A new report sponsored by the National Institute on Drug Abuse has determined that a heroin epidemic is underway in South Florida.
“The key issue identified in 2013 is the outbreak of a heroin epidemic in South Florida and particularly in Miami-Dade County,” says the report on local drug-abuse patterns and trends presented last week to NIDA’s Community Epidemiology Work Group.
“Heroin indicators which historically have been at relatively low levels compared to other drugs of abuse in South Florida rose sharply since the last reporting period.”
In Broward, where the misuse of prescription painkillers has declined yet remains high, “heroin and/or prescription opioids constitute an opiate epidemic,” the report says.
Heroin-related deaths in Miami-Dade jumped from 15 to 33, or 120 percent, between 2011 and 2012. During the same period in Broward, heroin deaths tripled from three to nine.
Medical examiner death statistics won’t be available for 2013 until next summer, but are expected to show further increases, according to report author James N. Hall, a drug abuse epidemiologist at Nova Southeastern University’s Center for Applied Research on Substance Abuse and Health Disparities.
The grim upswing in heroin deaths has occurred elsewhere in Florida, where the report says year-to-year statewide fatalities increased from 62 to 117, or 89 percent. Hall said other “hot spots” for heroin use in Florida are Orlando, Jacksonville and Sarasota.
While deaths linked to cocaine, oxycodone and certain other addictive drugs continue to eclipse those caused by heroin, evidence of its swift spread is the basis for the conclusion that an epidemic has begun.
“It’s the rapid escalation that’s disturbing,” said Hall. “This is the mother of all addictions, related to so much destruction and so many serious consequences, particularly death, most of which are preventable. To declare it an epidemic is a public health responsibility.”
A chart of heroin deaths in Florida since 2000 presents a roller-coaster effect, with deaths peaking early then declining sharply as misused pain medications became available at pill mills and elsewhere. The sources of those numbers are reports from the Florida Medical Examiners Commission.
Heroin’s surge was noticed last year in the wake of monitoring efforts following the state’s pill mill crackdown in 2011. One important change is the steady decline in deaths involving prescription opiates, notably oxycodone and its extended-release form, oxycontin.
Florida’s pill crackdown choked off supply and pushed up prices. But it may have had an unintended consequence as Mexican drug lords began flooding South Florida and other areas across the country with higher potency Mexican white heroin, Hall said.
The abundance of product has been accompanied by plummeting prices, which have dropped by nearly half since 2010.
“Heroin sells for as low as $10 for a little baggie, depending on how pure it is,” said Hall. “The target population is 18 to 29.”
Of special concern to researchers is the increased use of injections by young drug users who were children when the public learned about the high risk of infected syringes. Hall said 55 percent of those seeking treatment in Broward for being hooked on prescription painkillers reported their “preferred route of administration” was injection.
As a result, “a public health threat of increased HIV and Hepatitis C transmission is already occurring,” said a workgroup report issued last autumn.
TREATMENT ADMISSIONS JUMP
Deaths aren’t the only indicators measured by researchers.
The Florida Department of Children and Families tracks treatment admissions by primary drug for those seeking help at publicly funded facilities. In Miami-Dade, the number of persons admitted for heroin treatment more than doubled – 161 to 386 – between January 2012 and June 2013.
“Primary treatment admissions for heroin increased from four percent of all admissions in 2012 to eight percent in the first half of 2013 in Miami-Dade County, while remaining at five percent of all Broward admissions in both years,” according to the latest workgroup report.
Further, area crime labs reported a 13 percent increase in heroin detected in items analyzed during the same period.
Increasing or already high levels of heroin addiction were at the top of drug issues cited by researchers in 17 to 20 population centers across the country, including Philadelphia, New York, Boston, Baltimore, Washington, Atlanta, Detroit, Chicago, St. Louis, Texas, Seattle and San Diego.
Epidemiology Specialist Carol Falkowski is Hall’s workgroup counterpart in Minneapolis/St. Paul. She said a heroin epidemic is underway there, too.
“Heroin is more affordable than painkillers, produces the same effect and is sometimes just as available if not more available,” said Falkowski. “The growing presence of heroin in the U.S. now is akin to what the spread of cocaine was in the country in the 1980s.”
Hall sees things similarly from his vantage point in South Florida.
“I think it’s accurate to say that there are new heroin epidemics breaking out all over the U.S.,” he said.
The National Institute on Drug Abuse, part of the National Institutes of Health, has yet to release the latest heroin findings. But Hall, former longtime executive director of the Up Front Drug Information and Education Center in Miami, said those aware of the latest findings about heroin’s re-emergence have a uniform reaction.
“The reaction is, ‘Holy mackerel, this is really getting out of hand,’” said Hall.