The first thing I realized when I started reporting on the heroin epidemic in southern Oregon is that pretty much everything I thought I knew about it was wrong.
For one thing, unlike some places I鈥檝e lived, I didn鈥檛 see strung-out junkies hanging out on the street, so how much of a problem could it be? But Joshua Graner, an addiction counsellor in Ashland, told me most heroin addicts these days are not your sterotypical street junkie.
Joshua Graner: "These are professionals. They could be in government, they could be in medicine, they could be in drug and alcohol treatment as professionals that are actually actively using heroin, and they鈥檙e doing a really good job of covering it up."
Graner heads Kolpia Counseling Services in Ashland. He says he can count on one hand the number of his clients who started out using heroin. So how do professional people come to be heroin addicts? Dr. Jim Shames says, mostly, it鈥檚 their doctors who started them down the road to addiction.
Jim Shames: "We鈥檝e created a couple of generations of people who have been dependent on opioids because their physicians and their nurse practitioners and their PAs believed that what they really needed was opiates for their pain."
Dr. Shames is the medical director for Jackson County Health and Human Services. He鈥檚 leading the local effort to rebalance what he sees as a long-time over-emphasis on prescribing opioid painkillers. Those synthetic drugs chemically resemble heroin and they act on the brain in similar ways. And for many addicts, heroin proves cheaper and easier to get than prescription opioids.
Darryl Inaba says doctors weren鈥檛 alone in creating the addiction problem.
Darryl Inaba: "We鈥檙e in a major growing opiate epidemic, and it鈥檚 been initiated, I believe, almost by the pharmaceutical industry."
Inaba is Director of Clinical and Behavioral Health Services at the Addiction Recovery Center, or ARC, in Medford. He holds a PhD in Clinical Pharmacy and his book on how addiction affects the brain has become a widely-used training text.
He notes the pharmaceutical industry successfully lobbied federal regulators to increase the potency of their opioid pain relievers, using industry-funded studies to argue the higher doses would not lead to patients getting addicted. Those studies, he says, turned out to be wrong.
Darryl Inaba: "They learned a long time ago as major capitalistic industries learn that addiction is money. If you鈥檝e got something addictive, people do whatever they can to get it."
The pharmaceutical industry has denied any intent to profit from addiction.
Another assumption about heroin addiction I had to unlearn was a sense that it wasn鈥檛 that big a problem. But according to the Centers For Disease Control, from 2010 to 2012, the death rate from heroin overdose doubled in a 28-state study area that included Oregon and Washington.
Since 2009, more Americans die each year from drug overdose than from car accidents or guns.
In Southern Oregon鈥檚 Rogue Valley, there are a quarter-million prescriptions written each year for opioid pain relievers; that鈥檚 more than one prescription for every man, woman and child in the valley.
Living as I do in leafy, upscale Ashland, I assumed heroin addiction was likely focused in grittier parts of the area, like West Medford. Again, I was wrong.
Diana Cooper:" It was very easy to get heroin in Ashland."
Diana Cooper is a 27-year-old mother of four, and a recovering heroin addict. She started taking prescription opioids after a painful bout with meningitis when she was 18. She says the slide from prescription drugs to street drugs is ironically aided by attempts to rein in over-prescription of opioid painkillers.
Diana Cooper: "When your doctor days, y鈥檏now I鈥檓 not supposed to prescribe these any more so this is your last dose, you鈥檝e gonna panic and you鈥檙e gonna find an illegal source. And once you鈥檝e broken that barrier into illegal sources and illegal activity, there鈥檚 really no cap on it."
So as access to prescription opioids tightens, addicts shift to cheaper, more available heroin.
Over the next few days, we鈥檒l take a closer look at how the opioid epidemic started, the toll it鈥檚 taken on people and communities and what鈥檚 being done to turn the tide.
