Washington sees rise in heroin usage

Abusers of harder to get prescription pain killers switching to heroin was noted as a factor in the increase.

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SEATTLE — Prescription-drug abuse has fallen in Washington state, but heroin use — particularly among those under age 30 — has increased dramatically, according to a University of Washington report released Tuesday.

In King County, overdose deaths involving the drug increased from 49 in 2009 to 84 last year, with all of the increase coming in the under-30 age group, according to researcher Caleb Banta-Green, author of the report from the UW Alcohol & Drug Abuse Institute.

Because direct measurement of heroin use is difficult, Banta-Green compiled results from treatment programs, evidence tested by the state crime lab, overdose-death investigation records and information from law-enforcement sources.

“We are hearing about heroin as a major and increasing problem from law enforcement across Washington,” Dave Rodriguez, director of the Northwest High Intensity Drug Trafficking Area group, a coordinating center for federal and local law enforcement, said in a statement.

Banta-Green said he saw no evidence that legitimate pain patients were turning to heroin as tightened state regulations in recent years have reduced the supply of prescription pain medications.

“I think when we reined in opiate prescribing, it dried up the market for diverted prescription pharmaceuticals, and the people who were abusing prescription pharmaceuticals switched over to heroin,” he said.

Overall, police have seen a decline in the number of pieces of evidence of drugs sent to the Washington State Patrol’s Crime Laboratory for testing over the past decade, the report said.

Prescription opiate evidence has dropped dramatically since 2009. But heroin evidence has soared. According to the report, from 2007 to last year the number of samples collected by police testing positive for heroin nearly tripled, to 2,251.”The numbers are really dramatic,” Banta-Green said.

In general, regions with the highest rates of heroin evidence collected per 100,000 population now are not urban areas, but those in less populated parts of the state, including the westernmost counties from Clallam to Clark and the northern region from Whatcom to Snohomish counties, which includes San Juan and Island counties.

Walla Walla County had 12.6 per 100,000 rate over 2011-12, up from from 9 per 100,000 a decade earlier.

Across the state, first-time admissions to publicly funded addiction-treatment programs where heroin was the primary drug leapt from 590 in 2003 to 8,593 in 2012.

Last year, heroin users from age 18 to 29, the majority from outside the Seattle metro area, made up two-thirds of those entering publicly funded treatment programs for the first time.

“The increase among young adults is very concerning,” Banta-Green said.

Rodriguez said many young people began their drug use through pharmaceutical-type opioids, such as oxycodone and hydrocodone, often raided from a medicine cabinet.

“But once that free supply dries up, and they’ve developed an addiction, they have to go out on the black market,” he said, where Mexican black-tar heroin costs considerably less than prescription opiates. “I’m sure it was the last thing on their minds that they would end up getting addicted and using heroin.”

There isn’t enough treatment capacity now, Rodriguez said. “We are severely underfunded for public beds for treatment,” with capacity for only about 20 percent of the need. The federal health-care law may change that, he said, with coverage for drug treatment.

Deaths in King County from any type of drug have been dropping from a high of 286 in 2006, but last year saw a swing back upward, to 274. The largest increases were for deaths involving heroin or methamphetamines.

And the increase overall was driven primarily by deaths of those under 30.

“Usually people die in their 40s, not in their 20s,” Banta-Green said. “We don’t know if (the increase in young people’s deaths) is something about the drug, about how they use, combining it with other drugs, or that they haven’t developed tolerance yet. We just don’t know why. But it is unusual.”Dr. Daniel Lessler, chief medical officer for Washington state’s Health Care Authority, said many opioid overdoses can be prevented. In a statement, he urged those who might overdose or who could witness an overdose to obtain a prescription for naloxone, an antidote.

Under state law, users, family members and concerned friends can all carry naloxone.

In addition, said Banta-Green, the 911 Overdose Good Samaritan law provides legal immunity from prosecution to an overdose victim or anyone helping a victim seek medical care. More information on naloxone and the law is available at www.stopoverdose.org .

Banta-Green noted a bright spot in the report: Surveys of 10th-graders in 2012 showed the first statistically significant decline in use of prescription-type opiates to get high. “Now we just have to figure out what to do with those who are already addicted.”

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