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Heroin’s Death Toll Rising in New York, Amid a Shift in Who Uses It

  • 8/27/14  7:01am

    A heroin crisis gripping communities across the country deepened in New York last year, with more people in the city dying in overdoses from the drug than in any year since 2003.

    In all, 420 people fatally overdosed on heroin in 2013 out of a total of 782 drug overdoses, rising to a level not seen in a decade in both absolute numbers and as a population-adjusted rate, according to preliminary year-end data from the city’s health department.

    The death toll from heroin has more than doubled over the last three years, presenting a growing challenge to city officials who have so far been unable to reverse the rise. By contrast, amid a concerted effort to stem prescription pill abuse, especially on Staten Island, overdoses from opioid pills leveled off during the same time period, with 215 deaths recorded in 2013.

    The profile of an average user has shifted in the last 10 years, said Dr. Andrew Kolodny, an addiction specialist who was at the health department in 2003, when heroin overdoses last rose above 400.

    “It was almost exclusively central Brooklyn, South Bronx, east Harlem and overlapped with New York City’s highest-need neighborhoods,” said Dr. Kolodny, now the chief medical officerat the Phoenix House Foundation, a drug-treatment center. “The rest of the city — Staten Island, Queens, most of Manhattan — close to nothing.”

    Even before the latest data became available, the scope of the heroin problem was apparent on the streets, in treatment centers and at police precincts.

    Seizures of heroin spiked as the city became a hub for trafficking along the East Coast. Overdose victims turned up in neighborhoods from East Tremont in the Bronx to Tottenville in southern Staten Island, prompting the New York Police Department to begin outfitting officers this year with naloxone, a medication that reverses the effects of an overdose from both heroin and opioid pills.

    In an interview on Wednesday, Dr. Mary T. Bassett, the city health commissioner, celebrated the effectiveness of naloxone, which has been used to reverse well over 500 overdoses since 2010, when the city began an aggressive effort to get it into the hands of those closest to drug abusers.

    She also noted a significant downturn in overdoses from prescription pills and a modest dip in deaths from heroin on Staten Island, saying that door-to-door outreach to doctors and education about heroin abuse had helped reverse the trend in that borough.

    “We’re going to be turning attention to using some of these strategies in the Bronx,” Dr. Bassett said.

    But older addicts have not vanished and, in fact, continue to make up a large percentage of users.

    In the Bronx, Hispanic men in their late 40s and early 50s disproportionately fell victim to the drug last year, driving the high overdose rate in the borough, where 94 people died in 2013, one more than the year before. Across the city, Hispanic users showed the greatest increase in overdose deaths — to 146 last year, from 64 in 2010.

    “We have a much older demographic,” said Deborah Witham, the chief program officer at VIP Community Services, a Bronx treatment center where most of the patients are on Medicaid. But, she added, younger users are increasingly in the mix, as are those coming to the center with mental health issues, which complicates their treatment.

    Affluent areas of the north Bronx and eastern Queens have become hot spots as well, reflecting the heavy opioid pill abuse and heroin use in the surrounding suburbs in Westchester County and on Long Island.

    “I think it’s going to get worse,” said Kathleen A. Riddle, the head ofOutreach Project, which runs treatment centers in Brooklyn, in Queens and on Long Island.

    It is a situation repeated across the country: A new generation of younger and often more affluent users begin by using prescription opioid pills that deliver the same effects as heroin and then shift to the illegal drug because it provides a better high for less money, sometimes as little as $5 a hit.

    That grim progression characterized the growth in heroin abuse on Staten Island, where abuse of prescription pills was by far the highest in the city. In recent years, the authorities closed many rogue pain clinics, where young users could obtain illicit prescriptions, and arrested pill dealers who sold on the street.

    Those efforts coincided with the introduction last August of increased monitoring of prescriptions. By drying up the supply of pills, many treatment experts predicted a rise in heroin abuse as dependent addicts moved into the black market.

    “People who are used to getting high are not going to stop cold turkey,” saidWilliam A. Fusco, the director of Dynamic Youth Community, a drug-treatment center in Brooklyn where many young addicts from Staten Island end up.

    “The drugs that you use are the drugs that you find.”

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