Fulton County may not reflect the problems of more urbanized areas of Ohio, but it hasn’t escaped the traumas of heroin use.
That was the message delivered by local health and law enforcement officials during a recent presentation to Healthy Choices Caring Communities (HC3), a community coalition through the Fulton County Health Department that works to reduce underage substance abuse. But the event also offered hopeful measures being taken to stem the current tide of heroin use.
Speakers included County Prosecutor Scott Haselman, Delta Police Chief Nathan Hartsock, Fulton County Health Center Center Emergency Department Unit Manager Deb Bowman, and Health Department Director of Nursing Cindy Rose. All presented sobering facts about the heroin scourge, both locally and statewide.
In Fulton County alone, 733,747 doses of opiates and pain relievers were dispensed on average during the second and third quarters of 2014. Based on calculations by Haselman, that translates to 17.19 doses per capita, as compared to 16.49 doses per capita statewide.
According to a report by the Ohio Substance Abuse Monitoring Network covering June 2013 to January 2014, and including Fulton County, heroin and prescription opiates are incredibly accessible. Of the state’s citizens in treatment for substance abuse in 2001, 1.2 percent of cases involved treatment for opiates. That number grew to 23.7 percent in 2012.
Across the state, 2,482 unintentional drug overdoses occurred in 2014. It was the leading cause of accidental death.
A sampling of Fulton County statistics involving aberrant opiate use, as provided by Haselman, include the following:
• Eight percent of the county’s students in grades 6 to 12 took prescription medications not prescribed to them or took more than they were prescribed in order to get high. That percentage increased to more than 14 among youth over 17 years old.
• Six percent of county youth have misused prescription drugs in the last 30 days.
• Fifty-five percent of county youth believe the risk from misusing prescription drugs is substantial.
• Of 15 or more counties stretching from Sandusky County to the Indiana border, and from the Michigan border to Allen County, Fulton County had the second highest unintentional drug overdose death rate per 100,000 people between 2008 and 2013.
“Drug abuse in general, and opiate/heroin abuse in particular, is far and away the most important criminal justice issue in this county,” Haselman said. “I also believe that it is the most important societal issue in Fulton County because its impact is so widespread.”
He noted that opiate addictions often begin with the misuse of prescription pain medication. Abusers switch to heroin because it’s a much cheaper alternative, only about one-tenth the cost: $100 to $120 per gram, the equivalent of about 10 “fixes.”
“I believe that the prevalence of drug abuse would shock the average citizen,” Haselman said. “One of the largest issues that we face in addressing the issue is that most people believe that drug addiction is ‘out there’ somewhere rather than in their own communities. There is not a community in this county that is immune from drugs. Not one. We’ve had cases involving drug trafficking in every area of the county.”
Because they don’t recognize the signs, most people are unaware when they encounter someone with an addiction, he said. “(E)ven if someone is aware of what to look for, certain individuals are very good, especially early on, at hiding their problem.”
According to Haselman, the state has spent approximately $1.5 billion or more annually towards the Ohio Department of Rehabilitation and Corrections. Approximately two-thirds of the state’s inmates are or have been victims of substance abuse.
In Fulton County, he estimates that two-thirds of all felony crime – including one-half of all felony property crime – is somehow related to the pursuit of drugs. Consequently, the state attempts to make the drug problem the responsibility of local government.
“I always tell people that there is no single fix for this problem. It will take a large segment of the population each doing their part, some big, some small,” Haselman said. He credits HC3 and the Swanton Area Community Coalition with raising awareness locally.
Depending on whom you talk you, heroin use is a disease or an epidemic, Hartsock said. The Delta police chief said the village experienced three heroin overdoses in 2015, two of them fatal.
“I would call it a choice that led to an addiction. They made a conscious choice to try it,” he said.
He described a heroin “high” as a pleasant rush and comfortable feeling throughout the body. Unfortunately, as the effects dissipate the user experiences dry mouth, vomiting, itching, and a feeling of heaviness in the extremities. They also become drowsy for several hours, and basic bodily functions slow, including breathing. In fact, respiration slows so much it can crawl to a stop, resulting in death.
Hartsock said heroin is so potent it can take only one use to become addicted. It is injected by syringe, many times between toes or next to eyes to avoid detection. It can also be smoked, and to avoid detection crafty users have even begun loading heroin into electronic vapor cigarettes, the latest smoking trend.
Because the drug is relatively inexpensive and readily available on the street or through a telephone call, “it’s definitely on the rise,” Hartsock said.
That means felony crimes perpetrated to fuel drug habits are on the upswing as well. Many are property crimes that include theft and burglary.
Naloxone, a drug long used by emergency medical services to counteract opiate overdoses, has recently become available to police officers on patrol. Although it hasn’t been used yet by Delta police, its use by local authorities saved the village’s most recent victim of heroin overdose.
According to Haselman, Naloxone was administered in the county last year to 47 individuals, an average of almost once per week. “One can never tell how many of those individuals would have died of an opiate/heroin overdose if they had not received help,” he said.
But Naloxone alone won’t solve the overall problem, Hartsock said.
“Heroin users aren’t coming out of the woodwork to ask us to help,” he said. “We need to educate everyone on the use of heroin. We can’t police people’s bedrooms. It’s up to (family and friends) to start looking for these clues, such as spoons and syringes. People don’t realize what they’re getting into.”
State government is trying to do its part, said Cindy Rose, director of nursing for the Fulton County Health Department. In 2006, it launched the Ohio Automated Rx Reporting System (OARRS), a web-based program that allows doctors and pharmacists to cross-check prescriptions statewide to prevent drug abuse. While the original system was cumbersome, Gov. John Kasich made efforts to simplify the procedure.
“You can identify people who might be doctor shopping or check to make sure you’re not over-prescribing. It’s designed to identify when too many prescriptions are given to a patient,” Rose said.
The state made OARRS a mandatory procedure for doctors last April, and will place the same requirement on pharmacists as of Feb. 1.
Rose said the goal is to identify people requiring intervention and treatment for drug abuse. “Unless you have a system that monitors that, you’re not going to know,” she said. “It has helped to decrease significantly the number of prescriptions.”
According to Haselman, Fulton County Common Pleas Court Judge James E. Barber is overseeing the possible creation of a special court docket focusing on defendants with addictions. But Haselman said success in defeating opiate use, including heroin, seems to be hit-and-miss.
“The old phrase, ‘An ounce of prevention is worth a pound of cure,’ is particularly important in this arena because treatment for those who are already addicted can be enormously expensive, while prevention programs are comparatively inexpensive. Prevention is the area where everyone has a role to play,” he said.
Through an anonymous survey sample involving students in grades 6 to 12, a 2014 Fulton County Health Assessment reported that 48 percent had not spoken to their parents about drugs in at least a year. Twenty-nine percent said they have never discussed the issue with their parents.
Haselman said such conversations may be uncomfortable but they’re critical. He said it’s also crucial to have the discussion repeatedly as children continue to grow and become increasingly influenced by others.
“Do your best to make your kids aware of the physical and emotional dangers presented by drugs…We may think that our kids aren’t listening to us, but the statistics show that they are,” he said.
Hartsock believes tougher penalties for use are also in order.
“We can’t arrest ourselves out of this problem. Sooner or later, we have to have repercussions to use, some kind of penalty, not just rehab,” he said. “We have to get them away from the lifestyle, get them to realize there’s more to life than chasing a high.”
David J. Coehrs can be reached at 419-335-2010.