Ask anyone dealing with the battle against drug abuse in Caroline County, whether it be law enforcement officers, the warden at the detention center, addiction counselors at the health department, even family members who have experienced the effect heroin use has had on their family, and they will all agree. The use of heroin has reached epidemic proportions in the county and the resulting danger of overdoses is a systemic result of the problem.
“Yes, it’s an epidemic here, not just here, but all over the country,” said Caroline County Interim State’s Attorney Joseph Riley, who said that the majority of the cases he prosecutes are connected in some way with opiate use, of which heroin is by far the most common.
And, Riley adds, the drugs aren’t restrictive to one group or one kind of individual.
“Opiates don’t discriminate in age, gender, race, religion or economic stature. And there is no good way of knowing who those people are and who they aren’t,” he added. “Opiates are very addictive and can make the user totally dependent upon them.”
Heroin is the worst of them. The attraction to heroin is that it gives the user an almost immediate, intense rush. It has a strong addictive nature to it, as well, so once a user starts using it regularly, it’s extremely difficult to quit.
“The catch is that when you take opiate you feel so good on it, but you feel so bad when you’re not on it,” said Joe Jones, director of addictions and a local addiction authority for the county health department.
Riley said the dependence trail usually follows a pattern – a person might start with a prescription from a doctor for a pain medicine for short-term use, become addicted to the pain reducing effect of the drug, then move on to other opiates when they can no longer get the pills. In many cases they become heroin addicts.
“It goes from smoking it, to snorting it and then taking it intravenously,” added Riley.
Riley said it’s a misconception that all heroin addicts are adults. Many of those who wind up addicted to heroin start out as teens abusing pain pills and the number of teens who abuse drugs and go on to heroin is growing.
“That’s not uncommon,” said Catherine Bowrey, the mother of two sons who started their habits as teenagers by getting hooked on pain pills given them for injuries and moved on to heroin.
“They can start with pain pills and go from there and end up on heroin or they can start out by smoking pot and moving along the chain (of addiction),” said Bowrey, who serves on the board of Caroline County’s Local Drug and Alcohol Abuse Council and runs her own non-profit with the purpose of helping women to kick their dependence on opiate drugs.
Bowrey said one of the problems with understanding when and how people become abusers is because people have the wrong stereotype of heroin addicts.
“People think all addicts are like the bum on the corner, but it can be your 13-year old kid just as easily,” she said.
Riley said heroin addicts find different ways to fund their habit – by becoming petty thieves, shoplifters, by stealing from their families, and by becoming sellers themselves. Riley said he often is faced with law breakers who start out committing a single crime to get money for their use, are set free because they have no previous record, then commit more crimes before being caught again.
“Now, the addict comes to court with several crimes – say five crimes with five different victims- and I cannot do anything for him at that point. It’s too late to get them the help they needed,” he added.
Caroline County Sheriff Randy Bounds said one of the problems his department deals with is determining where the heroin is coming from because most of the heroin sold and used in Caroline County comes from somewhere else.
“Most of the heroin comes from the Annapolis/Baltimore and Philadelphia areas. Caroline County is right along the corridor,” said Bounds. “It’s easy to get, easy to transport and inexpensive for the user to purchase.”
Even smaller towns like Middletown and Seaford are seen as places where heroin is readily available.
The poppy seed from which heroin is made does not originate from the United States, however, so it’s hard to stop the drug at its truest source.
“There are no poppy plants in the United States, which means it comes from somewhere else,” said Riley.
Capt. James Henning, a member of the Caroline County Drug Task Force added that “it makes no difference the size of the town, the sellers go where the demand is.”
Jones said the opiate epidemic has led to a more serious problem, an increase in overdoses, and that fighting the problem actually is a multi-faceted approach; prevention, treatment, counseling and hopefully, a permanent cure.
Henning said the two-pronged strategy is to find the users and bust the sellers, lowering both the demand and the supply for the drug. But it’s not that easy, and the overdoses aren’t decreasing according to statewide numbers. In 2015, there were 748 deaths from drug overdoses, compared to 578 in 2014.
“Heroin addiction usually begins one of three ways, with a dependence on other opiates like pain pills, through peer pressure among younger addicts, or as a drug user’s quest for a greater high,” Jones said.
