Heroin use surges, scarring addicts, communities in Kitsap County

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BREMERTON, Wash. - The history of an addict's drug use is told in the scarring on the arms, legs and feet.

The arms of a 52-year-old woman in Suquamish, Wash., show trails of discolored and depressed veins. The large infection on her leg might be from staph bacteria resistant to antibiotics, doctors say. A fresh bandage on her hand shows where she recently pushed melted oxycodone.

For 20 years, the woman -- who agreed to be interviewed if her name wasn't published -- has abused heroin and other opiate drugs that give the same high. She's watched the ebb and flow of heroin in Kitsap County --on Puget Sound, across from Seattle -- but she's never seen it so cheap and easily available.

"It's the preferred high right now," the woman said.

For years, heroin has had a steady undercurrent of U.S. users. Approximately 3.8 million Americans 12 and older have tried it in their lifetimes, according to the federal 2008 National Survey on Drug Use and Health. In the last decade, it has been upstaged by meth and prescription drugs.

But now it's resurgent -- certainly in Washington state.

Monte Levine has seen the local increase first hand, from a converted garage in West Bremerton. The former health district employee has run a sanctioned needle exchange for more than a decade. He'd been trading about 250,000 clean needles a year for dirty ones addicts used to shoot heroin and other drugs. But the number of needles exchanged through the county health department program has skyrocketed -- from 282,039 in 2008 to 682,462 last year.

A broader measure comes from the North American Syringe Exchange Network, which reports that the number of needle exchange programs rose from 68 in 1995 to 186 in 2007, its most recent data.

Levine said he's seeing more needles, more users and more diversity in his clients. A man in overalls recently dropped off his used needles -- and left behind $100 to help keep Levine's volunteer exchange running.

He's seen food service workers, lawyers, doctors, high school kids. "These are not what people think of (as) addicts," Levine said.

Levine gets a brief opportunity to intervene. He reminds users of treatment options while they fill out the logbook tracking how many needles they take. If they insist on using, he gives them information on risks and how to reduce them, and how to avoid overdose.

With opiate use and abuse, deaths from overdose have jumped from 188 in 1995 to 644 in 2009, according to Washington State Department of Health statistics.

Nationwide, there were 14,459 poisoning deaths from opioid analgesics in 2007, the most recent year for which data are available, according to the Centers for Disease Control and Prevention.

A 27-year-old Central Kitsap man said he got hooked on prescription drugs, started using heroin and now injects heroin at least three times daily, spending $30 to $50 a day for 1 to 2 grams. "It was cheaper than buying pills."

Health and drug treatment officials wonder whether the rise and fall in prescription pills' availability is pushing people to cheaper, quick-hit heroin.

Some research suggests that it is. A May 2009 survey of syringe exchange clients by Public Health-Seattle & King County found that of 433 heroin users, some 39 percent -- or nearly two out of five -- reported being addicted to prescription-type opiates before they began using.

Intravenous drug use can spread infection and disease, including HIV, hepatitis, botulism and the virulent Methicillin-resistant Staphylococcus aureus (MRSA).

Scott Lindquist, Kitsap County Health District director, worries that "if we move from oral opiates to injectable opiates, we're going to spread more blood-borne pathogens."

Drug traffickers are happy to meet the growing demand for heroin. The heroin coming to Kitsap County originates in opium poppy plants grown in Mexico's Sierra Madre mountains, according to Dave Rodriguez, a regional director of the White House's Office of National Drug Control Policy.

It's converted to black tar heroin, a stiff, molasses-like blob that, when heated, forms a syrup ready for injecting into the bloodstream.

In 2009, Washington state drug task forces seized 47 kilograms of heroin. In 2010, the number exploded to 1,490 kilograms, Rodriguez said.

"For the same high and a lot less in price, the heroin's the better bang for the buck," said James Mjor, sergeant in charge of the West Sound Narcotics Enforcement Team, a local drug task force.

The task force, which relies upon confidential informants to build cases, has watched as its network of individuals stopped being able to facilitate purchases of dozens of pills.

But there's one drug they can get, Mjor says. "All those people that could buy pills can now buy heroin."

The 52-year-old woman says she feels trapped by the drug. She was prescribed methadone for a degenerative back injury, but her own friends and family steal her drugs, she says. "They're taking them, or selling them so they can go buy black (tar heroin)."

She turns to heroin to kill the back pain caused by her grinding discs.

Her children are using heroin. She worries about her preteen grandchildren, too.

"Sure, they'll use," she says sadly. "They already know what it is."

(Contact Josh Farley of The Sun in Bremerton, Wash., at jfarley(at)kitsapsun.com.)