Heroin is making a deadly comeback

Victims include local youth, ‘Glee' star

Debbie St. John and her son, Joey St. John, share a moment together. Joey died in October 2010 after a heroin overdose while he was living at a halfway house.

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Last Modified: Saturday, July 20, 2013 at 11:18 p.m.

In the back of her mind, Debbie St. John often feared she would find her youngest son dead one day.

Joey St. John had been honest with his mother about his on-and-off drug addictions. When he confessed to her in early 2009 that he had begun taking drugs again, she thought it could be prescription pills or cocaine, or maybe the methamphetamine that he had struggled with before.

“When he said it was heroin, you could've floored me,” she said. “I had all these images in my head that you see on TV. I've never known a heroin addict or anyone who had taken it in my life.”

Joey St. John got clean for about six months, but relapsed and died from a fatal dose he took while living in a halfway house in October 2010.

St. John, who was 21 when he died, fits a fast-growing demographic of heroin users. The television stereotype of a sickly-looking person shooting up in a dirty apartment on the wrong side of town is just that — a stereotype.

“The customer base for heroin now is very young adults,” said Drug Enforcement Administration agent Clay Morris, assistant special agent in charge of the Birmingham district office. “Very young, suburban, middle-class young adults. That's a shift for us.”

Earlier this month, “Glee” actor Corey Monteith, 31, was found dead at a hotel in Vancouver, British Columbia. Tests showed that he died from mixed drug toxicity involving heroin and alcohol.

Overdose numbers

In Tuscaloosa this year, two young men died in an off-campus student housing complex within a month. Of the 25 death investigations that the Tuscaloosa County Homicide Unit has conducted, five could be heroin-related based on statements and evidence recovered, said the unit's assistant commander Lt. Kip Hart. Toxicology reports haven't been returned in those cases.

In 2012, six of the 26 accidental overdose deaths in Tuscaloosa County were heroin-related. Toxicology reports are still pending in 13 of the overdose cases. Hart believes that at least two of those will be heroin-related.

In 2011, four of 25 accidental overdoses in Tuscaloosa County were heroin-related. Three of the 18 reported in 2010 were related to heroin.

DEA Agent Morris said that heroin overdose deaths have increased significantly in the Jefferson and Shelby County area in recent years.

According to DEA statistics, 10 people died from heroin overdoses in those counties in 2010. That number rose to 42 in 2011 and between 70 and 80 in 2012, Morris said.

Why heroin?

Several factors play into the rise in the drug's accessibility and popularity, he said.

First, the demand for cocaine has lessened. Drug traffickers have opted to move heroin across the country instead, he said.

“The drug business is like any other business,” he said. “It's economically-based on supply and demand.”

The heroin sold in Alabama typically originates in Mexico and is a coarse, brown powder. Law enforcement in Southeastern cities have reported a black tar heroin being sold there.

“We're seeing the Mexican brown powder here,” Morris said. “It depends on the organization and where they have their connections.”

The coarse brown powder seen here is often mixed with water and injected. It can also be smoked or inhaled. A small package of heroin can be bought for as little as $5 or up to $20. A gram costs about $150 to $200, Morris said.

Heroin acts as a euphoric depressant. The drug's effect on the central nervous system slows mental function, cardiac function and breathing, sometimes to the point of death.

Oxycodone abuse

People addicted to heroin most often start abusing opiate prescription drugs that aren't very potent. They work their way up to taking the more potent oxycodone.

“Eventually they'll move on to heroin. It's readily available and is actually cheaper on the streets than most pills,” Morris said. The increase in heroin use is very likely linked to the increased use and abuse of prescription medication, he said.

Why it's dangerous

Heroin is more risky for users, because it's unclear whether it's been cut with other non-drug fillers.

“Heroin is much more dangerous because you don't know the purity level of the heroin you're injecting,” Morris said. “Traditionally, the purity level of what you buy on the streets is in the single digits to the teens percent of pure heroin. If you're used to taking something that's eight percent pure and you get a shot of something that's 20 to 25 percent pure, the likelihood of an overdose is greater.”

Erin Hinz, administrator of the Tuscaloosa regional office of Bradford Health Services, has heard many heroin abusers say that they turned to the drug after the 2010 reformulation of OxyContin, which made it impossible for people to crush for inhaling or injection.

People seeking an opiate high have begun to choose heroin over pills because it's cheaper, easier and gets you higher, Hinz said.