Jones said many addicts start out as teens on pot or by stealing pills from their parents’ medicine case. A more common way is for the student to get pain pills for an injury, then lie to get more, or even the adult who starts out getting opiates for pain relief after surgery and gets “hooked” on the pills. Very few addicts start out directly on heroin.
“It doesn’t matter how it started, we need to solve it,” said Jones. “Seven out of ten people can stop taking prescribed pain medicine and will feel some sort of withdrawal; most can handle it without further problems. It’s the three in ten who can’t.”
Rodney Cox, Denton chief of police and head of the Caroline County Drug Task Force, said heroin use and the resulting spike in overdoses are a serious problem and “an uphill battle” to fight, but that through interaction with other law enforcement agencies, the group effort has brought more success in investigating and zeroing in on where the drugs might be in the county.
During the final six months of 2016, there were 33 overdoses in Caroline County and two deaths due to overdoses, figures that are hard to compare to previous years since records were kept differently.
“The drugs are all over the county, not just in one place. No place is immune from it. The drug task force is always doing undercover investigations and conducting joint investigations with other jurisdictions,” Cox said. “It takes all our resources to keep up with the supply.”
Cox said officers are not seeing as many cocaine cases as in the past, perhaps due to the lower cost of getting a “heroin fix.”
“Heroin has replaced a lot of other drugs due to its availability, plus it’s easier to transport,” he said.
Cox said heroin can sell for as little as $10 for 1/10 of a gram, enough for a user to get the rush that heroin is popular for.
Sheriff Bounds also supports the premise that the rise in heroin use is due to its availability and cost.
“A user here might go somewhere else to get the drug and might buy enough to come back to the county and sell what he doesn’t use at enough of a profit to support his habit. A single dose might go for $15 to $20 on the street around here. The availability is what is so disconcerting and the price is amazingly low.”
Still, it might cost a user $150 to $200 a week to support the habit. This leads to petty thefts, robberies, assaults and other crimes as the user tries to find funding for his habit.
Bounds said, the better the user feels taking the drug, the more likely he is to need more, and need more money to support his habit.
“Heroin has taken the place of prescription drugs; it has filled the void created by the stricter controls placed on the writing of prescription pain pills,” added Henning, who said arrests for possession and seizures of heroin have increased in the county due to the consolidated efforts of law enforcement agencies.
In 2015, there were three heroin seizures from raids. From July to December 2016, there had been 11 raids.
Cox said when talking about heroin use, one of the most serious concerns is that it’s not all made the same.
“The scariest thing is the stuff they mix with it…fentanyl. It is a very powerful, very dangerous drug. People don’t know what they are getting when they buy heroin from a dealer and may get a stronger dose (mix of fentanyl) than they are used to,” Cox added. “That might give them a lot different reaction to it than they normally have, and it could end in an overdose.”
An important aspect in the effort to combat heroin use and overdoses in the county is treatment and steps which can be taken to prevent its use and in the case of those who have been jailed, keeping them from using the drug again.
One drug, Vivatrol, is one of the newest medications available and can treat opiate and alcohol addiction. It blocks opiates from acting on the receptors in the brain and can also help ease drug cravings. By blocking the effects of the opiates, it takes away the pleasurable effect, which can help prevent a relapse.
Ruth Colbourne, warden at the Caroline County Detention Center, is in favor of giving every inmate leaving the facility who has had an opiate addiction in the past, a Vivatrol injection upon their release.
“We can get them clean when they are here. Every inmate who comes in hooked on a drug, goes through detox, but once they leave here we can’t control what they do. We would like to start giving a Vivatrol injection to every inmate upon their release because it prevents them from (feeling the effect of) getting high or drunk for 30 days,” she said. “If they don’t feel the effects, it might prevent them from using.”
“It would be better than just letting them loose on the streets of Denton,” Colbourne added. “They might have a better chance of staying clean if they didn’t feel high for 30 days.”
Colbourne, Bounds and Jones are all in agreement that Vivatrol could also be used to help users “on the street” and are proponents of acquiring a mobile unit that could visit towns around the county and offer Vivatrol to users who came to the unit.
