An increase in local heroin cases appears to mirror a trend across the nation, where health officials have noticed a startling jump in fatal overdoses.
"Our data shows heroin use is resurging," said Dr. Wesley Clark, director of the Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration in Maryland.
Heroin use has ebbed and flowed in America over the last century. The latest surge was first spotted in 2007, said Clark. But it has been further fueled by changes in 2010 to the formula for a potent painkiller called OxyContin.
The drug, a time-released version of oxycodone, is similar to morphine and was prescribed by doctors for severe pain relief. OxyContin abuse led to a nationwide addiction epidemic by the late 2000s, starting earlier in the decade on the East Coast and sweeping westward.
In 2010, Santa Rosa police reported a wave of crimes involving OxyContin by local addicts, including armed pharmacy robberies.
In August 2010 Purdue Pharma changed the formula, reducing the potency and making the pills harder to tamper with. For the most part, the change diminished the abuse of OxyContin, but it also shifted the problem elsewhere. Full-strength OxyContin began disappearing from the street, and addicts began seeking their highs from other drugs.
Heroin as the favorite new option caught the attention of the national media in July, when researchers published a letter in the New England Journal of Medicine.
The researchers explained surveys of drug abusers seeking treatment revealed high numbers had switched from OxyContin to heroin and other somewhat less potent opioids, or synthetic versions of opium, such as high-potency fentanyl and hydromorphone. They switched, researchers said, because the OxyContin formula had changed and heroin was cheaper and easy to get.
The increase has led to a jump in heroin-related deaths.
Fatal heroin overdoses nearly doubled in the United States during a recent 10-year period, the Centers for Disease Control and Prevention reported. In 1999 there were 1,725 heroin deaths reported. Ten years later there were 3,278.
The bigger problem, according to the CDC, are deaths from prescription medication overdoses.
During the same time period, fatalities from opiate-style painkillers and other similar drugs went from 4,030 to 15,597, according to the CDC.
In Sonoma County, there have been 10 deaths in the past year due to overdoses from combinations of drugs and one attributed to heroin alone, according to reports through Nov. 15, said sheriff's Sgt. Greg Stashyn, Sonoma County Coroner's Office supervisor.
More extensive data was difficult to obtain because the county's death records aren't computerized. But Dr. Kelley Arthur-Kenney, who conducts autopsies for Sonoma County, said there hasn't been an increase in heroin overdoses in recent years.
However, pinpointing whether heroin was to blame can be difficult to diagnose in some fatal overdoses, due to a timing issue involving body metabolism after death.
She's seen deaths involving narcotic medication and muscle relaxers and combinations with the abuse of another painkilling option, high-potency fentanyl.
Arthur-Kenney said she's also seen a growing number of fatalities involving overdoses in younger adults.
"Over the past almost 10 years I've seen a lot more younger age groups, 40's and younger, with poly-pharmacy including oxycodone and hydrocodone and methadone," she said.
With an aging nationwide population, the opiate-like pills aren't going away as older people want relief from their aches and pains, Clark predicted.
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