BERLIN – In January of this year, Heidi McNeeley’s son was arrested.
Ten months later, she considers that a miracle.
“That was his wake up call,”
she said.
McNeeley, who lives in Bishopville, said her 25-year-old son called her to tell he’d been arrested — for heroin possession. He went on to tell her that he was addicted to the drug and needed help.
She was shocked. She thought heroin was something you heard about in the inner city.
McNeeley soon found out heroin use is now considered an epidemic in Worcester County — and the state at large. Between 2011 and 2013, there has been an 88 percent increase in heroin related deaths in Maryland, according to the state’s Department of Health and Mental Hygiene. Larry Hogan, the republican candidate in Maryland’s governor’s race, has even pledged to declare a state of emergency regarding heroin if he’s elected.
Here in Worcester County, the most recent data (collected between 2007 and 2011) shows 65 percent of intoxication deaths were related to opiates, which can include heroin and prescription pills.
“Opiate use has been a growing epidemic in Worcester County for the last several years,” said Tracy Tilghman, director of behavioral health for Worcester County. “There’s been an increase in heroin use but also in people being addicted to their painkillers.”
According to health officials, many heroin addictions start with a dependence on prescription opiates. While some people experiment with prescription medicine in search of a high, others get hooked on painkillers after being prescribed them legally following an injury or surgery.
“They start with prescription pills and it transitions to heroin,” said Tracy Simpson, coordinator of the Worcester County Circuit Court’s drug court program. “It’s cheaper and more accessible.”
McNeeley says that’s how her son was drawn to the drug. What started as experimentation with marijuana as a teenager led to prescription pills, which led to heroin.
“Pills are expensive,” she said. “Heroin’s cheap.”
Just how cheap? Seven to $10 a hit, according to local criminal defense attorney Marc Zeve. It gets expensive though when users are taking a dozen hits a day. And that point comes sooner than you would think.
“It’s not a drug you can use once and put away,” he said. “It’s so physically addictive. That’s the heart of it.”
When McNeeley’s son started snorting heroin, he did it for the high. By the time he approached her, though, there was no enjoyment in it.
“’It’s not fun. I have to do it so I don’t throw up and have diarrhea all day,’” she recalls him telling her.
But staying on the drug takes a toll, too.
“Physically they get really thin,” Zeve said. “It’s so hard to watch … They’re very secretive. It’s easy to conceal. Not everybody injects it.”
McNeeley didn’t even know the drug was a problem in Worcester County, let alone that her only son was dependent on it.
“We as parents have no clue,” she said.
A Desperate Search For Help
When McNeeley did find out her child had a drug problem, she realized she didn’t know what to do. In spite of a background in nursing and a job in the healthcare industry, she had no idea where to start. All she knew was she wanted to get him help. Immediately.
“I got on the Internet and started looking up rehabs,” she said.
Online searches quickly revealed the limited number of options available on the shore.
“I couldn’t get a rehab bed on the Eastern Shore — not just Worcester County — for three weeks,” she said.
She eventually found a facility on the other side of the state that could take her son in five days.
“My concern was in five days he’ll change his mind,” she said.
With that fear in mind, she kept searching and eventually located a Christian rehab facility in Baltimore that she could take him to immediately.
That wasn’t the end of the struggle though. He needed to bring his medical history, a recent physical and blood work results with him. His regular doctor said it would be 10 days before he could get an appointment.
“It was like every door was shut,” McNeeley recalled. “It was scary and overwhelming.”
A newly opened immediate-care clinic was able to perform the work, however, and McNeeley was able to get her son to the rehab clinic. Ten months later, he’s living in a sober home, working and participating in a 12-step program.
“He’s getting his life together,” she said.
Not everyone struggling with heroin addiction does, however.
Willards resident Randy McClain has watched a close friend spend most of the last year addicted to heroin. She was in a serious car accident and was prescribed Percocet for back pain as she recovered. When the prescription ran out, her pain didn’t stop.
“She couldn’t handle it,” McClain said, “so she turned to heroin. When she’s not on it she can’t get out of bed.”
Tilghman says she has learned through her work with the health department that’s not uncommon.
“If a person is addicted to a pain medication and they’re cut off, they start using heroin, which is more accessible. That’s very surprising for the general public,” Tilghman said.
McClain said in recent years he has seen several people become dependent on the drug. Most stay that way.
“I’d say 99 out of 100 (that quit) fall back,” he said. “The temptation is too much.”
Drug Court Program’s Role
While resources to address the growing heroin problem on the shore are lacking, there are programs in place.
The drug court division of Worcester County Circuit Court was created in 2005. It’s basically a court-supervised treatment program for people whose criminal behavior has been motivated by substance abuse, according to Simpson. Nearly all of the people enrolled are opiate addicts.
