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Region is responding to heroin problem with more money for treatment

This article first appeared in the St. Louis Beacon, Nov. 8, 2012 - I’ll take your money. / I’ll take your freedom. / I’ll take your family. / I’ll take your life. / My name is … Heroin

This chilling warning, printed on a colorful placard at an anti-drug rally in September at the Gateway Arch, sums up the impact of heroin abuse in the St. Louis area.

Once regarded as a drug whose use was confined to desolate pockets of cities, heroin has now penetrated suburbia, luring naïve teenagers and young adults into a web of addiction that can destroy them.

“It hijacks the brain, and the only thing you can think about is the next high,” explains Chad Sabora, 36, a recovering addict active in an emerging local movement against heroin.

While the heroin death rate may be declining in St. Louis County, the drug has claimed at least 500 lives in the St. Louis region during the past two years, according to the St. Louis unit of the National Council on Alcoholism and Drug Abuse. The number of heroin-related deaths last year included 107 in St. Louis, 91 in St. Louis County, 18 in St. Charles County, 16 in Jefferson County and five in Franklin County.  Overall, the number of deaths from heroin overdoses rose to more than 247 last year from 81 in 2007.

Officials report that 90 percent of heroin deaths statewide occur in the St. Louis region, partly because sophisticated cartels have targeted this region as a market.

The number of heroin-related admissions for treatment also has risen statewide – to 2,321 in 2010, from 1,413 in 2008, according to the Missouri Department of Mental Health.

The good news, some say, is that the St. Louis area is beginning to respond more forcefully to the problem, first, by putting more money into treatment and, second, by bringing the community together to discuss the problem.

The latest discussion is coming from the Nine Network of Public Media. It hopes to broaden the conversation with a live town hall program on Nov. 12 at 7 p.m. to talk about signs, stigmas and treatment associated with heroin and about how the epidemic is affecting neighborhoods. 

Equally significant is an expanded effort to address the heroin epidemic as a public health problem. That move began earlier this year when Kathy Gardner of the local United Way convened a meeting of service leaders, government representatives and funders to talk about developing a more unified response to the area’s heroin problem. Out of those discussions grew a broader public awareness campaign, along with a goal of offering outpatient detox services to an additional 200 addicts a year during the next three years.

So far, the partners have found about $900,000 for this initiative. Along with the United Way, the partnership includes state health agencies, the St. Louis Mental Health Board, the Lutheran Foundation, and children’s service funds run by St. Louis County, St. Charles County, Franklin County and Lincoln County. The National Council on Alcoholism and Drug Abuse-St. Louis will run the public awareness campaign, while Bridgeway Behavioral Health and Preferred Family Healthcare will handle treatment services.

Dan Duncan of the National Council on Alcoholism and Drug Abuse-St. Louis  (NCADA) says drug treatment is only part of the therapy needed to lift people out of a heroin addiction.

“I don’t want to give the idea that it’s all about medication because it’s not,” he says, adding that treatment and counseling must be used together to address spiritual, psychological and physiological issues surrounding addiction. 

As for medications, addicts are treated with Subozone for detoxification, followed by Naltrexone or Vivitrol, both of which help prevent relapses to opioid dependency after detox. Treatment by Vivitrol also has the advantage requiring only one injection monthly.

Years ago, Duncan notes, methadone was the medication of choice for treating heroin addiction. Those treated with methadone had to remain on it for a lifetime. Duncan says the newer drugs, such as Subozone and Naltrexone, are used for six months to a year, along with counseling, to help addicts break the heroin habit.

Why are so many middle-class kids attracted to heroin? Experts and addicts themselves told the Beacon that heroin use usually follows abuse of prescription pain pills, often from the medicine cabinets of relatives or acquaintances. When the pills are in short supply, some addicts look for alternatives and turn to heroin in pill or white powder form. This form is acceptable to some because it eliminates the stigma of having to use a needle to inject it. Instead, the heroin can be snorted, smoked or ingested. Heroin tends to be more plentiful, accessible and cheaper than pain killers. The main drawback, however, is its highly addictive nature.

Even so, addiction levels may be declining in St. Louis County, according to Sgt. Mark Whitson of the department’s Drug Task Force. He said the county had recorded 51 heroin overdose deaths as of Oct. 1, representing a 29 percent decrease over the number at this time last year.

The most heroin-related calls last year to the NCADA came from ZIP code 63119, which includes Webster Groves. Thirty-one calls came from 63119, followed by 17 from the 63123 ZIP code, south of the Webster Groves area and including Affton.

“The calls are either from a parent or an addict on the edge and needing help right now,” Duncan says.

On the other hand, he notes that the calls may also signal that the anti-drug campaign is having a positive effect in the two county ZIP codes and that the callers have learned to take steps to protect someone at risk.

That’s also the thinking of John Thomas, director of student services in the Webster Groves School District. He believes the problem has been limited to less than 1 percent of students, and he notes that concerns about heroin are common among many other county districts.

“We’ve tried to really be proactive with our kids and help them make good decisions. I think there is a glimmer of hope that some of this is working because we’re not hearing as many rumors about our kids being involved” in heroin use.

Robert Joiner has carved a niche in providing informed reporting about a range of medical issues. He won a Dennis A. Hunt Journalism Award for the Beacon’s "Worlds Apart" series on health-care disparities. His journalism experience includes working at the St. Louis American and the St. Louis Post-Dispatch, where he was a beat reporter, wire editor, editorial writer, columnist, and member of the Washington bureau.

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