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Experts: Prescription drug abuse leading to spike in heroin use

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PHOENIX – Experts say an epidemic of prescription drug abuse in Arizona is fueling a spike in heroin use.

“The gateway to heroin use is through prescription pain pills containing oxycodone and hydrocodone,” said Dr. David Greenberg, a Scottsdale-based expert in addiction medicine. “Over 95 percent of heroin addicts that I see got their start using prescription opioids.”

Abusers of prescription opioid painkillers such as OxyContin and Vicodin are switching to heroin for two reasons: It’s cheaper and more readily available, law enforcement officials and substance abuse counselors say.

“Price is a huge factor,” said Stephanie Siete of Community Bridges, a behavioral health and treatment organization with programs throughout Arizona. “If you have a $200-a-day habit for pills, you can spend 40 bucks and get yourself some heroin. It’s become a high school drug of choice.”

The stigma of using heroin has also largely disappeared, she said.

“There’s not the fear of jamming a needle in your body anymore because it’s so pure,” Siete said. “People smoke it and it gives the same euphoric effect as painkillers – for a fraction of the price.”

Users can make the switch and get the same kind of high because heroin and the pharmaceutical drugs oxycodone and hydrocodone all belong to a class of drugs called opioids.

“If you’re addicted to an opioid, you’re really addicted to the whole class, because they act on all the same receptors in your body,” said Dr. Frank LoVecchio, toxicologist at Maricopa Medical Center in Phoenix. “Your body doesn’t know if it is getting it from oxycodone or heroin.”

From 2009 to 2011, heroin overdose deaths in the state more than doubled – from 56 in 2009 to 120 in 2011, according to an Arizona Department of Health Services report.

Meanwhile, law enforcement officials in the Valley report an increase in trafficking of the drug.

“The DEA has seen a great upsurge in heroin investigations and seizures,” said Special Agent Ramona Sanchez of the Drug Enforcement Administration’s Phoenix Division. “We’re seeing more Mexican heroin coming across the border.”

Police in Washington, D.C., Baltimore, Chicago, Philadelphia and Ohio have all noted the same trends: prescription drug users have turned to heroin after OxyContin was reformulated to be less desirable to addicts and when cost or access to prescriptions become prohibitive.

Siete said heroin on the East Coast has a different origin than that sold in Arizona.

“We see a lot of Mexican heroin here, and it’s cheaper,” she said. “The East Coast gets hit by Afghanistan’s crop.”

Either way, production reports don’t bode well for curbing heroin use. The U.S. Justice Department reports that Mexican heroin production increased six-fold from 2005 to 2009 to 50 metric tons. The Mexican government reported in April that opium poppies overtook marijuana as the top illicit crop grown in the country. And a U.N. report released this month projects that Afghanistan’s opium production will hit record levels in 2013, up 36 percent from last year.

The overall opioid addiction epidemic is wreaking havoc on white youth, according to Greenberg, the Scottsdale addiction expert.

“It’s really hitting the younger Caucasian demographic – teenagers and young adults,” he said. “They are being decimated. At my clinic, we get about 30 new cases people coming in for treatment for opiate addiction per day. If you do the multiplication, you’ll see the scope of what we’re dealing with.”