Heroin deaths in NKY decline – see why

Stop the dying.

That was the first idea in Northern Kentucky to address the heroin scourge, and for the first time, activists in the heroin fight say that appears to be happening.

They are cautious but bolstered by the Kentucky Medical Examiner's latest numbers, which show that Boone, Campbell and Kenton counties together had 64 heroin-related overdose deaths in 2014 – down from 72 in 2013.

"I hope this is the beginning of a trend that we've at least begun to stabilize the crisis," said Dr. Mina "Mike" Kalfas, a Northern Kentucky certified addiction specialist. But he added, "We have to keep fighting. We need to tighten our defenses."

Key leaders of the Northern Kentucky Heroin Impact Response Task Force think the drop shows community efforts to are beginning to yield results.

"The numbers show people are getting to where they can get help," said Jim Thaxton, coordinator of the task force. "This could just be an anomaly. As quick as we find a plausible solution, these cartels seem to find a way to speed things up and make heroin more available and more palatable. It comes down in price. It comes in a different form."

Dr. Tracey Corey, Kentucky's chief medical examiner, this week released to The Enquirer the latest count of overdose deaths statewide that included heroin in the bloodstream. Her analyst noted that the medical examiner does not get all heroin-related overdose death cases, however.

The medical examiner had 233 such deaths in 2014, up from 230 in 2013.

But Kenton County's dropped from 34 to 28; and Boone County's, from 22 to 17.

Campbell County's heroin-related overdose deaths increased: The county coroner reported 19 deaths – 18 through chief medical examiner's office – up from 16 in 2013.

"It is no coincidence that these numbers are lower where we have concentrated our efforts," said Jason Merrick, chairman of Northern Kentucky People Advocating Recovery. He attributes the drop to multipronged efforts to curb heroin, including getting out the life-saving drug naloxone.

The pharmaceutical can pull heroin and opioid overdose victims into immediate withdrawal, restoring breathing and saving lives. Merrick leads a team of volunteers that distributed 500 naloxone kits since October 2013 in the three counties. To date, 25 lives were saved with the medication distributed.

Merrick said the idea to provide the life-saving medication and direct addicts to available treatment.

Dr. Jeremy Engel, who fought in Frankfort in 2012 to make naloxone more accessible to the public, said more people have since become aware of the non-narcotic drug, so it's more frequently used, preventing deaths.

"People know that naloxone can save people's lives," Engel said. "We're more vigilant about it. People are calling (911) earlier. More families have it and are using it."

St. Elizabeth Healthcare's emergency department staff continues to see more heroin overdose cases, and to save more lives with naloxone. In March alone, the hospitals saved 122 heroin overdose victims. Engel and others watching the crisis believe that the public awareness about naloxone is bringing more overdose victims to the hospitals.

But Engel explained there are an uncounted number of heroin addicts in the region, and many are "savvy."

"People learn not to die," he said. "That's my best guess, but I've surveyed enough heroin addicts to know that they try to come up with their steady amount to use to balance between getting high and getting sick. The problem is, it's a bit like Russian roulette. They don't always know what they're getting."

The heroin fighters said law enforcement efforts and additional treatment for addicts within the last year could be helping to stabilize the heroin-addicted population.

Engel noted that NKY Med Clinic, the region's only methadone clinic, has more than 1,000 clients who come every day to get a dose of liquid methadone to combat heroin or prescription painkiller addiction. He and other medical professionals addressing addiction nationwide believe there should be more use of other medicine-assisted treatment, such as Suboxone, which helps curb cravings and stabilize heroin users, and Vivitrol – a non-narcotic that blocks the effects of heroin and prescription painkillers. Few Northern Kentucky doctors prescribe the drugs, although St. Elizabeth plans to open a clinic in June with six doctors who can help.

The community leaders said they are fighting a battle much greater than its deaths, which, they note, continue to plague the region and the nation.

"We have a culture that seeks to reduce pain through prescription drugs ... and heroin, which is cheaper and often easier to get," Thaxton said.

"We are seeing results from harm-reduction efforts," Merrick said. "But this is a problem that is going to require a lifetime of care, not a quick solution.

"This is going to take a total shift in culture," he said, "and in systems of care that will continue to work toward solutions."

Heroin overdose deaths at a glance

Kentucky:

•2014: 233

•2013: 230

Northern Kentucky:

•2014: 72

•2013: 64

Change 2013-14, Northern Kentucky counties:

Boone: 22-17

Campbell: 16-19 (state had 18, county added one)

Kenton: 34-28.

Source: Sarah LaMantia, Office of the Chief Medical Examiner drug fatality research analyst, Kentucky Injury Prevention and Research Center; Campbell, Boone, Kenton county coroner's offices.