Delco is still trying to quell raging heroin epidemic
Despite huge Delco effort to stem tide, opioid problems persist
Despite all efforts to combat the rise of a heroin epidemic in Delaware County, the general consensus is that it appears to be worsening.
“I really thought we were going to drive the numbers down a couple years ago, but what we’ve seen is just the opposite,” said District Attorney Jack Whelan. “The numbers have spiked up, the number of overdoses has spiked up, the number of people who seem to be addicted and also the number of naloxone (used) has spiked.”
Statistics from the U.S. Drug Enforcement Agency show fatal overdoses in Pennsylvania alone jumped 37 percent between 2015 and 2016, taking 4,642 lives statewide. Of those, 85 percent were attributed to prescription or illegal opioids.
Delaware County seems to have thrown just about everything it can at the problem. It formed a Heroin Task Force, expanded treatment and educational resources, established new courts and programs for minor drug-related offenses, imposed a “Good Samaritan” provision that forgoes prosecution for overdosing addicts and supplies every police force with Narcan, a life-saving emergency nasal spray that can stop or reverse the effects of an overdose.
And yet, for all that, the problem only continues to get worse, said Upper Darby Police Superintended Michael Chitwood.
“The heroin epidemic is totally out of control,” he said. “Since January until June 14, 23 people have died in Upper Darby as a result of heroin. Twenty-three. That’s a lot. Overdose totals, about 150.”
Those numbers are up from last year, which Chitwood attributes in part to the introduction of a powerful and relatively new synthetic opioid called fentanyl, either being mixed in with heroin or passed off as heroin. Fentanyl is 50 to 100 times more powerful than heroin.
Making matters worse, Chitwood said, the heroin of today is itself much more pure than it was during the last epidemic in the 1970s, when he was an undercover cop in Philadelphia. At that time, heroin was about 5-percent pure and mixed with baking powder, he said. Nowadays, heroin
“I’ve never seen anything like it. I’ve been doing what I’ve been doing for 53 years and I’ve never seen anything like it. And I don’t see an end in sight.”
— U.D. Police Superintendent Michael Chitwood
can be 80 to 85 percent pure and could contain fentanyl, driving the risks of overdose through the roof.
Upper Darby alone recently saw six overdoses in a single day and 35 over a period of 12 days. Two of those were fatal. Investigators recently pulled 182 bags of heroin off the street, including 70 stamped with the “Bull Dog” marking associated with many of those incidents, but Chitwood said it is not enough.
“You make this big drug bust, you think OK, we got that off the street,” he said. “And then the next day, two more overdoses. Then the day after that, two more ... People are dying, people are overdosing. Families are being destroyed and there’s really, really nothing that I see that’s making it even out. It just continues to get worse.”
Numbers going up
“I can tell you anecdotally right now that we are serving a whole lot more people than we used to serve,” said Delaware County Office of Behavioral Health Administrator Jonna DiStefano. “It’s about 30 percent more … since the end of 2015 or halfway through 2015.”
DiStefano said the county has had to broaden its network of providers to meet that need, but luckily has a deep roster to work with. Typically, addicts seeking treatment will contact the office and be routed to one of three “anchor providers” as a point of entry.
These providers – Keystone Treatment Centers, Northwestern Human Services and Crozer – will do an assessment of their needs and treatments available, as well as their level of insurance. Some may have commercial insurance, but many have Medicaid.
DiStefano said the Department of Human services has about a $6 million budget that can also be tapped for those with no insurance coverage whatsoever, though she encourages providers to try to get potential recipients on Medicaid first. The state expanded Medicaid coverage about 18 months ago to 133 percent of the poverty level, which DiStefano said has helped in that regard.
Crozer Keystone also opened the First Steps Treatment Center earlier this year, a 52-bed addiction treatment center at Crozer-Chester Medical Center in Upland, thanks to a nearly $1 million cash infusion from the county. That center is also tied to a grant from the state for Crozer’s designation as one of 20 Centers of Excellence for the treatment of opioid-related substance abuse.
Pennsylvania is slated to receive an additional $26.5 million in federal dollars earmarked for treatment and prevention services under the Comprehensive Addiction and Recovery Act, though DiStefano noted the state has not yet crafted a budget. While funding for drug and alcohol addiction services appear to be holding steady, she said her office is waiting to see whether there will be cuts to other services, such as mental health treatment.
Path to addiction
Chitwood and County Councilman Dave White noted many heroin users begin the path to addiction at a young age using old prescriptions found in relatives’ medicine cabinets.
