Delray steps up push for solutions
Packets of heroin and cash were seized during a recent arrest.
Photo provided by Delray Beach Police Department
By Thomas R. Collins
The heroin addict is unconscious, teetering between life and death.
A paramedic swoops in and gives a shot of medication that — almost literally — brings the person back from the dead.
The reaction from the user? Not amazement, not gratitude. And definitely not relief. Instead, there’s anger and contempt. What a powerful high he had going — the addict often says, according to Delray Beach Fire-Rescue Chief Danielle Connor — but the paramedic stole it from him.
Such is the twisted world of a heroin addict — an increasingly common figure in the landscape of drug use in the Delray Beach and southern Palm Beach County area.
In an uptick over a 24-hour period on Aug. 28 and Aug. 29, there were three overdose deaths in Delray Beach that police believe were due to heroin.
The rise in heroin use has put drug-abuse-prevention specialists and drug-treatment professionals to a new test. As regulation of pain pill prescriptions has found success and made those drugs harder to get and more expensive, many of those addicted to oxycodone and other pain medications have turned to heroin.
It’s an obvious choice, really — it’s cheaper, more accessible and more potent.
Professionals are trying to attack this latest scourge of drug abuse: Narcotic-reversing medications, new laws, and a slew of brainstorming action teams and task forces are coming out of the toolbox.
“We have definitely in recent years seen an increase in heroin use in our community,” Connor said. “It’s truly epidemic levels in our community.”
Delray Beach police went public with a spike in the city’s heroin use in June, after a huge uptick in heroin overdoses was seen in May. There were 17 in the city that month, compared to nine for the entire calendar year up till then. There were four deaths from heroin.
“When we started seeing that uptick in that month, we decided to attack it head on,” Police Chief Jeffrey Goldman said. The public was asked not to clean up overdose scenes, so that evidence would be more available to police. All crime scenes where the August deaths happened were cleaned up before evidence could be gathered, so police weren’t able to test the substances to see if they were laced with anything, such as the poweful opiate fentanyl, to make them more poweful.
Sgt. Nicole Guerriero sought to reassure those who clean up crimes scenes out of fear of police, saying state law doesn’t allow prosecution of those who phone in an overdose emergency, or the prosecution of the person overdosing, lest a potentially life-saving call not be made.
Since the May uptick, more confidential informants have been used, Goldman said. He said the police have not seen a corresponding rise in people and property crimes — such as assaults or burglaries — as a result of the heroin spike.
In May, there were 70 calls to Delray fire-rescue for a bad reaction to a drug, for an overdose or for a death, Connor said. Before that, Delray hadn’t had more than 26 in a single month in 2015. In June, there were 70 calls again.
In July, the number of calls dropped to 39. Connor said it wasn’t known how many of those involved heroin, but it stands to reason that heroin drove the spike.
In September 2013, a similar rash of drug calls was seen when “a bad batch of something” hit the streets, Connor said.
“I don’t ever remember — and I’ve been here 22 years — getting these types of numbers at any time,” she said.
Of 394 drug-related calls to Delray Fire-Rescue from August of last year to July of this year, paramedics have injected drug users with Narcan 192 times — almost exactly half the time. Narcan, the brand name for naloxone, almost immediately reverses the effects of opiates. So when paramedics use it, addicts are out cold one minute, often on the brink of death, and alert — and faced with their grim reality — the next.
New laws affecting
reversal drug, referrals
A change in Florida law that took effect in July now allows caretakers and other nonmedical personnel to administer Narcan — it can be done with virtually no training. Delray police, often on the scene before paramedics, are working out the logistics of carrying it, including how to store it in the police cars.
The drug gives addicts a new lease on life, but, usually, they don’t see it that way — they just want their high back, Connor said. High users, upon seeing paramedics in emergency rooms, sometimes beg them not to inject them with Narcan, Connor said.
Another legislative move, which also took effect in July, creates a voluntary certification program for sober homes, where addicts recently out of rehabilitation programs live to get further support as they continue their recovery. Law enforcement and treatment professionals frequently refer to “the good and the bad” sober homes, distinguishing between those that are run properly, with recovery the real goal, and those that exist only to work the system and make a profit.
Starting in July 2016, rehabilitation centers will be allowed to refer patients to certified sober homes, which is when experts expect the real change to begin taking hold.
Sober homes are highly concentrated in southern Palm Beach County, particularly in Delray Beach. The Fix, an addiction and recovery website, lists the city as one of the country’s Top 10 destinations for sober living, along with metropolises New York, Los Angeles, Boston and San Francisco. The 5,000 people going to 300 12-step programs a week, and its eclectic therapy settings, give it “the sobriety footprint of a much bigger city,” the site says.
Unrelieved pain
a path to addiction
Suzanne Spencer, executive director of the Delray Drug Task Force, said the sequence of events leading to heroin addiction in the Delray area, and elsewhere, can be gradual and insidious. An accident causes pain. People take pain medication the proper way. Legislation hits and suddenly they have trouble finding a doctor willing to give them a prescription. They turn to heroin.
“No one wakes up and says, ‘I think I’m going to have an addiction,’ ” Spencer says. Anyone can be just a car accident away from becoming a heroin addict, the saying goes.
Spencer has assembled a “heroin response team” to try to draw up new solutions. The team is looking at potentially modeling something after the Montana Meth Project, a savvy, hard-hitting media blitz that has capitalized on social media.
But there are realities to be dealt with: Team members don’t want to tackle heroin and somehow lead addicts to other addictions. Plus, medical advancements in the treatment of HIV, while welcomed, have taken away what was formerly a natural deterrent: The fear of AIDS got some people to think twice before injecting themselves.
“There are some who feel that HIV is no longer a death sentence,” Spencer said.
Indeed, HIV and hepatitis C infections are generally on the rise, possibly reflecting this reshaped view, said Terri Neil, communications specialist with the Comprehensive AIDS program. Addicts know about the advancements in HIV treatment just like everyone else, Neil said.
“The last thing they care about is getting HIV,” she said. “All they care about is getting their next fix.”
Success in treatment
is quite possible
Paul Cassidy — chief operating officer at Access Recovery Solutions, which offers methadone treatment and medication-assistance treatment approaches — said that Delray Beach has been seen as underserved by methadone treatment for opiate addictions since 2010. His company finally opened a center several months ago.
The treatment challenges for pill addicts and heroin addicts is largely the same, he said. Everyone seems to be at risk; Access Recovery’s clients are 18 to 71 and an even split between men and women, Cassidy said.
Treatment can work, though. About 63 percent of patients are unemployed when they first arrive; in two months, that’s down to about 28 percent, he said.
“In a relatively short period of time, people have rejoined the workforce and are doing something,” he said.
Joe Bryan, executive director of the 12-step, abstinence-based Beachcomber rehabilitation center near Briny Breezes, said that the makeup of the person, not necessarily the drug, dictates his or her recovery success. For instance, those in positions of privilege, who aren’t used to being told no, might have a more difficult time getting and staying sober, he said.
Compared to pain-pill addicts, heroin users — because of the extra stigma linked to heroin — might be a little quicker to lose their support structure of family and friends, a factor so important to someone’s recovery odds, he said.
“There are many successes,” Bryan said. “I don’t know if more than not, but enough to keep working at it.”
Cassidy’s assessment of the future of the drug battle, here and nationally, was tempered — he’s “not that optimistic” the problem will go away.
“We don’t spend nearly enough to reduce the demand,” he said. “But that’s basically retooling as a country how we’ve handle the drug problem for 50 years.”