Iowa’s death toll from heroin more than doubles in ’13

Heroin overdoses killed more than twice as many Iowans last year as in any year in the previous decade, state officials reported this week.

Experts say the deaths reflect how heroin’s national comeback has hit Iowa in force.

Iowa medical examiners blamed heroin overdoses for 20 deaths in 2013. That was up from eight in 2012. Until 2008, Iowa was seeing one to four such deaths per year.

Dr. Ed Bottei, medical director for the Iowa Poison Control Center, said many people falsely believe heroin is just a problem for the underclass. He pointed to high-profile deaths involving heroin, including those of actors Cory Monteith and Phillip Seymour Hoffman.

“Those are perfect examples dispelling the myth that it’s just the homeless street people doing this,” Bottei said.

Dr. Kevin Hill, an addiction-treatment specialist who teaches at Harvard University, said heroin’s soaring popularity in Iowa should be no surprise.

“It’s easily accessible, it’s cheap, it’s an incredibly powerful drug,” he said. “It’s everywhere.”

Federal experts say the number of heroin overdose deaths nationally has more than doubled, from 2,089 in 2002 to 4,397 in 2011.

Hill, who spoke at a medical conference Thursday in Altoona, said in an interview that the heroin epidemic is related to abuse of prescription painkillers. Many of the prescription pills are chemically similar to heroin. Doctors and government officials are attacking the problem, “but we have not gotten a handle on it yet,” he said.

Hill stressed that the solution must involve more access to effective treatment, including the use of less dangerous medications to help wean addicts off heroin.

The new statistics from the Iowa Department of Public Health give no details on who the 20 victims were, but experts say heroin is being abused by Iowans across many age groups and social circles.

Paul Feddersen, assistant director of the Iowa Division of Narcotics Enforcement, said the heroin problem seems to be worse in eastern Iowa than in the rest of the state. That’s apparently because of the proximity to Chicago suppliers, he said. But the drug is readily available throughout Iowa.

Feddersen said many heroin users started with prescription painkillers before switching to the street drug. “It’s a cheaper, better high for them,” he said.

Methamphetamine remains a bigger problem in Iowa than heroin, Feddersen said, but heroin is catching up.

The new state overdose report does not break out methamphetamine-related deaths. However, it shows that overall drug overdose deaths rose from 213 in 2012 to 227 in 2013.

An initial review of the figures by the Iowa Office of Drug Control Policy estimated that deaths from prescription painkillers rose from 64 in 2012 to 77 in 2013. Those numbers suggest that abuse of narcotic pills has not decreased despite the state’s relatively new method of tracking all purchases of addictive prescription drugs.

The computerized prescription drug registry is designed to prevent addicts from obtaining pills via multiple doctors.

The Iowa Board of Pharmacy reported earlier this year that the number of people trying to obtain addictive medications from five or more Iowa physicians or pharmacies dropped from 2,270 in 2009 to 264 in 2013.

Medical system leaders have discouraged careless prescribing of addictive pills, and several Iowa doctors have lost their licenses or have been prosecuted criminally for allegedly being too loose with their prescriptions. But pain pills continue to pile up in Iowans’ medicine cabinets. For example, Iowans filled prescriptions last year for 69 million hydrocodone pills, or an average of about 23 tablets for every man, woman and child.

Hydrocodone pills, also known as Vicodin, will soon become a bit tougher to obtain. Federal officials plan to tighten rules in October, requiring more record-keeping from health care professionals and making it harder for patients to obtain multiple refills without going back to a doctor.

Proponents of the change say the new rules match those governing similar narcotic pain relievers and should rein in overuse of hydrocodone. Skeptics fear that the new rules will complicate the lives of patients with real pain but won’t do much to combat drug abuse. They note that one alternative for addicts could be to switch from hydrocodone to heroin.

by the numbers

in Iowa

20

deaths due to heroin overdose in 2013

8

deaths due to heroin overdose in 2012