A pervasive problem: Local leaders say collaboration needed to fight Northland heroin outbreak

Heroin  

Kevin Beck stole from his 13-year-old brother.

If his brother had no money, he stole from his brother’s friends.

If they had no money, he got creative.

He’d wait for his dad to leave the family’s house in the Twin Cities, he said. Once alone, he’d go to where his dad kept the guns.

Beck stole, sold and pawned anything he could to get his hands on heroin. Not long out of high school, he was hooked on the finely crushed, highly addictive powder known for inducing a high somewhere between euphoria and extreme relaxation.

“I loved my family, but the feeling of heroin was just so consuming,” said Beck, 26. “It got to the point where that was all I could think about. I didn’t care about anything else.”

Beck doesn’t use heroin anymore, he said, but he still struggles with that part of his life.

Now he works for Know the Truth, the prevention program of a drug and alcohol treatment group called Minnesota Adult and Teen Challenge. As part of the program, Beck and other recovered heroin users share their stories at schools across Minnesota.

“A lot of people try to hide behind addiction. They went through it, but they don’t want to talk about it,” Beck said. “I’m not proud of it, but I went through it. I kind of have to accept it as part of my story.”

If heroin use is a trend, Beck was ahead of his time.

Once nearly invisible -- exclusive to a small number of hardcore drug users -- heroin has exploded in Minnesota in the past few years, with Duluth at the epicenter.

Through May 8 of this year, local law enforcement had referred 111 heroin-related cases to the St. Louis County Attorney’s Office in Duluth, according to an article this spring in the Duluth News Tribune. That’s up from 51 for all of 2013 and seven for all of 2011.

Police say heroin is spread by a complex network of distributors that doesn’t seem to weaken when dealers are arrested.

Social workers say heroin has infected every corner of Duluth and St. Louis County, even those typically untouched by crime and drug use.

Medical professionals say heroin poses unique problems -- from its addictive properties to its deadly-but-hard-to-detect symptoms during withdrawal -- that require collaboration and public outreach.

It all seemed to happen overnight, they say, and it doesn’t seem to be slowing down.

‘This is heroin’

The drug sweeping the Northland is a very pure form of brown heroin that can be traced to cartels in Mexico. After crossing the border, it flows through major Midwest cities before reaching Duluth.

Police have said most dealers come from large metropolitan areas and don’t stay in Duluth for long. That makes dealers more difficult to catch, police say, and a similar trend across the country was the drive behind “Operation Exile,” a federal incursion this year against the spread of heroin.

With the help of local law enforcement, federal officers arrested 41 people in St. Louis County with alleged involvement in heroin trafficking. “Operation Exile” was a success, police say, but only a start.

At a town hall-style meeting last month at Duluth’s Harrison Community Center, Duluth police Lt. Jeff Kazel talked with about 50 Northland residents and a panel of local experts about the challenges built in to the region’s heroin pandemic.

“This is heroin,” Kazel said, pointing to a picture of about a gram of brown powder that was part of an introductory slideshow presentation.

“It’s death,” he said. “Literally death.”

A gram of the brown heroin commonly found in Duluth sells for as much as $250 on the streets, said Kazel, who also heads up the Lake Superior Drug and Violent Crime Task Force. It can be smoked, snorted or injected into the bloodstream for maximum effect, he said. With each encounter, users tend to crave more powerful doses.

Law enforcement officials have expressed a reluctance to punish users with jail time. Instead, they seek to refer people hooked on the drug to medical and outreach professionals.

Those who sell heroin are the targets of criminal lawsuits, but Kazel said any dealers they arrest seem to be replaced by new dealers within a few weeks. And since federal authorities -- let alone local officers -- have a difficult time taking on the cartel leaders in Mexico, the source of the problem for the most part goes unaddressed.

‘My best friends were drug dealers’

Before he stole from his brother (younger than him by eight years), his brother’s friends and pawned his dad’s guns, life seemed easy for Kevin Beck.

He had friends and excelled in sports. Good grades came for him without much effort. His family was more than functional; it was a great family, he said.

“I was really provided for,” he said. “I was actually kind of spoiled growing up.”

Beck didn’t seem like the kind of kid who, several years later, would break into cars and homes looking for money to buy drugs.

None of that mattered, though, when he reached high school.

“I started to face insecurities,” Beck said. “I didn’t know how to deal with it. My friends started using a little bit, and that’s how I was turned on to it.”

Before long, Beck was drinking alcohol and smoking marijuana.

“I opened up that door, then I started trying different kinds of pills,” he said. Beck said his friends shared painkillers they were prescribed for various injuries.

“When I took Oxycontin for the first time, I laid on my friend’s bed, and I felt like I was melting into the bed. It gave me the sensation like, ‘Where has this been my whole life?’ ”

Beck moved to the Twin Ports to attend the University of Wisconsin-Superior, but his stay there was cut short. He transferred to a school in Florida after “failing out,” and his addiction to prescription pills hardened.

During a visit to Minnesota, a close friend introduced Beck to heroin. Beck said it helped get his mind off prescription pills, from which he was trying to withdraw.

“All I could think of was getting high off heroin because of the way I felt,” he said. “I was sweating, and my mind was just saying, ‘If you take this, you could feel better.’ It consumed me from the moment I took it.”

Soon, Beck was raiding cars and homes, including his parents’.

“I got involved with guys carrying guns, and I had guns pulled on me,” Beck said. “My best friends were drug dealers.”

