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W.Va.’s Heroin Epidemic and How We Got Here

The Needle and the Damage Done: West Virginia’s Heroin Epidemic

By Glynis Board
West Virginia Public Broadcasting

      Editor’s Note: This is one in a series of stories by West Virginia Public Broadcasting, called “The Needle and the Damage Done: West Virginia’s Heroin Epidemic.” You can find the entire series, as well as interactive graphics and sound files at

      CHARLESTON, W.Va. — The opium poppy is a source of beauty in gardens and fields all over the country and the world. But its also a source of pain relief and when abused, death.  In recent years death tolls from heroin, a derivative of the poppy, has tripled nationwide, and the numbers are just as stark here in West Virginia.the_needle_logo-06

      “Frontline PBS” recently tackled the poppys intimate connection to humans, tracing it back thousands of years.

       It started with the Sumerians in 3400 BC, who passed it to the Assyrians, to the Babylonians, to the Egyptians, the Greeks, the Persians, the Chinese, British, and in 1905 Congress banned U.S. imports of opium — the derivative of poppy seeds and base of heroin. Little good it did.

      A black market bloomed thereafter and of course, the 5,000-year-old obsession with the opium poppy continues.

       But today our region of the world is in the grips of an especially nasty resurgence of heroin addiction.

Follow this series on West Virginia Public Radio's 'West Virginia Morning' each day at 7:41 a.m.
Follow this series on West Virginia Public Radio’s ‘West Virginia Morning’ each day at 7:41 a.m.

The new old high

      “When you use [heroin] you’re happy, you have no worries, you can just be free. You don’t have to think about your responsibilities. That’s all you think about, that’s all you care about, and that’s all you’re out to get.”

       Meet Ashley. She’s 24, a mother of four, third generation West Virginian, and currently she’s going through a highly structured drug court rehabilitation program. West Virginia Public Broadcasting agreed to withhold Ashley’s last name to protect her privacy.

       Heroin was her whole world not long ago.

       “I was 18 when I first started using heroin,” Ashley said. “I just wanted to try something new. I’d seen everybody else using it and it looked fun. So then I decided to use it. And then when I started using it I couldn’t stop.”

Drug trends: A moving target

       William Ihlenfeld, U.S. District Attorney for the Northern District of West Virginia, began paying attention to the drug issues in West Virginia in the mid-90s while he was a county prosecutor.

         He said that before this latest resurgence of heroin, it was synthetic opioids. In 2010, prescription opioids accounted for 44 percent of all U.S. overdose deaths. But law enforcement, legislators across the country, communities and pharmaceutical companies joined forces to make pills harder to get and harder to abuse.

          “And then things started to change,” Ihlenfeld said. “Around 2012, we started to see the shift from pills to heroin. We saw that through what was available on the street, what was being sold. And now, from what I see, heroin causes far and away more death from drug overdose than anything else in West Virginia. And probably other states as well.”

          Ihlenfeld’s counterpart in the southern district Booth Goodwin said that throughout Appalachia during the past 15 years, people have developed an intense addiction to prescribed, synthetic opioids.

        “People think they can take a pill and relieve almost any ailment and its’ just not that simple,” Goodwin said. “And I’ll tell you, this addiction to opiates is as bad as it gets.”

        But Goodwin said this shift to heroin may not be an entirely bad development.

          “There is a silver lining to it,” he said, “if you can call it that, and that is our young people won’t just start off by shooting up heroin, whereas, they will raid the medicine cabinet, take drugs from friends and family that they believe are safe because they come from a pharmacy and are prescribed by a doctor.”

        That’s how many people, young and old, rich and poor alike started falling into the world of drug abuse, according to law enforcement officials. But heroin can also be snorted.

Big Business

        Ihlenfeld explained that savvy drug lords responded to the crack down on pills by shifting clientele to unregulated opioids.

        “We don’t give [drug lords] as much credit as they deserve as far as their business acumen. The people at the top are like level 500 CEOs. They operate their business just like any major company here in the United States,” he said. “And they identify places where profit can be made; they identify areas of their industry where profit can be made. And when they see that the ability to get pills has dried up, it’s tougher to get them, they know that heroin can easily replace that.”

         Goodwin explained that the difficulty in the shift to heroin is the likelihood of overdose growing exponentially.

Overdose: Flip A Coin

         Narcotics are precisely measured by drug manufacturers, who ship it to pharmacists to be prescribed in exact dosages, Goodwin said. Anyone who reads the label knows exactly how much of a narcotic is going into their body. Heroin isn’t the same.

         “With heroin, it could be 20 percent potency or 80 percent potency and you never know,” Goodwin said. “You’re used to 20 percent potency heroin and you take the same amount and you get a batch of 80 percent and it’s laced with fentanyl, and you overdose and very likely die.”

        And the numbers are growing. In 2003, there were five reported deaths from heroin use throughout West Virginia, according to the state’s Department of Health and Human Resources. In 2014, 151 heroin deaths were reported.

        Some, like Ashley, are learning about it the hard way.

         “It happened at my sister’s house,” she said. “And it was at night. My sister called me and told me that her friend wasn’t breathing. So I went down and when I went into the bathroom she was laying over on the sink. Her airway was getting cut off by the sink. That’s what we thought.

        “Then we moved her and when we did she was still purple and wasn’t breathing. Finally she gasped for air and she was back. And she had no memory of it whatsoever. And she wouldn’t leave with the ambulance.”

          Things turned out okay for Ashley’s friend that night. But many law enforcement and medical officials, families and friends in West Virginia know that the coin doesn’t always land heads-up. And many believe this is just the beginning of an epidemic that’s bound to continue to grow in West Virginia.

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