White is urging county residents to clean out any old and unused medications, which can be safely disposed of at secure drop boxes at police stations and other locations throughout the county.
He said it imperative that people wake up to the fact that heroin can no longer be viewed as a problem that only impacts a certain segment of the population. It is everywhere, he said, and needs to be addressed head on.
“We need to understand the stigma against this no longer exists,” White said. “This affects everyone across the board, it doesn’t matter if they’re rich or poor, educated or uneducated, male or female – it affects everyone.”
Asking for help
“I think one of the biggest things we have to relay to the public is it’s OK to ask for help,” said Sean Rodgers at a recent opioid forum at Neumann University. “You have to remember it’s OK to ask for help because so many people drown in their own misery and end up dying of this disease because they’re so afraid to ask for help.”
Rogers, who works in the region as a National Clinic Outreach Representative for the Lubbock, Texas-based treatment center Ranch at Dove Tree, said the demographics of those addicted to opioids has also shifted into higher age ranges.
“Initially, when this epidemic opened up, we were talking about the 18 to 25 population,” he said. “Now, we’re talking about 18 to 55, we’re talking about 18 to 65.”
“I did a presentation to a senior community … and they were saying this is a serious problem in the nursing homes,” added David Moran, director of the Recovery Center of Prospect Crozer-Chester Medical Center.
Moran noted at the Neumann event that some legislation is beginning to emerge that addresses the epidemic at its earliest tier: The prescription level. A pending proposal would require doctors issuing painkillers to first check a database and see how often a person has received opiates in the past, he said.
Whelan said the county also is considering further efforts to combat the heroin epidemic by increasing education outreach initiatives in schools through the Intermediate Unit, rolling out a mobile prescription drug disposal unit to community events and providing police departments that see higher overdose rates with stockpiles of Narcan.
Whelan said the education piece for younger children is vitally important to driving those numbers back down. It is much easier to deter children from heading down a road to addiction than it is to break that addiction once it sets in, he said.
He added that there now seems to be a coalition of law enforcement, schools, doctors and legislators that recognize the epidemic for what it is and are aiming to reign in the abuse of prescription drugs through a concerted effort.
“So I’m optimistic that even though we haven’t achieved the goals of the Heroin Task Force of driving the numbers down, it’s only a matter of time,” said Whelan.
No treatment, no optimism
Chitwood does not appear to share that optimism, at least not with the system currently in place.
“I’ve never seen anything like it,” he said. “I’ve been doing what I’ve been doing for 53 years and I’ve never seen anything like it. And I don’t see an end in sight. I don’t see even an out for the near future.”
Chitwood has often said addressing heroin requires a three-pronged approach of education, enforcement, and treatment. Without all three, he said, it definitely won’t work, but even if they are in place, there is still no guarantee.
“I get a kick … out of all the politicos, all the politicians, all the talking heads, they’re doing this, they’re doing that – they ain’t doing nothing, and I’ll tell you why: Somebody comes in here and they’ve got a heroin problem, and they need help. The first question asked by all these recovery centers is, ‘Do they have insurance?’” he said. “If they have insurance, it’s a 30-day treatment. Well, with 30 days all they do is dry out, then they come out, they start shooting up again. So 30 days means nothing. Unless there is some type of insurance or some type of payment for the treatment, there is no treatment. There is no treatment.”
Chitwood said it can take months, if not years, to successfully kick heroin, but the bureaucracy of insurance companies and government agencies makes it nigh impossible for addicts to receive proper treatment. And that can be frustrating from the point of view of law enforcement who tend to keep seeing the same faces again and again.
“Since January of 2016, we have saved 214 lives (with Narcan),” he said. “If five or six of them got some type of treatment, that’s a lot. They continue to go on the street and use heroin. And this is just here in Upper Darby.”
Chitwood said he has heard stories of people going into rehabs 14 or 15 times. Maybe they get clean that 15th time, he said, but how many people’s lives do they ruin along the way? Chitwood said he would like to see not only more long-term treatment made available for those addicts, but also harsher penalties for dealers – a five-year mandatory minimum for trafficking, just like illegal gun possession.
At any rate, Chitwood said it would likely take many years and a lot of money to pull out of this epidemic. And in the meantime, people are going to die, families are going to be torn apart and communities will continue to suffer, he said.
“It’s a horrible, horrible way to think, but it’s a reality of life,” said Chitwood. “The tragedy is across the board. It’s the whole system.”