No letup in heroin overdoses

The heroin overdoses at St. Elizabeth are still climbing.

In the first six months of 2014, the hospitals' emergency room staff saw an average of two heroin overdoses a day. So far in 2015, the staff is seeing three a day.

As heroin-overdose victims continue to increase and get rescued at St. Elizabeth Healthcare's five hospital emergency rooms, those watching the heroin epidemic aren't sure why.

St. Elizabeth released its report this week showing a new rise in heroin users saved by the overdose reversal drug naloxone in every six-month period since the hospital system tracked the numbers in 2011.

The hope among heroin prevention groups is that more people are getting to the hospitals because others are calling 911 for help. But it also raises a question: Are there simply more people on heroin?

"The reality is, we have never known how many people are using," said Bonnie Hedrick, who co-chairs the Northern Kentucky Heroin Impact Response Task Force.

St. Elizabeth's numbers, year over year, have been the best gauge over time in the region.

Every so often, the hospitals see a drop, such as in June, when 53 people who said they were heroin users were saved by naloxone, compared with 132 in May. But those numbers are "just going to happen sometimes," Hedrick said.

And there may be others who are saved that aren't identified as heroin users, because St. Elizabeth counts only those who say they use the drug, according to Ashel Kruetzkamp, nurse manager for St. Elizabeth Fort Thomas Emergency Department.

Jason Merrick, director of inmate addiction services for Kenton County and a harm-reduction activist in Northern Kentucky, wasn't surprised to learn of the jump in St. Elizabeth's numbers.

"It's almost expected, because more people are becoming aware of the disease and the shame and stigma his decreasing," Merrick said. "Fewer people are hiding."

The heroin supply doesn't seem to be changing in Northern Kentucky or Southwest Ohio, according to Northern Kentucky Drug Strike Task Force Director Chris Cummins. He said there's no sign the cost of the drug is changing dramatically, when a jump in price would indicate a decrease in demand, or vice versa.

But Van Ingram, executive director of the Kentucky Office of Drug Control Policy, is cautiously optimistic that the supply isn't growing in the commonwealth based on submissions of heroin cases to the Kentucky State Police crime laboratory.

Heroin submissions jumped year over year since 2010, from 451 to 3,840 in 2014, but have a current projection of 3,790 in 2015, Ingram said.

"They seem to be stabilizing," Ingram said. "That is my hope."

Kristie Blanchet, who chairs the grass-roots Northern Kentucky People Advocating Recovery, says there are no data indicating fewer people are addicted, but her hope is that more are getting help.

"What's happening with the overdoses is, people are getting a chance to live. And they're living because of naloxone out there in the community," she said.

NKY Par, as the organization is known, has been leading an effort since October 2013 to get naloxone kits into the hands of Northern Kentucky residents at high risk of overdose from heroin and prescription painkillers. The group has given more kits away each year, totaling 500 kits free of charge. As of early May, the provided naloxone has saved the lives of at least 25.

With every kit comes both training and written instructions to call emergency responders for help.

"We tell them they have to call 911," Blanchet said.

In addition, some pharmacists, including Sam Coletta, owner of Avenue Pharmacy in Dayton, train people who receive the naloxone kits, including direction to call 911.

That's partly because while a squirt or two of naloxone in the nostrils of a heroin or prescription-painkiller overdose victim can cause immediate withdrawal, restoring breathing, but it isn't necessarily life-sustaining over time. It's also because to qualify for immunity from criminal and civil complaints under Kentucky's good Samaritan law, you have to call 911.

"What's really going on here is, these people are living," said Jim Thaxton, coordinator of the heroin task force. "Had they not gotten to the hospitals, they would be a death statistic."