Beck’s addiction to heroin was personally devastating -- “I hated myself so much,” he said -- but that didn’t make it any easier to shake.

In his early 20s, Beck went in and out of treatment five times.

He found himself in the Minnesota Adult and Teen Challenge center in Minneapolis, and after a year in the center’s long-term recovery program, he was clean.

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Beck said acknowledging the problem helped him and his family come to grips with his addiction and ultimately recover from it.

When he tells his story in Minnesota middle schools and high schools, Beck said some students approach him and say they’re experiencing their own version of his past.

What Beck made it through, so many teens are only beginning, he said.

“The message we bring … is everybody struggles, but you have to confront it and talk about it. Bring it home to your parents and make that an open-ended conversation,” he said. “It’s changed my entire life.”

Breaking the taboo

Similar stories to Beck’s are playing out today in the Northland, but not all have had uplifting endings.

Some residents who attended November’s town hall meeting brought along friends and relatives they said are using heroin or have in the past. Others -- including one couple who said their daughter died from using the drug -- spoke of losing friends and relatives.

Marcia Gurno, a social worker for St. Louis County Substance-Abuse Prevention and Intervention, said she has dealt in the past year with cases of heroin use in every Duluth neighborhood.

“It goes across culture; it goes across economics -- people from good homes,” said Gurno, who was joined by Beck and Kazel on the meeting’s six-person panel. “It’s everywhere.”

In 23 years working for the county’s child protection program, Gurno said she encountered only one case involving heroin.

When she moved to the county’s chemical dependency program in 2010, heroin was still a “hardcore, taboo drug,” she said. The next year, Gurno met with a pregnant woman who was reported to have taken a substance potentially harmful to her fetus.

“She was drinking alcohol,” Gurno said. After that, “we didn’t have any (such cases) for three years. Now I have nine, because of heroin.”

Police have said users typically fall into heroin by first smoking marijuana, but some people, even those without histories of drug and alcohol abuse, seem to gravitate toward heroin almost immediately. That’s especially true for teens and young adults, on whom dealers seem to be focusing their attention.

“Kids have gone from Mountain Dew to heroin that quick,” Gurno said.

A quiet killer

At the turn of the 20th century, pharmaceutical companies were searching for a painkiller to replace morphine, to which patients were becoming addicted and from which they were suffering highly unpleasant withdrawals.

Bayer chemical and pharmaceutical company trademarked heroin, bottled it and marketed the drug as a remedy for morphine addiction until World War I.

Congress in 1924 banned the manufacture and distribution of heroin, and in 1970 it was deemed a Schedule I drug, meaning it has little to no medicinal benefits and has a high potential for abuse.

Elisabeth Bilden, a toxicologist at Essentia Health in Duluth and a panelist at last month’s meeting, sees patients who have been admitted to the emergency room or the opioid floor of the hospital.

She said an “overwhelming number” of the patients she treats are not admitted because of incidental exposure to chemicals or toxins.

“It’s really heroin,” she said.

Bilden said heroin users typically receive the care they need once hospitalized, but they often fall back into using once released. If users build up a tolerance to heroin, withdraw from the drug and then start using it as they had before, they are at even greater risk. Their bodies no longer are accustomed to powerful doses, she said, and the results can be fatal.

The side effects that accompany heroin withdrawal also present problems that friends and relatives of users might not notice or might be ill-equipped to handle.

“Some people might get nauseated,” Bilden said of recovering users. “They’re hard to awaken. Their respiratory rate decreases. The heart slows and can stop. Unlike with methamphetamine, they don’t get agitated.”

Users going through withdrawal might just appear sick or sleepy, Bilden said, which results in some never receiving the care they need.

“They die prehospitalization,” she said.

Bilden said hospitals in the area are working with the county to fill gaps in care, outreach and prevention. She related addiction to any disease -- “just like diabetes,” she said -- and added that different approaches will work for different patients.

“It’s about collaboration. Nobody has the one right answer,” she said. “We can’t do it alone at the hospital. I see only a little piece of this.”

A fight already won

Kazel described to the audience at last month’s meeting a three-pronged approach the county hopes will help resolve the outbreak of heroin in the region.

The plan is to track down and prosecute dealers, Kazel said, to create community partnerships intended to help users at different stages of addiction and to educate the public about the dangers of the drug.

Work has been swift to put in place the appropriate resources, and local leaders admit they’re playing catchup.

St. Louis County this year hired four social workers -- two located in each the northern and southern half of the county -- dedicated to substance-abuse prevention. It’s part of a model called SBIRT -- Screening, Brief Intervention and Referral to Treatment -- which seeks to reach users at various stages of addiction.

Representatives from seemingly all sides of the fight against heroin have speculated that collaboration in the community will be key to expelling the drug from local neighborhoods.

Gurno noted the intense public outcry and the coordinated response that helped take down the Last Place on Earth, a now-shuttered head shop on Superior Street that served as the nucleus for a synthetic drug trade that has dwindled away in recent months.

Since the Last Place on Earth was boarded up in July of 2013 and owner Jim Carlson was convicted by a federal jury that November, Duluth city officials have reported a sharp decline in the use of synthetic drugs.

It was a different problem with different challenges, authorities say, but that it was resolved in part by community policing could hold lessons about the problem they’re facing now.

“This community really came together,” Gurno said, “but heroin is harder. It’s not being sold from a storefront that advertises it.”

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