The news that two young men had died of suspected heroin overdoses in Ashland on Dec. 3 and 4 shocked many, but those who deal with opiate addicts say the use of heroin is more widespread than the public understands.
"It's become a fairly large community dilemma," said Susan Nebelsick, health consultant for the pain management program with OnTrack Inc.
Doctors, police officers and addiction treatment specialists say prescription pain pills become a gateway for those who end up as heroin addicts. Heroin has the same opiate-based ingredients as commonly used prescription pain medication such as Vicodin and oxycodone.
"We're seeing a lot of poly-drug problems, too, where they are not only taking heroin, but oxycodone as well. It's really problematic," said Lt. Brett Johnson, commander of the Medford Area Drug and Gang Enforcement team, or MADGE.
"We've seen a spike in the usage in the last few years," he said. "I attribute it to the use of pills, and the availability of gun powder heroin, which takes away from the stigma of putting it in a needle. It's a lot easier to get someone to try to snort or smoke it."
Determining appropriate and sustainable treatment for short-term and long-term pain is a complicated problem for both the medical community and patients, according to Dr. James Shames, medical director for Jackson County Health and Human Services.
"It's kind of a new phenomenon to use opiates for pain," said Shames. "We (physicians) all pretty much know how to use painkillers for short-term pain problems, and we assumed it would be the same for chronic pain treatment. I think what we've discovered is that the drugs are very dangerous, people become addicted easily and they are hard to get off of."
According to Shames, prescription painkillers are not particularly effective for chronic pain, and there are many dangers and misuse.
"We have an epidemic of opioid abuse in this country, state and this area," said Shames. "The thing about getting addicted is, it's not very much fun. It doesn't take long before what you're really doing is trying to avoid getting sick."
Chari Weatherford, 36, of Ashland who is 15 years sober from heroin this year, said her addiction was so great that she needed a fix every three to five hours. She would wake up during the night sick with withdrawal symptoms, which she described as 100 times worse than the worst flu symptoms imaginable.
In withdrawal from heroin, a person sweats and shivers, one's brain feels like it's on fire, their muscles hurt and they go through bouts of vomiting and diarrhea, according to Shames.
"Your whole body is just screaming, 'Don't do this to me,' '' said Shames.
But stopping the pain often means prolonging the addiction.
"Heroin addicts never say they are going to get high; they are going to get well," said Weatherford, "I don't think anybody decides to be a junkie overnight."
Weatherford moved to the Rogue Valley in 1999 from the Salem and Portland area where she says heroin was considered cool. She said she's not surprised it's made its way into this area, but added that honest, unhyped drug education efforts could make a difference locally.
"If people would have told me more about the truth about heroin, I might not have done it," said Weatherford. "But when they are lying to me about marijuana, they didn't teach me truth, so I didn't believe them. I feel like it's something we need to talk about and educate about."
There are also two schools of thought when it comes to kicking heroin addictions: sobriety-based treatment and medication-assisted treatment. Shames said people who are addicted to opiates have a harder time staying clean without medication assistance in the form of methadone, or suboxone.
Locally, a methadone clinic in Medford treats about 600 patients. Weatherford said it became a lifeline that allowed her to slowly ease herself off of heroin. A methadone treatment would keep her from getting sick from withdrawal for about 24 hours — compared with a fix that only lasts three to five hours — which meant she could feel well enough to look for a job and put her life back together.
"For me, I didn't have to be hustling 24 hours a day to get the next fix that only lasts three to five hours," said Weatherford, "I could go in and get my dose that was safe, that wasn't going to kill me, and I had the rest of the day that I could look for work and start changing my life. I could be a normal human being again."
Weatherford said her heroin habit cost about $200 a day to maintain when she was hooked. Of course there is danger in overdosing on methadone as well and Shames says there is no treatment that works for everyone.
"At some point they realize they can't stop, and then they have a tiger by the tail," said Shames.
Shames recommended that people who realize they are addicted to opiates should immediately get into treatment and tell their doctors.
"Don't keep it a secret; enlist your friends, enlist support, enlist your doctor," said Shames, "Yes, there are a lot of people that will judge you, but at some point that becomes their problem and not yours."
Mandy Valencia is a reporter for the Mail Tribune. She can be reached at firstname.lastname@example.org or 541-776-4486.