BLOOMINGTON — Heroin remains in some Central Illinois homes.
The good news is the heroin problem — after worsening for several years — may have started to plateau, say Central Illinoisans working to stem the opioid epidemic.
"It's been steady," said Chief Paul Adams of the Lincoln Police Department that has trained two more officers in DARE (Drug Abuse Resistance Education) to work with youths. "But I'd like to have it back to zero."
"I don't know that I can say it's getting worse," said Dr. Darrell Rust, an emergency department physician at OSF Saint James-John W. Albrecht Medical Center in Pontiac and medical director for the detoxification unit of Chestnut Health Systems in Bloomington.
"But it's still a huge problem," Rust said. "Hopefully, things are turning around. There are a lot of things (initiatives) trying to make a difference."
A year ago, The Pantagraph series "Dopesick: The Heroin Epidemic" detailed how heroin, a highly addictive opioid, moved from the back alleys to the family rooms of more Central Illinois homes.
"It used to be a skid row problem," Rust said. "Now it's a problem of the middle class, the upper class and the lower class."
Linda Barber, clinical supervisor for Bloomington-Normal Treatment Center in Normal, said "It's a cross section of Central Illinois. It could be your neighbor and you wouldn't know it."
According to the Illinois Department of Public Health, 1,877 Illinoisans died of an opioid overdose in 2016. Of those, 1,002 died of a heroin overdose. The rest died from other opioids, including prescription painkillers.
The New England Journal of Medicine reported that prescriptions for opioid analgesics (for moderate to severe pain) increased substantially from 2002 to 2010, prompted by well-intended efforts to control pain following injury or surgery, said Central Illinois medical professionals and substance abuse treatment providers.
But it's easy to become addicted to opioids. In response, "we (medical professionals) are way better about judiciously prescribing pain medicine," said Lori Ritter, trauma quality coordinator for Advocate BroMenn Medical Center in Normal.
Some people — when their prescriptions weren't refilled — turned to buying an illegal opioid, heroin, on the street. Heroin is cheaper than prescription painkillers.
Generally, people start using heroin by snorting a powder form, said Ed Betzelberger, director of addiction services for Tazwood Center for Wellness that provides mental health services in Tazewell, Woodford and Logan counties. Then, intravenous use becomes the preferred method because it's injected directly into the blood stream so users get high quicker.
When people overdose on opioids, the body's functions slow to the point where people lose consciousness and, in some cases, stop breathing.
McLean County Area EMS providers administered naloxone (Narcan) 136 times during 2016 to restore breathing in people experiencing an opioid overdose, compared to 134 times during 2015, said EMS Director Dylan Ferguson.
"Comparing first quarter 2016 to first quarter 2017, we have seen an increase of 25 percent" of patients administered naloxone, Ferguson said.
"One trend we started to see at the end of 2016 that continues into 2017 is EMS providers are having to administer higher doses of Narcan than they did before," Ferguson said. "We are seeing more heroin cut with Fentanyl (a powerful synthetic opioid), which results in a deadly cocktail."
He explained, "A standard dose is 2 milligrams. Sometimes, we're administering 4 to 8 milligrams just to bring their breathing back."
At Advocate BroMenn, which has an addiction recovery unit, 271 people were treated for opioid addiction during 2016, a slight increase from 258 people during 2015, Ritter said. Through April 17 of this year, 80 people were treated.
At OSF St. Joseph Medical Center in Bloomington, 30 patients were treated for opioid-addiction related problems in the ER from January 2016 through the end of April this year, said clinical coordinator Cathy Belcher. About 45 patients were treated at OSF Saint James-John W. Albrecht Medical Center in Pontiac, said Erin Nimbler, director of emergency services.
Chestnut Health Systems' detoxification unit has to turn away an average of 38 people each month because it doesn't have room for them, said Joan Hartman, Chestnut vice president of behavioral health services.
"Ninety-five percent are alcohol- or opiates-related," she said.
One reason that Chestnut is seeing more opioid admissions is because Chestnut is a provider for Safe Passage.
Safe Passage is a program being adopted by some police departments, including the Pontiac agency, for opioid addicts to come to the police department with their heroin and prescription opioids. In exchange for handing over their drugs, the police department arranges to get people the help they need, said Pontiac Police Maj. Dan Davis.
"We have helped more than 10 people (Livingston County residents)," said Davis. "I wish more people would take advantage of this program."
"Programs like this (Safe Passage) have made a huge difference to individuals," said Betzelberger.
Bloomington-Normal Treatment Center has about 170 active patients, Barber said.
At IHR (Institute for Human Resources), Livingston County's mental health and substance abuse agency, 257 substance abuse clients were treated between July 1, when the fiscal year began, and the end of April, said Teresa Diemer, substance abuse program director. Of those, 59 were treated for abuse of heroin, opioid pills or both, she said.
About 40 percent of people contemplating suicide last year who were assisted by the crisis team of Center for Human Services (CHS) of McLean County were people who had used heroin or another opioid, said crisis program manager Meghan Moser.
There is more than one addiction treatment option available in the Twin City area.
Bloomington-Normal Treatment Center uses a methadone maintenance program.
Methadone, which comes in a liquid or tablet form, is an opioid, but it's longer-acting than heroin, Barber said. The idea is to get people who are addicted, sick and unable to function down to a therapeutic dose so they can stop illegal activity, hold down a job, improve their personal relationships and have a life, she said.
"With methadone, what they get is a longer-acting steady dose in their system so they don't get sick," Barber said.
Withdrawal from heroin, which is like a severe and painful flu, is one reason people continue to take heroin.
The goal is to slowly reduce the methadone dose so the person is opioid-free, said Barber, admitting that replacing one drug with another is controversial.
"People come to us addicted," she said. "Abstinence is our goal. But we will accept harm reduction. We will accept people not dying. We will accept people doing better."
Chestnut Family Health Center has a medication-assisted treatment program that provides Suboxone that can deliver relief from heroin cravings, Hartman said.
Betzelberger said "we're seeing a growing interest in Vivitrol to aid people in treatment of opioid addiction."
Vivitrol, a monthly injection and a longer-acting form of naloxone, "keeps cravings away," he said. "It's a tool that can be effective with other tools," including therapy, taking care of your health and surrounding yourself with supportive people.
"If you relapse, it's not a failure on your part," Ritter said.
"If you're still drawing a breath, it's not too late," Betzelberger said. "People who recover realize, 'My life is worth saving.'"