Cheap, easy-to-get heroin leads to spike in Oregon overdose deaths

From the Oregonian, April 4, 2012

The warnings from law enforcement started early last year, said Dr. Karen Gunson, the state medical examiner: Police told her they were seeing a big increase in the amount of heroin entering the state.

As the year wore on, the bodies kept piling up. By the end of 2011, 143 people, mostly young men, had died of heroin overdoses in Oregon. That’s 53 more than died the year before, and the most since the 131 who died in 2000.

“The numbers are driven by the availability of heroin and how cheap it is,” Gunson said from her offices at the State Medical Examiner’s Office and the Oregon State Police forensic laboratory across the street from the Clackamas Costco. “More than ever it’s just a flood–especially of heroin. It’s like a tidal wave.”

Gunson said heroin deaths peaked in the state in 1990, with about 250 tied to the drug’s use. That number kept dropping until about 2005 when it gradually started going up again.

She said the other factor driving the increase other than its availability is the fact that most heroin in Oregon is black tar heroin, which is not easy to cut with fillers that might decrease its potency.

“When you use it, you have no idea what you’ve got,” Gunson said. “It could be 20 percent, or 60 percent pure.”

She said most of the overdose victims are men, and they have been getting younger and younger each year. Rather than middle age men, she said, the victims are in their early 20s and early 30s. Where and how they die is agonizingly familiar.

“You can die in your car, die in restrooms, die down at Waterfront Park, in restrooms at fast food places,” she said. “Some of them get out of jail or the penitentiary and die on their way home.”

Years ago, Gunson said, a man went into a locker room at an upscale athletic club in Portland, injected in the locker room and died.

“We’re not just talking about lower socioeconomic classes,” Gunson said. “It spans all of society from top to bottom.”

Heroin is a central nervous system depressant. An overdose can kill quickly but is usually a long, drawn out process. If someone is with the person that overdoses, the story is frequently the same, Gunson said: The person nods off, falls asleep and then begins snoring–often loudly.

“They will tell me, ‘They were snoring for a long time and then thank God, the snoring stopped.” Well, they stopped snoring because they died. When they are in snoring phase, they are really in a coma.”

A traffic stop in Southeast Portland in November resulted in the seizure of a kilogram of heroin valued at more than $100,000, police said.

Gunson said many times she can tell by a person’s body, or the circumstances of where the person died–surrounded by needles, or a tourniquet still around an arm–that the death was a heroin overdose. That and the meringue-like foam that comes out of the nose and mouth. Many times an autopsy is not required, she said, although drug toxicology tests are always done.

Overdoses from methamphetamine and cocaine–both central nervous system stimulants–have remained fairly steady, as have deaths from abused prescription drugs such as Oxycontin or methadone; last year, 130 people died from prescription drug overdoses.

Those who overdose on cocaine either die from a seizure or an irregular heartbeat. With meth, she said, they take too much and they do stupid things, such as jump off buildings or die in car wrecks.

“That’s not saying that meth isn’t everywhere or a big problem,” Gunson said. “But people just don’t die from it like they do from heroin.”

Lt. Derek Rodrigues with the Portland Police Bureau’s drugs and vice division said the uptick in heroin overdoses in Portland can also be linked to the steep price and scarcity of the prescription painkiller oxycodone.

“A hit of oxy is hard to get and can go for $30, $40 But a hit of heroin is only $10,” Rodrigues said. “Same high, cheaper price. And if it’s a bad batch…”

Not surprisingly, the Oregon State Police’s drug enforcement section recorded the most drug seizures in its history last year, with 296, a 30 percent increase from 2010 and a 150 percent jump from 2008. That included 24 pounds of heroin; 242 pounds of meth; and 164 pounds of cocaine. The seizures led to 382 arrests.

“Although these seizures have kept traffickers from delivering substantial quantities of dangerous illegal drugs to their destination, significant supplies remain available and have a real effect on our communities and individual users,” said Capt. Calvin Curths, director of OSP’s criminal investigation division.

Curths said this year is shaping up to be another big year for drug seizures by the department, and like last year, most of the seizures are occurring on Interstate 5.

That will probably mean another year when more than 100 people die from heroin overdoses. The ledger is already adding up, Gunson said.

“We’ve got eight bodies in the cooler and three of them are overdose deaths from this week,” she said.