“Within the last two years, we've seen more people seeking treatment for heroin,” she said. “They're often around 20 years old, college-aged people now. Typically, it's someone who abused pain pills and moved on to heroin.”

Tuscaloosa Police spokesman Sgt. Brent Blankley said that narcotics agents are seeing heroin users who started their habit with pills.

“We've seen people overdose due to the purity of the drug and the users being unaware of how harmful it is,” he said. “It's a very dangerous drug that's ruining a lot of young people's lives.”

Joey's story

Debbie St. John caught Joey smoking and drinking beer when he was 15. Joey had been prescribed Adderall for attention deficit disorder. He traded those pills with his classmates, St. John said.

“He was able to get whatever he wanted at school,” St. John said.

Joey was diagnosed with bipolar disorder in 2010, the year he died. The diagnosis came after years of appointments with psychiatrists, therapists and physicians who didn't detect it. St. John believes that her son may have turned to drugs as a way to self-medicate.

“He told me that the first time he ever used heroin, that he knew right then that he would use it every day for the rest of his life if he could,” she said. “He said that when he was on it, he didn't have to worry about anything. There's such a sense of peace and euphoria. I told him that it would go away, and everything would be back and he just said that I didn't understand.”

A year after his death, St. John was able to read the journals that her son kept while in rehab. In them, he wrote about how he wished he could curb his addiction because of the effect it had on his family.

St. John works as an administrative assistant and her husband is a retired minister. Joey was born in 1989 and had and older brother and sister.

“We lived in a modest home and had modest incomes. Our kids always had pretty much everything we could afford to give them,” St. John said. “We're just a normal, middle-class family.”

A final text

St. John's last text to her son was a reminder to attend a tuxedo fitting before his older brother's wedding on Oct. 10, 2010. She asked that he be clean that day. They would bury him two days before the wedding date.

St. John learned that her son had died from Facebook. She was at work when she received a flurry of friend requests from Joey's friends. She accepted, and noticed that one had posted something along the lines of “My heart is in shock, Joey's memory will live on forever.”

The halfway house staff confirmed her fears. St. John believes that someone had delivered heroin to Joey at the halfway house and he took a lethal amount.

“And you can get it here now. What he was able to get in Bessemer then has moved to Tuscaloosa,” St. John said. “For about $5 or $10, you can buy some that's about the size of a sugar packet. Any young person who's wanting to try it can.”

Joey had been injecting the drug, she said.

Overdoses can happen if someone has been clean for a while and decide to use again, said Hinz, the administrator at Bradford. Users build up a tolerance that drops when they abstain. Someone who relapses may take the same dosage they were taking before, while risking an overdose because their body wasn't accustomed to so much.

“Your body is not prepared for that because it hasn't built up the tolerance,” Hinz said. “That will be the time that kills them.”

Treatment problems

Heroin users don't often transition well from inpatient to outpatient care. There's a high unsuccessful transfer rate, Hinz said, and people often relapse when they're released from treatment. Longer-term treatment centers are needed so people can be cared for until they're clean, she said.

Quitting cold-turkey is rarely successful for opiate addicts. Medication-assisted treatment along with counseling yields the most successful results.

Bradford administers Suboxone to patients for four to six weeks. The medication suppresses withdrawal symptoms and opiate cravings but doesn't provide the euphoric high. It blocks the effects of other opiates. The treatment center administers the drug as part of an extended-taper Opiate Outpatient Detox program, designed to get someone completely drug-free. Some maintenance programs that use Suboxone or Methadone, another drug that suppresses withdrawal symptoms and cravings, could go on for years. Bradford is a 12-step oriented, complete abstinence-based treatment program, said Bradford Regional Director Chuck Wint.

Joey’s legacy

Since her son died, St. John has spoken to school groups and youth groups about the dangers of the drug and how to cope if you love someone who is addicted. She said she believes that creating long-term rehabilitation programs that are affordable is the way to save others from their addictions.

“It’s got a hold of our nation again, like it did in the ’60s, and I don’t know what the answer is,” she said. “People need to realize that this drug, this hellacious drug, could be affecting the kid next door. This is happening to good kids.”

She said that telling her son’s story, while sometimes painful, is worth it if it can save a life or help another family. She still hasn’t been able to clean out his closet, and said that she and her husband still talk about him every day. They’ll always remember him as their funny, sociable youngest son who showed love to his family even as he struggled with drug addiction and the issues that caused it.

“He wasn’t just another junkie,” she said. “He was my son.”



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