Heroin: Small cities, even rural towns face growing problems

For years, heroin was considered an affliction mainly of poor urban neighborhoods. But these days, the drug is becoming popular in affluent suburbs, small cities, and even rural towns – especially among young people.

From Arizona to New Jersey, many communities that never imagined they would have a heroin problem now face a rising toll of addiction, overdoses, and even deaths.

“You would have to go pretty remote to find a place that didn’t have this,” says Kathleen Kane-Willis, a researcher at Roosevelt University in Chicago who has tracked heroin use since 2004. “It’s just everywhere.”

But for communities and in particular parents, the problem can come as a total surprise.

Take Tamara Olt and her husband, who were vacationing in Mexico last April when they got the call that every parent dreads. One of their sons was lying unconscious in his basement room at the family’s home in Dunlap, a small town in central Illinois.

Joshua Olt died in the emergency room that evening. He was 16.

“Heroin was the biggest shock of my life,” says Dr. Olt, an obstetrician and gynecologist. “The drug had never crossed my mind.”

Yet as more communities realize they have a problem, efforts to confront it are slowly gaining ground. Concerned parents, school administrators, and law-enforcement officials are holding town-hall meetings, forming support groups, and starting campaigns to discourage heroin use.

“We recognize that this is an emerging problem,” says Dianne McDonald, a curriculum director at two Joliet, Ill., high schools. “We want to be proactive.”

According to the National Survey on Drug Use and Health, heroin use in the United States rose 66 percent between 2007 and 2011. The US Drug Enforcement Administration says seizures of heroin have doubled since 2008, and arrests have risen by a third. Most heroin comes from Asia, but more and more is arriving from South America and Mexico.

Although heroin use has been expanding for a decade or more, many communities are just beginning to understand the extent of their own heroin problem. The Dane County Narcotics and Gangs Task Force, which includes personnel in Madison, Wis., reported last year that drug overdoses had risen from 31 in 2007 to 175 in 2011, most due to heroin. In Will County, Ill., just outside Chicago, heroin-related deaths rose from five in 2000 to 53 last year. In Missouri, heroin deaths increased from 69 in 2007 to 244 in 2011 – more than half of them in the age group 15 to 35.

The National Council on Alcoholism & Drug Abuse – St. Louis Area (NCADA), which offers emergency counseling and other services, has seen a dramatic shift in heroin-related calls. Until recently, most came from middle-aged people in poor urban areas. But four or five years ago, that changed. “They were mostly from youth, which was shocking to us,” says Dan Duncan, director of community services. “And they were coming from the suburbs. In 2010, it just seemed to explode.”

Heroin use is still relatively modest. According to the most recent National Survey on Drug Use and Health, 8.7 percent of Americans had recently taken illicit drugs, mostly marijuana and cocaine. Only a quarter of 1 percent over the age of 12 said they had used heroin. But heroin raises additional concerns because, like other opiates, it is considered powerfully addictive and difficult to give up.

“I’ve been working at this for 29 years,” Mr. Duncan says. “I’ve seen people addicted to many things, and heroin is always the hardest to deal with.”

Heroin’s rising popularity reflects what the Centers for Disease Control and Prevention last year described as an “epidemic” of overdoses from prescription drugs, especially painkillers like OxyContin and Vicodin. Users often switch from painkillers to heroin because it’s cheaper and more readily available, experts say. A tenth of a gram, enough for two or three uses, sells for as little as $20. Moreover, heroin has become increasingly available in refined forms that can be sniffed or snorted. Many young people are introduced to heroin in a powder form but eventually switch to injections.

William Patrianakos is one of them. Mr. Patrianakos, who grew up in Lockport, just outside Chicago, tells people that “if there was a graduating class of first addicts to heroin around here, I was one of them.” He started by taking OxyContin pills he got from a girlfriend, and he switched to heroin when he no longer could get the pills. He had struggled with depression, he says, an drugs made him happy.

To finance the addiction, Patrianakos stole from his family, borrowed from friends, and taught himself to counterfeit $100 bills. Like many addicts, he entered treatment programs several times, only to return to heroin. He finally was arrested for counterfeiting and spent a year in a court-mandated drug program. Even then he relapsed for three months before, he says, he finally quit heroin for good.

Today Patrianakos, who is in his mid-20s, works as a computer programmer, makes speeches about drugs, and works with support groups for parents whose children are struggling with addiction or have died from overdoses.

