When the older among us were growing up, the mere mention of heroin would have our blood running cold.
It was the most addictive and most dangerous of the wide spectrum of drugs that began permeating our culture in the 1960s.
But it wasn't the province of hippies, college students or those searching for spiritual enligtenment. Heroin addicts were instead inner-city derelicts whose minds and bodies were being eaten alive by a drug pushed in the darkest corners of society.
On the other hand, we didn't worry much about heroin. It wasn't in better parts of cities, it wasn't in suburbs and it certainly wasn't in the Mother Lode.
In his annual report to the Tuolumne County Board of Supervisors,
District Attorney Donald Segerstrom had the unsettling news: Use of
heroin is here and on the rise.
What's more, he added that illegal drugs such as methamphetamine,
cocaine or ecstasy were not the stepping stones that were leading users
to heroin. Instead, said Segerstrom, those stepping stones are often
Vicodin, OxyContin and other opiate painkillers available by
When abusers of these prescription drugs can no longer get them
from a doctor, the DA said, they are likely to turn to heroin instead.
Meanwhile, the abuse of these prescription drug is reaching record levels.
What Segerstrom said was a "huge rise" in illegal use of
painkillers has brought a spike in overall drugs arrests. In 2010, the
short-staffed DA's office handled 629 drugs cases, a jaw-dropping 68
percent increase over the 375 filed in 2009.
Segerstrom didn't explore the causes of the prescription drug-abuse
epidemic, but a grinding economy, chronic unemployment and depression
may all play a role.
A more overreaching factor was suggested by Sonora physician Ralph
Retherford in a guest opinion that appeared in The Union Democrat last
November: the sheer proliferation of methadone and other opioid
Locally, he said, they are used and abused at a frightening rate.
One pharmacy Dr. Retherford surveyed was ordering up to 6,000 methadone
pills a week, along with 32,000 Norco pills and tens of thousands more
of Vicodin, OxyContin, Lortab and other potentially addictive
That, he reckoned, was about 100,000 painkillers a week for just one Sonora pharmacy.
Use often starts innocently, with a middle-age or older patients taking painkillers for sore ankles, backs or knees.
Then consequences begin to snowball: Patients become dependent on
the pills, need ever-increasing amounts of them, and ask for renewal
after prescription renewal. Pills fall into the wrong hands, often
those of juveniles, and are abused. Overdoses follow, as do arrests
and, yes, deaths.
Dr. Retherford, medical director of Maynord's Recovery Center in
Tuolumne, said the Coroner's Office reports that opioid overdoses claim
from one to three Tuolumne County victims a month. If heroin becomes
the drug of choice for the desperate and deprived, this toll will only
Doctors should prescribe these effective but highly addictive and
potentially lethal painkillers with great caution and graphic warnings.
Patients should take the smallest amount possible over the shortest
Users should set an example for their teen children, both through
moderate use and by removing any temptation by locking the pills away
or destroying them after use.
Law enforcement should redouble efforts to stop prescription drug
abuse and nip the nascent heroin market while it still can. Schools
should educate students on the inherent danger of pills that, if in
name only, are legal.
And the county and those in the health-care field should explore
affordable options for helping those who want to kick their addiction.
One thing we can't afford to do - is stand still. As Segerstrom's
report and Retherford's guest opinion make clear, the price of
complacency is far too high.