NORTH FULTON, Ga. – Heroin has become stronger, cheaper and more available in recent years as the drug is in the midst of an unprecedented resurgence.
According to the Centers for Disease Control and Prevention (CDC), over 669,000 Americans used heroin in 2012 with 18- to 25-year-olds having the highest number of use. Since 2006, heroin-related overdose deaths have risen by 45 percent.
In 2014 in Alpharetta, Roswell, Johns Creek and Sandy Springs, there were 23 overdose deaths directly caused by heroin, heroin laced with the drug fentanyl or heroin combined with other drug use. Of those deaths, males accounted for 74 percent, and nearly two-thirds involved those under the age of 30.
According to Georgia Poison Control Center Director Dr. Gaylord Lopez, the resurgence in heroin use can partly be attributed the tougher regulations on opioid prescription drugs and the crackdown on pill mills.
“The supply of [prescription opioids] is drying up. The market is such that those pills are becoming too expensive to purchase. The alternative is heroin, which is going to be half the price. And then you’ve got yourself a resurgence,” said Lopez.
For many, the use of prescription opioids, such as common pain killers, acts as a gateway to heroin. However, many of these opioids are now classified as schedule II versus schedule III drugs, meaning that the amount that can be prescribed to patients at one time is much lower. Thus, these opioids become harder to obtain and are more expensive. For those who abuse these prescription drugs, heroin proves to be more available, cheaper and stronger.
George Gordon of the Alpharetta Public Safety Department said heroin has been confiscated at much higher levels of purity than in the past. However, heroin that is not particularly pure is now being mixed with fentanyl and fentanyl derivatives such as acetyl fentanyl.
Fentanyl is a prescription opioid often given to patients that are not responding well to other pain medications or given to cancer patients for “shooting” pains. Fentanyl is extremely powerful –doses are measured in micrograms. According to the CDC, it is estimated the fentanyl is 80 times more powerful than morphine.
According to Lopez, the addition of fentanyl could forever change heroin itself.
“When you talk about shooting up garden-variety heroin, those days are probably long gone,” he said. “Often fentanyl is substituted for heroin. It makes the [heroin] that much stronger. In fact, you could probably get away with having low-grade, low-potency heroin and add fentanyl to it and you’ve got yourself a decent opioid. That’s where the problem lies. People don’t know they’re taking fentanyl. They’re not going to know what the product actually contains. When you’re dealing with an opioid that is much stronger and much more potent, people are thinking ‘I’ll take the same dose that I’m used to taking,’ not knowing that it is combined with fentanyl and you have a recipe for disaster.”
The combination of fentanyl and heroin has proven to be lethal.
“Drug incidents and overdoses related to fentanyl are occurring at an alarming rate throughout the United States and represent a significant threat to public health and safety,” said DEA Administrator Michele M. Leonhart in a Drug Enforcement Administration statement. “We have lost too many Americans to drug overdoses.”
The rise in deaths in the North Fulton area coincides with the number of heroin overdoses nationwide. According to a DEA report, heroin overdose deaths rose 172 percent from 2010 to 2013. The report also states that heroin use has spread to suburban areas and is now attracting users of higher socio-economic classes, younger users and is used by all races.
“There is no longer a typical heroin user,” stated the report.
For Alpharetta resident Kate Boccia, the statement holds true. Her son Daniel is currently an inmate at Central State Prison in Macon.
Boccia explained that at the time of Daniel’s arrest, he was a heroin addict and that he was able to score heroin even in affluent Alpharetta.
Daniel, like many heroin users, was introduced to opioids after having his wisdom teeth removed.
“I would have never given him those pills if I knew how powerful they were,” Boccia said.
Daniel became addicted to prescription opioids such as OxyContin and Roxicodone. When the crackdown on pill mills came, Daniel turned to heroin.
“Daniel became someone that is not the person you know,” Boccia said. “He became a lying, cheating creep. And all heroin users are like that.”
Daniel was arrested for armed robbery at a party on the campus of Georgia Tech. His sentence carried a minimum sentence of 15 years in prison.
However, Boccia explained, her son’s arrest has had a positive effect, because Daniel is now clean.
“At least my son is alive. Lock-down isn’t all so bad,” she said. “He’s so happy to be free of [addiction]. We saw him go in as a very sick man. He was suicidal. The first time I visited him, I didn’t recognize him. He had changed in that short amount of time. He talks about how good he feels. He says he’d never go back to it, and I can tell.”
She said that she was naïve as to how to handle her son’s addiction. Boccia, along with Remco Brommet, started The Hub Family Resource Center in Johns Creek that provides information and assistance to those in need of resources and information, including drug addiction.
“If I had something like the Hub available to me, Daniel wouldn’t be in jail,” said Boccia.
Lopez says that curbing heroin use is extremely complex, although there is at least one way in which the amount of overdose deaths can be prevented – naloxone, a drug that can counteract the effects of a heroin overdose.
“People like me would love to see naloxone made available over-the-counter. That can at least cut down on the number of overdose deaths,” he said.
Naloxone use was made more available in Georgia by the passing of the 911 Medical Amnesty Bill in April 2014. The bill extends legal protection to those who administer naloxone to someone overdosing and also grants limited liability to those who have drugs in their possession if they seek medical attention for someone overdosing.
Some police departments and emergency personnel have begun carrying naloxone to combat overdoses. The police departments of Woodstock, Atlanta and Holly Springs now carry naloxone, however no city in the North Fulton area currently carries the drug.