In many places, heroin is still a hidden problem because of the stigma attached to the drug, parents and drug experts say. “There’s still an unwillingness to talk about it in some communities,” says Ms. Kane-Willis of Roosevelt University. “There’s a sense of shame and a ‘it’s not here’ mentality.”

That may be changing, with communities trying to deal with the problem more openly. “We’re trying to raise the curtain,” says Janice Harris, the mother of a 22-year-old heroin addict in Tucson, Ariz. Ms. Harris is founder of the There Is No Hero in Heroin Foundation, which held its first “community awareness forum” in Tucson in November.

The response to such endeavors has often exceeded expectations. Two years ago NCADA, a leader in anti-heroin efforts, planned three public meetings. It ended up holding 27. Schools that initially “didn’t want to have anything to do with us” began asking for help, Duncan says. Organizations outside Missouri wanted advice, too. “We’ve had calls from all over saying, ‘What did you guys do? We need to do something here,’ ” he says.

Recently, 11 high schools and middle schools in the Chicago area began teaching students about heroin using new educational materials from the Robert Crown Center for Health Education, a private organization in the Chicago suburbs. The center developed the materials because existing antidrug education wasn’t working, says Kathleen Burke, the center’s chief executive officer.

“Students didn’t know about heroin,” she says. “They were not aware of what addiction was.” As part of the new curriculum, students are guided through an interactive computer program based on the true story of an addict their own age.

For young people who become addicted, there’s often too little help available, parents and others say. “The problem is getting the kids into treatment quickly,” Duncan says. Some parents recount desperate struggles to find help for their children. Patty DiRenzo of Blackwood, N.J., just outside Philadelphia, recalls how, after her son was turned down by rehabilitation centers and away from hospital emergency rooms, she gave him vodka so he could be admitted to a rehabilitation center with beds available only for alcoholics.

“You do what you have to to save your child,” Ms. DiRenzo says. In and out of treatment, her son, Salvatore Marchese, was found dead of an overdose in his car in June 2010.

Parents also complain that courts and hospitals are sometimes poorly prepared to deal with drug addiction. “It was frustrating and heartbreaking to see, to live, the experiences my son when through – to see how the ‘system’ threw my son around and really got him nowhere,” says Bonnie Flazone-Capriola, a mother in Rockford, Ill. Ms. Flazone-Capriola says her son was arrested several times while seeking help for addiction.

“He once said to me, ‘I don’t know why they keep throwing me in jail. The only person I am hurting is myself,’ ” she says. He died of an overdose in 2010, she says, after a judge refused to allow him to receive methadone as a treatment for the addiction.

Increasingly, families of addicts are turning to one another for help. John Roberts was a newly retired Chicago police captain living in Homer Glen, Ill., when, in 2010, his youngest son died of a heroin overdose. Mr. Roberts reached out to another local father who had lost a son, and together they organized a march through their town.

“We were just a couple of dads just shocked by what was happening in our community,” Roberts says. They also started the Heroin Epidemic Relief Organization, or HERO, an organization devoted to publicizing the heroin problem and helping the families of addicts.

Families have established many such groups around the country. Others are turning to the Internet. Vicki Allendorf, a mother in Dubuque, Iowa, started a Facebook page last year after running out of ideas for how to help three sons who had become heroin addicts.

“I was sort of reaching out to other parents,” she says. “ ‘Help! What do I do? This isn’t working.’ ”

In just a few months, more than 2,500 people responded. They wrote from New Jersey, Florida, California, and rural Wisconsin. Many were parents of addicts, but addicts wrote, too.

“The really beautiful thing about this is that addicts have contacted me,” Ms. Allendorf says. “Now I really understand the addiction part of it.” The site has also helped more than 20 young people find treatment for addiction, including one of Allendorf’s sons, who is now at a rehabilitation center in Florida.

Advocacy groups are also trying to help addicts through legislation. One issue, they say, is the reluctance of friends to call for help when an overdose occurs. Victims are left outside emergency rooms or simply abandoned. “The fear of police involvement is the main reason people don’t call 911,” Kane-Willis says.

So far, 11 states have passed “good Samaritan” laws that grant limited immunity to witnesses of a overdose. Advocates are also seeking new rules that allow doctors to prescribe naloxone, a drug used to counteract overdoses, to families of addicts.

Dr. Olt, who started a support group after her son died last April, has spoken frequently about her son in interviews with local news media. “My first inclination was, I want people to know who my son was,” she says. “He wasn’t a bad kid. He was an amazing person.”

She also hopes to warn other families: “It doesn’t matter where you work or live or what your social status is. Your child can be at risk.”