Addressing Rx Drug Abuse in Rural Communities

From Aspen Daily News

Opiate addiction, treatment on the rise in the valley

At least three have died due to overdoses of heroin, painkillers in the past year

At least three Roaring Fork Valley residents have died in the past year from either heroin or painkiller overdoses, and the Aspen Valley Hospital emergency department has treated more opiate-related cases in 2013 than in the past two years combined.

The deaths, two from heroin and one from prescription medication, occurred throughout the upper and midvalley. The average age of the deceased was 30 years old, according to law enforcement records.

Heroin use “in general in Colorado is definitely on the upswing,” said Jim Schrant, the agent in charge of the U.S. Drug Enforcement Administration’s Grand Junction office, on Monday. “Denver has always had a significant heroin issue, and now we’re seeing it more in the Grand Junction and Durango areas.”

Numbers from AVH show that the upper valley has not escaped the surge in opiate use.

“It’s definitely on the increase,” said Steve Ayers, an Aspen emergency room doctor. “It used to be that I’d see a case of heroin use or withdrawal every month or so.”

That rate has nearly doubled, according to figures provided by hospital spokeswoman Ginny Dyche.

So far in 2013, the emergency department has seen 21 cases of opiate “dependence, non-dependence or poisoning,” she said.

That compares to eight such cases in 2011 and 10 in 2012. Those are not just heroin cases, as AVH’s coding of opiates also includes a number of other drugs, including codeine, morphine, Dilaudid and Demerol.

The Wall Street Journal, in an August article on heroin plaguing small communities, reported that supplies of the drug from Mexico have skyrocketed while prices have plunged.

“Heroin use in the U.S. is soaring, especially in rural areas, amid ample supply and a shift away from costlier prescription narcotics that are becoming tougher to acquire,” the paper reported.

Both Ayers and Schrant said that oftentimes when someone is addicted to painkillers and finds the supply has dried up, heroin is where they turn.

“There’s a clear correlation between pain medication, prescription drug abuse and heroin,” Schrant said.

The trend of substituting heroin for painkillers comes on the heels of a nationwide crackdown on doctors and pharmacies who authorities say are over-prescribing drugs like Oxycodone, Ayers said.

Aspen police continue to investigate the heroin overdose death of a woman in November 2012.

“We did pick up some evidence from the scene,” said Linda Consuegra, Aspen assistant police chief.

The investigation, including several interviews, led to another jurisdiction, and Aspen police forwarded their results to authorities there, she said.

Consuegra said finding who was or is selling heroin in the valley through an overdose victim is very difficult because people with knowledge of the drug sales rarely come forward.

The postmortem report for the woman says she had a history of heroin use and was attempting to stop.

She wasn’t alone in using the drug. Since opening in February, the Aspen detoxification unit of Mind Springs Health, which provides substance abuse treatment, has had 13 admissions, including four alone in April, for heroin, said the organization’s program director, Andrea Pazdera.

Ayers said he believes that more people are using opiates, a change in Aspen drug users’ habits.

“It used to be cocaine, alcohol and sedatives,” he said. “Now it seems to me there’s more heroin use.”