Heroin Deaths Spike In Connecticut; Push Past 300 In 2014

July 12--Heroin deaths have increased dramatically across Connecticut over the past three years, with the drug playing a direct role in 306 fatalities last year, state medical examiner records reveal.

In combination with other drugs or alone, heroin was a key factor in 222 deaths in 2013 and 100 in 2012. The troubling trend mirrors national numbers recently released by the federal government.

While most heroin-related deaths involved residents of the larger cities, the number of towns with at least one fatality jumped from 45 in 2012 to 79 in 2014.

"It's in Glastonbury; it's in Avon; it's in Farmington; it's down in Fairfield County," said Pat Rehmer, the former commissioner of the state Department of Mental Health and Addiction Services who now serves as senior vice president of Behavioral Health Network at Hartford HealthCare.

From 2012 to 2014, heroin was blamed for the deaths of 30 people from Waterbury, 30 from Hartford and 27 from New Haven. But there were also large numbers of deaths in mid-sized communities, including 24 in Torrington, 14 in New London, nine in Montville and seven in East Hampton.

It's been more than three years since Sean Madec, a 18-year-old from New London who loved played music and had recently become an uncle, fatally overdosed on heroin and cocaine in a Mystic hotel.

On Jan. 14, 2012, Madec, was brought by emergency personnel to Lawrence and Memorial Hospital but he was already dead, said his grandmother, 72-year-old Sandra Kenny of Groton. Before that, he had been in a suite at the Residence Inn snorting heroin and cocaine purchased with several friends.

"It's something that touches all families," Kenny said. "If you want it, you can get it. It doesn't discriminate."

The federal Centers for Disease Control and Prevention this week declared the sharp national increase in heroin use a "public health crisis" and called for a comprehensive response, including tighter control of narcotic painkillers that are often associated with heroin abuse, and greater access to naloxone, a drug marketed as Narcan that can counter the effects of an opioid overdose. Earlier this week, EMTs in Stamford credited Narcan with saving the life of an apparent overdose victim who was not breathing.

State police troopers began carrying Narcan kits in late October 2014 and since then have used it 33 times, with nearly one third of those uses taking place in Griswold, according to department.

"[Narcan] has been effective to curb overdoses," said state police Trooper Kelly Grant, a department spokesperson. "The troopers arriving on scene is a life-saving step. They are there fast."

Rehmer said that the move to get Narcan into the hands of more emergency responders and police has made a real difference.

"It saves lives, there's no doubt about it," Rehmer said. She said now it needs to get into the hands of parents, along with education about the drug.

The city of Hartford has been exploring equipping police with the drug, although ambulance crews already carry it, Deputy Chief Brian Foley said. Those crews typically arrive quickly at the scene of an overdose, which is not always the case in more rural areas, Foley said.

The federal report cited a steady increase in heroin use, abuse and deaths dating to 2002, with a particularly sharp increase in addiction and deaths beginning in 2011. Overall, the agency estimated, 517,000 people nationally were abusing or addicted to heroin in 2013 -- roughly double the figure a decade earlier.

There was a particularly steep rise in heroin use among non-Hispanic whites, while blacks and Hispanics collectively saw a decline in rates of heroin use over the decade, the CDC reported.

Whites also are over-represented among heroin-related deaths in Connecticut. Non-Hispanic whites in the state accounted for 84 percent of heroin deaths in the last three years, while making up only about 70 percent of the population. The greatest increase in deaths, however, was among Hispanics, with the number of fatalities rising from 9 in 2012 to 38 last year.

Three quarters of those who died in Connecticut were men -- a ratio that held steady from 2012 to 2014. While drug abuse is often assumed to be associated with younger users, the number of deaths in Connecticut in the past three years was fairly evenly spread among people 25 to 50 years old. And the biggest increases in deaths were among those over 50, rising from 16 in 2012 to 61 in 2014.

Tracking heroin deaths can be tricky because medical examiners do not always list the specific drugs implicated in an overdose death. The CDC report, for example, notes that in about one-quarter of fatal overdoses, death certificates do not identify the drug or drugs involved. Moreover, as heroin deaths increased -- and awareness increased as well -- it became difficult to determine if the rapid increase in apparent deaths was merely the result of more accurate reporting by coroners.

Before 2013, many drug deaths in Connecticut were identified simply as "multidrug intoxication." But when Chief Medical Examiner James Gill took office in May 2013, he instructed medical examiners to list specific drugs on death certificates. He also reviewed toxicology reports from 2012 and 2013 to discern the drugs implicated in past deaths.

Law-enforcement seizures of heroin -- considered a proxy for the amount of the drug exported into the country -- have quadrupled in recent years, as drug cartels have flooded the U.S. market. That has pushed down the price of heroin, even as the purity has increased, leading to more drug use and more overdoses.

"Increasing availability points to the importance of public health and law enforcement partnering to comprehensively address this public health crises," the CDC reported.

Partnerships among local, state and federal law enforcement have formed to head off the problem. The state police operate a statewide narcotics task force that has offices across Connecticut and works with federal law enforcement to share intelligence aimed at both monitoring how heroin is getting into the state, and targeting the drug dealers.

In Hartford, the police department works closely with the Drug Enforcement Administration, the FBI and Homeland Security and state police to share information and intelligence about heroin that's been collected by each organization, according to Foley.

Experts generally agree on how heroin addiction starts for many addicts. According to the CDC, individuals who are addicted to painkillers were 40 times more likely to being addicted to heroin.

Foley said nine out of 10 heroin addicts he has spoken to say their addiction to the drug started with taking a painkiller. "The biggest driver of heroin use is Oxycontin and the over prescription of painkillers," he said.

For young adults, the road to heroin addiction often begins with prescription painkillers, Rehmer agreed.

"What we saw; what we heard; what we hear is mom had back surgery, she got 30 Vicodin or Percocet and she used five. She leaves them in the medicine chest and the kid goes in there to take one and seems to enjoy the feeling he gets," Rehmer said. "He continues to take them and he goes to buy one on the street for $10 a pill and you can get heroin for about $5 a bag."

In a Twitter chat following the release of the report, Dr. Tom Friedman, director of the CDC, said: "We're awash in prescription opiates. Patients need the best, safest treatment. For chronic pain, that's rarely an opiate."

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