Hamilton County has been called a prime market for heroin dealers.
The affluent lifestyles, the low crime rate, the ability for higher status drug dealers to go unnoticed-all reasons why distributors for the Mexican drug cartels love places like Hamilton County Indiana, said Fairbanks Chief Clinical Officer Robin Parsons.
"They like areas like Hamilton County. There's no street activity. They don't have to worry about getting shot for selling on someone else's turf. It's a much more laid back atmosphere," Parsons said. "There's not a lot of competition. It's a great place to market. So we have to equally market treatment and recovery."
Fairbanks is the only in-patient rehabilitation facility in Hamilton County. Even as the sole provider, they rarely turn people away due to lack of space.
"I think there's kind of a misconception about the lack of treatment availability for the people that need it," said Parsons. "Treatment costs money. You have to have insurance, or you have to be able to pay for treatment. There probably is a lack of availability for people with no resources to pay for treatment."
However, even with insurance, treatment is not cheap.
"Our government needs to do something," said L, who is currently in a Suboxone treatment program. "There are people out there that don't want to get help, but there are people like my husband and me that don't know what to do, that struggle because they can't afford it or they can't find a doctor."
There are 12 doctors in Hamilton County with the necessary license to provide medication assisted therapy. There are two medications that have been FDA approved to help people overcome opiate addiction: methadone, a full opiate, and buprenorphine, also known as Suboxone, a partial opiate-partial opiate blocker.
"We went to a clinic and they gave us methadone, which to me is like a synthetic heroin," said L. "It has the same effect."
Methadone treatment is controversial, as it can also be addictive, causing the patient to stop using other opiates, but become dependent on the methadone. However, as a treatment method, medication assisted treatment has proved successful for those suffering from opiate addictions.
"It usually takes people two or three years to get through the program," said Glen Leer, one of the 12 licensed drug doctors in Hamilton County. "A majority are successful, more than half, but you've got to be really committed."
Fairbanks also uses medication assisted treatment, but not on its own.
"The cure for this epidemic is to put the focus on recovery. Medication without counseling is not a plan" said Parsons.
Part of recovery is acknowledging that addiction is rooted deeper than the drug use. In order to successfully overcome heroin, one must work on his or her mental and emotional health while also focusing on physical well-being, Parsons said. You have to admit you have a problem.
"You have to be willing to admit you're an addict" L said. "I'm an addict. Even when I'm off Suboxone, I will still be an addict, but I'll be a recovered addict. You will never ever lose that label once you become an addict."
Many times, it's that label that stops people from asking for help.
"Everybody has an addiction to something," she said. "That's what everybody needs to understand. You can't judge. Judging people doesn't help them. All it does is create a bigger problem than we already have."
A problem so diverse, it's almost impossible to come up with a solution.
"There are no simple solutions to complex problems," said Hamilton County Coroner John Chalfin.
Heroin acts as a respiratory suppressant, causing one's breathing to shut down.
"You don't breathe, you don't live," Chalfin said. "Nobody knows the strength of what they're getting. That's why people are dying. What you get today is not what you get tomorrow."
The increased number of opiate overdoses has led to the discussion of whether Narcan, an opiate agonist, should be available to the public.
When Narcan is injected or given as a nasal spray, it reverses the effects of opiates like heroin. It is not a preventative drug, so it is only effective after someone has overdosed.
"I've seen people in complete arrest, they're dying, and to be able to reverse them out of that overdose, it's amazing," said Captain Steve Moore of the Westfield Fire Department.
It has no effect on individuals who do not have opiates in their system.
"The cool thing about Narcan is that it really doesn't hurt the patient if it's not an opiate or it's not heroin that's causing their problem," said Moore.
Heroin is often being mixed with other substances, such as Fentanyl, a synthetic version, hundreds of times stronger than morphine, and claimed to be many times stronger than pure heroin.
Fentanyl is mainly produced in China and can be purchased on the internet due to less strict regulations. This lack of regulation leads to a lack of consistency, creating an end result of more opportunity for overdoses.
"It's like playing Russian Roulette with five loaded chambers," said Chalfin. "You don't know what you're putting in your veins."
B had gotten to the point where every time he shot up, he was taking enough heroin for it to be the last time.
"I had to ask myself every time I did it, 'are you okay with not making it through this one because it's enough to kill you'" he said.
Before taking the largest dose he had ever taken, he told himself if he survived it, he would get help. B has been clean for four years.
Heroin worth $860,000 was seized in Hamilton and Boone Counties in 2016. That's enough to get 43,000 people high.
"It's not until people realize that it's not a personal problem, it's a society problem, that's when people will come together, and we'll be able to help each other," said C.
L has come to find it is hard to explain the complexity of the opiate epidemic to people who have never dealt with drug addiction before. But if people could stop relying on the stereotypes, she said, maybe a solution can be found.
"A lot of people that are hooked on heroin, they're not bad people" said C. "They're just lost right now."
- The Times has agreed to use initials to protect those in recovery.
A look at the heroin epidemic in Hamilton County Hamilton County is perceived as an affluent county. Prosperous, growing, wealthy. A mix of modern and historic.
But there's an underside to all outward appearances. There's are problems, and in that, Hamilton County is not immune.
Heroin, or opioid abuse.
Its been called an epidemic. Its taken lives all over the country, and here in Hamilton County.
Opioid abuse has not ignored Hamilton County, in fact it's as much a problem here as it is in Indianapolis, or Cincinnati, or Louisville.
Hamilton County has seen deaths and arrests increase as a result of the epidemic.
The Times' Alex Pollock takes a look at the problem locally, what it's costing, who it's affecting, and possible solutions.
Note: The Times usually does not allow anonymous sources, but has agreed to use initials in this series to protect the identities of those in recovery.
Posted: Friday, May 19, 2017
Article comment by:
I just want to say that Fairbanks isn't in Hamilton County but just outside of it. I do not agree that it's a misconception that we lack treatment facilities. We do. Especially when it comes to detox. it DOES take a great amount of money to get in to FB even with insurance. Or the people needing treatment have already lost jobs and money and using medicaid. NOT ALL medicaid plans are accepted either. THIS is the problem Harbor Lights is the only main detox center but the bridge between detox and finding recovery for long term is missing. The mental health issues for these people are the missing link in treatment. NOT being focused on, too many people in early recovery trying to dive in to help but not ready or certified, no required IOP or ability to pay for it. But yet we have people going to the ER around the clock in every city with no insurance and they get help. People are revived with Naloxone and then ER's let them go. No protocol!! No mandate or order to treatment. All this does is cause repeat offenders. lock them up, six months later they come out and use again, steal again to buy, get caugt and go back to jail IF they hadn't overdosed yet!!!