“If we have 50 people, 48 are opiate addicts,” she said. “This has been a steady increase over the last five years.”
Like other drug courts throughout the country, Worcester County’s program has about a 50-percent success rate.
“That was before the heroin epidemic,” Simpson said. “But that hasn’t changed. We have had to change techniques.”
As heroin has grown in popularity, she explained, medically assisted treatments have become more common. That’s when those battling heroin addiction are given drugs like methadone and suboxone to help them kick the habit.
While drug court works to address addiction in people who are moving through the criminal justice system, those who haven’t broken any laws can seek help from the Worcester County Health Department. Tilghman says the organization offers inpatient and outpatient services. Inpatient services are offered in conjunction with Hudson Health Services in Salisbury. A two- to three-week wait to get into the program is not unusual.
“For inpatient care, there’s always a lack of resources for the needs we have here,” Tilghman said.
An example of that, she said, was the fact that on the entire Lower Shore there were just 11 “state beds” — spots for the uninsured.
“That’s not a lot,” she said.
As healthcare programs have expanded in recent years, the number of people eligible for services has increased. The number of service providers has not.
“People are covered but the beds are full,” she said. “We’re going to continue to see those types of limitations. When there’s more availability to people but the same amount of resources, there’s always going to be a lack of access.”
She says providers do the best they can with the space they have. When a wait for inpatient services is unavoidable, every effort is made to enroll the individual in outpatient programs — therapy, peer support, and medically assisted treatment when possible.
“That’s often the best we can do,” she said. “The highest need person gets the bed. People presenting always think they’re the highest need. It’s a very difficult decision to make.”
As McNeeley feared, the time spent waiting for a bed at a rehabilitation center is a common time for addicts to give up on their efforts to get sober. This is particularly true for people detoxing from opiates, Tilghman said.
“Detoxing from heroin is very uncomfortable,” she said, adding that it involves nausea and flu-like symptoms. “It’s not pleasant.”
Organizations like the Worcester County Health Department, however, strive to accommodate everyone seeking help with an addiction.
“When they’re ready to make that change, it’s important to engage them and encourage them,” she said.
Overdose Prevention Targeted
As heroin use has increased, so have the number of programs to address it. Just last year, the health department began an overdose prevention program in response to the increasing number of heroin-related deaths. Statewide, there were 464 such deaths last year, according to the Department of Health and Mental Hygiene.
Those people identified as high-risk, or those who come in contact with people who are, are given a voucher for a free Naloxone kit and taught how to use it. Naloxone can be administered to heroin overdose victims for temporary relief while they are waiting for emergency assistance. Tilghman said the concept was similar to that of the EpiPen.
“It’s to keep people from dying,” she said.
The county has also just started a drug overdose fatality review team. That group, made up of law enforcement, treatment providers and school system officials, will look at trends, data from local deaths and ways to prevent overdoses.
Health officials are also making more of an effort to track what they call “near misses” — those who come close to dying after using opiates. Some of those cases occur simply because people didn’t know better. People using opiates legally, with a prescription from their doctor, sometimes don’t realize the danger that can occur when they’re taken with alcohol or other drugs.
“Especially people with more frail health,” Tilghman said. “They have a lot of doctors they go to and they get prescriptions at all of these doctors and they don’t realize they’re supposed to communicate every medication to every doctor.”
Through her work in drug court, Simpson has also taken to cautioning people on the contents of their medicine cabinets.
“Be very careful with your use of prescription opiates and your storage of them,” she said.
Teenagers are often tempted to experiment with the drugs, thinking that because they’ve been prescribed they’re safe.
“The addiction is rapid,” she said.
McNeeley is well aware of that now after watching her son spend the last 10 months fighting just such an addiction. She believes people on the shore need to be made aware of just how big the heroin problem is becoming. She recalls the popularity of marijuana during her own youth but points out that it didn’t lead to the crippling addictions youth abusing heroin face.
“Kids try it because it’s cheap and accessible,” she said, “but you become physically addicted to it and then you don’t know what to do.”
As a criminal defense attorney, Zeve says he knows some of his clients do things that are wrong. Nevertheless he can’t help but empathize with the young people he represents whose lives began unraveling when they got hooked on heroin. He still remembers how one girl described the high to him.
“It was like kissing God,” she told him.
Since helping her son begin the rehabilitation process, McNeeley has wondered what she could do to help parents who have found themselves in similar situations. She says she’s willing to talk to and share her experiences with anyone who’s interested. She can be reached via email at [email protected].
“I don’t know what the answer is,” she said. “Maybe it’s just getting the word out there.”