforts to help addicts; Needle exchanges? Not so much

By Melissa Patrick
Kentucky Health News

Heroin is a growing concern for many Kentucky communities, with much of the discussion around prevention and rehabilitation for addicts over incarceration as the most effective way to fight the problem.

The Greater Hardin County Narcotics Task Force reports heroin use in Hardin County jumped 1,200 percent in 2014," and "Based on the trend so far this year, task force officials expect cases involving the drug will double in 2015," according to an editorial in The News-Enterprise of Elizabethtown.
The editorial called heroin a "scourge" and said that this "menace lurks in the shadows" of the county. While expressing hope that a recent federal grant will make a difference in the region, the editorial also said that education, prevention and effective rehabilitative treatment "must be a large part of any effective assault on heroin abuse." It noted that "statistics and science reveal the past efforts of increasing criminal penalties and lengthening incarceration have done little to curb the nation's drug plague."

The grant alluded to by the editorial will fund the Heroin Response Strategy, a new initiative that creates a partnership among five regional "high intensity drug trafficking areas," which includes Appalachia, New England and the Washington-Baltimore, New York-New Jersey and Philadelphia metropolitan areas. The focus of this program is on treatment, rather than punishment, of addicts.
"Only time will tell how effective these funds will be in reversing the trend of heroin abuse in these target areas," says the editorial.

Louisville is embracing this approach of treatment over incarceration with its new, expanded 'rocket docket" model which bypasses the grand jury process on low level offenses to expedite cases and will "help heroin users get rehab help more quickly, spend less time in the court system and have lower chances of committing new crimes," prosecutors told Mathew Glowicki of The Courier-Journal. Glowicki noted the concerns of treatment providers that there aren't enough resources to handle an influx of heroin addicts, especially because "there are fewer treatment beds for those without private insurance and healthcare benefits such as Medicaid."

Northern Kentucky's St. Elizabeth Healthcare's five hospital emergency rooms have reported heroin overdoses continue to climb, increasing to three a day in 2015, compare to two a day last year, Terry DeMio reports for The Cincinnati Enquirer.

DeMio reports that this increase could be because of an increase in heroin use, but it could also be because of increased awareness and a decrease in the stigma associated with heroin, causing more people to seek help and also to an increase in the use of the overdose reversal drug Naloxone that comes with instructions to call 911 after administration. The "Good Samaritan" provision of Kentucky's new heroin law allows for immunity from criminal and civil complaints for heroin overdose as long as 911 is called.

"What's really going on here is, these people are living," Jim Thaxton, coordinator of the heroin task force, told DeMio. "Had they not gotten to the hospitals, they would be a death statistic."

Lexington hosted an event on Aug. 30 for International Overdose Awareness Day to bring awareness to heroin overdoses that attracted hundreds of people, WKYT in Lexington reported. City officials told WKYT that 82 people have died from drug overdoses in Fayette County this year, "most of which are a result of heroin." Louisville also held a rally for International Overdose Awareness Day, WLKY reports.

Heroin overdoses killed 233 Kentuckians in 2014 and 230 in 2013. Kentucky had only 22 deaths attributed to heroin in 2011, according to the state's 2014 Overdose Fatality Report.

Advocate-Messenger image by Clay Jackson

Danville hosted a three-day event in August called "Hope Over Heroin," which was organized by local clergy in the community. The event provides some entertainment, but its true purpose is to provide information about addiction and available resources in the area , Pam Wright reports for The Advocate-Messenger.

The public relations director for Isiah House Recovery Center, a residential treatment center for men and women, and an organizer for the event, Jason Roop, told Wright that four people asked for help at the event and immediately entered rehab.

?Four people last night just stepped up and said they were broken, that they needed help and we took them right away in to get that help,? Roop told her.

Danville Church of God Pastor Bryan Montgomery told Wright that he hoped to "keep the momentum going" after the event including looking at ideas for several new facilities that will be available as ?immediate crisis centers? for the area, as well as ?similar events to Hope Over Heroin, but on a smaller scale? in Boyle and surrounding counties.

Heroin is also bad in Woodford County, but apparently not bad enough to start a needle-exchange program under a law passed by the state legislature this year.

At an Aug. 25 Fiscal Court meeting, the jailer said that 80 percent of her inmates have a drug problem, and for most of them it?s heroin. The ambulance director said that the county has 10 to 15 drug overdoses a month, and said, ?Our Narcan use is going through the roof,? at $40 a dose. ?We may give two or three doses to one patient? to counteract an overdose.

But when Magistrate C.L. Watts asked about a needle-exchange program, County Attorney Alan George said that would take joint action of the fiscal court, the county health board and the city of Versailles, and opinions are divided and no one is taking the lead for action. ?I do not believe it?s going to initiate at the Board of Health level anytime soon,? he said.

Louisville implemented a needle-exchange program in June and is finalizing plans to extend this service across city neighborhoods to increase its reach, Phillip M. Bailey reports for The Courier-Journal. Lexington launched its needle exchange program Sept. 4, KyForward reports. The News Democrat reported that Northern Kentucky's needle exchange is "inching forward."

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