“It’s a matter of getting the funding and support from the county or some other agency, and the community’s involvement,” said Colbourne.
Jones said that the county health department would also like to be able to offer Vivatrol to users who came there looking for help to kick their habit. He said the drug Buprinorphine can be used as a blocker, as well, from the effect of opiates, but offers the benefit of a user not feeling the full effects of withdrawal. He said the health department hopes to be able to start offering injections in January.
A third new ‘drug” is being used by the sheriff’s office and state police in overdose situations. It is called Narcan.
Narcan, when a dose is sprayed up the nose of someone who has suffered an overdose, can block the effects of the opiate on the receptors in the brain and can prevent death if given in time. Bounds said all deputies are being trained in the use of Narcan and once trained, carry dosages of it with them should they be called to an overdose situation.
“We’ve been using Narcan for about six months,” said Bounds. “I am very much a proponent of it. We have already had at least one confirmed saving of a life from its use. The Maryland State Police have also had saves.”
So with opiate use and heroin abuse such major problems in Caroline County, what agencies or organizations are available to offer assistance to those who want it? And not just the users, but persons who aren’t on drugs but feel they might have a family member who is, or the often overlooked family member, the one whose life has been torn apart by the addiction and reactive actions of an opiate abuser in the household.
“Unfortunately, there are no in-patient or out-patient addiction facilities in Caroline County that we can refer people to; they have to go out of county to get that kind of help,” said Jones, who said the situation will get even worse in Caroline now that the county health department has lost much of its federal funding and will have to go on a fee basis for its mental health services. Having to pay for an appointment will mean even fewer persons will seek the mental health counseling they might need.
Bowrey agreed that there are not enough places that a person from Caroline County can turn to get help.
”There is no help for people on the weekend, and weekends are the toughest time because that’s when people party and that’s when the addict goes out looking for a fix,” said Bowrey. “We need to have something to help them. Until we get something that is 24/7, we aren’t offering the help that they need.”
Bowrey said there is too little support in the county for the families of heroin addicts, many feeling it is just a matter of time before their family member overdoses and dies. She said she had spoken with one parent “who was to the point that she said to me: I already have the funeral planned.”
“It (drug addiction) affects everyone in some way. It has touched you either directly or indirectly. We need more resources, more help, a 24/7 place to send people to,” she added.
There are some groups in the county, however, that have been organized to offer support not just to the family but to the addict, though addicts often won’t come forward with their problem until they are forced through arrest or court-ordered confinement. Many support groups are religion-based or non-profits, and most deal with the mental health aspect. Few offer an actual path to a cure.
One highly-respected program is Celebrate Recovery, a religion-based 12-step program offered by the Next Generation Church in Denton. Many of those interviewed, mentioned this nationally-based organization as a good program aimed at healing “hurts, habits and hang-ups.” Another is the Christian Shield organization, which is also faith-based.
Jones said a good website for people to go to is the “Wish I Knew” website (www.IWishIKnewMidshore.org) where if you push the resources tab, it will give you many listings of where you can get help and the telephone number. Jones also recommended the Sante Group at 1-888-407-8018, a 24-hour Eastern Shore based organization that serves all nine counties on the shore.
Melanie Rodriguez, a prevention specialist for the county health department, said the department was also in the process of “putting together a resource help line for call-in help that will direct callers to resources closest to them to call for any drug-related incident affecting a family or individual.”
Bounds said that every county deputy also carries business cards with a referral number where families or individuals can seek assistance.
Counseling programs are also available from groups like For All Seasons and Mid-Shore Behavioral Health.
Riley said a major drug bust a few years back broke up a local heroin ring and temporarily had a positive effect on the opiate traffic in Caroline County, but that sellers have returned, in particular the user who is supporting his habit by also selling the drug.
“It’s a problem and we’re going to fight it. I am optimistic we can decrease it. Though the drug task force has done a great job, we’re not going to arrest and incarcerate our way out of it,” said Riley. “It’s got to be a team effort that requires all the resources we can muster.”
“There are many levels on which we deal with the opiate problem,” Riley added. “It can be combatted, but we need every tool in our toolbox to fight it and then we won’t know for another generation, what our success rate is because we won’t know if we’re making a difference until the next group of teenagers come along.”