Heroin scourge hits the Keys

Monroe County is experiencing a spike in opioid use, particularly heroin and a much more potent synthetic cousin, after years of bucking and avoiding the nationwide trend.

This has Keys cops making drug busts every week and first responders dealing with a spike in overdoses.

“I can easily recall five last month that I have heard EMS called to,” said Chief Don Bock with the Key Largo Volunteer Fire Department and the Key Largo Ambulance Corps. “Years ago, we might get a couple a year.”

Monroe County Sheriff Rick Ramsay said the resurgence of heroin use in the Keys is keeping his men and women busier than usual.

“We almost never saw it,” Ramsay said. “Now we’re making heroin cases on a weekly basis.”

The reason for heroin’s popularity, not only among local addicts but nationwide, is because of the crackdown by authorities on doctor shopping and the so-called pill mills that were popular in Florida a few years ago. The drug of choice then was the powerful pain pill Oxicodone, which remains popular among addicts and substance abusers.

“It’s 10 times more addictive than crack cocaine,” Ramsay said. “These doctors turned a large portion of our population into drug addicts.”

Ramsay said doctors across the country mismanaged their patients’ care and got them hooked on opioids. Now that pills like Oxycodone are harder to come by, they’ve turned to the cheaper, more readily available heroin.

“Once the pill mills were shut down, millions of people were now addicted to pain killers inappropriately prescribed by their physicians,” Ramsay said. “It affected everyone at every level of life, and now these people are just as addicted and they see no other choice than to move to heroin.”

Ramsay noted that heroin users today are not necessarily the stereotypical junkie shooting up in an ally. The drug can be smoked, snorted and injected.

“It’s a lot cleaner than it used to be,” Ramsay said. “You don’t really have people going around sharing needles.”

Monroe County Medical Examiner Dr. Thomas Beaver said there is an even bigger problem. Much of the heroin people are using also contains the very powerful prescription synthetic opioid fentanyl. It’s in the same opioid family as heroin but much more potent. This makes for a better, but deadlier, high.

“Fentanyl is 1,000 times more powerful than morphine,” Beaver said. “A very small amount can cause someone to stop breathing.”

In a medical setting, fentanyl is often prescribed as a patch for adults and, controversially, lollipops for child patients. But Beaver believes much of the heroin coming from China is laced with fentanyl.

“This is not unique to the Keys, but what users think is heroin turns out to be fentanyl,” Beaver said. “China is either selling us fentanyl marketed as heroin or it has fentanyl in it.”

Beaver’s office has handled three drug overdoses this year that he suspects are due to fentanyl. Considering there were no fentanyl deaths in 2015, Beaver is concerned.

“That is a significant increase,” he said.

A death in January was due to a combination of heroin and cocaine. A February fatality was likely due to a toxic mix of cocaine and fentanyl. Beaver also believes a death in May was caused by fentanyl.

Opioids like heroin and opium come from the poppy plant, which has been a part of human culture for thousands of years and still plays a significant role in many societies, particularly in Asia. The addiction that comes with it is not novel, and Beaver said he’s not surprised to see it back in the Keys. Along with the law enforcement component to deal with the problem, he said a therapeutic solution is also needed to treat addicts instead of just locking them up.

“It was the first plant we cultivated as we came out of the cave. This poppy and this opium go way back in human history and has been used and abused by society and culture for thousands and thousands of years,” Beaver said. “This is not new. It’s been around a lot longer than cocaine, longer than even alcohol. If in 4,000 years people haven’t been able to get rid of it, it takes a little bit of arrogance to think now you’re going to make a difference.”

This story was originally published October 14, 2016 at 9:07 AM with the headline "Heroin scourge hits the Keys."