'Glee' star's death sheds light on young adults hooked on heroin

SEATTLE -- "Glee" star Cory Monteith's death has many wondering how someone so young and talented could have died from a heroin overdose, but local experts say users under 30 are the fastest growing group to die from heroin use in Washington state. While efforts by the medical community may prevent future generations from trying heroin, a growing number of young adult users are struggling to get treatment today.

The University of Washington Alcohol and Drug Abuse Institute reports opiate deaths in our state have nearly doubled over the last decade, with the greatest increase among young adults. In King County, there were 84 heroin involved deaths in 2012, compared to 49 in 2009. All of the increase was among adults under 30.

The age of users seeking treatment has also dropped. According to Dr. Caleb Banta-Green, a research scientist at ADAI, the average age of heroin users entering treatment between 2004 and 2010 dropped from 40 to 29. Among 18-to-29-year-olds who sought treatment in 2012, Banta-Green said heroin was the most common drug of choice.

While Seattle's heroin problem has not lessened, the greatest increases in heroin use can be found in Washington's midsized cities, such as Port Angeles, Ellensburg, Longview and Aberdeen.

Banta-Green said many of today's young-adult heroin users started out abusing prescription opiates. In a survey of 10th graders, ADAI found that nearly one in four who had used prescription opiates to get high had also used heroin. Thirty-nine percent of all Washington heroin users surveyed reported they were hooked on prescription opiates before they began using heroin.

Molly Carney, executive director of the drug treatment center Evergreen Treatment Services, said the prescribing of opiates increased in the 1990s in response to patients managing chronic pain.

"It became an attractive source of substance abuse among young people because it was so readily available," she said.

Banta-Green said prescription abusers may move onto heroin when pills become too expensive or difficult to find because heroin is cheaper and more widely available.

Police evidence suggests when the number of opiates prescribed in Washington began to level off in 2008 and supply dwindled, heroin use shot up, according to ADAI. Similar trends have been seen in Portland and San Diego, Banta-Green said.

"There have been a lot of efforts by state medical directors to get prescribing under control," Banta-Green said. "But getting rid of prescription opiates does not get rid of opiate addiction."

While Banta-Green hopes future generations are less likely to be introduced to prescription opiates as the supply dwindles, he said there is a growing number of people in their 20s and 30s who are already hooked on heroin and struggling to find treatment.

"We need to take care of them," Banta-Green said. "To make sure they know there is drug treatment and that it saves lives."

Studies have shown the most effective treatment is medication-assisted, using the drugs buprenorphine or methadone. Unfortunately, treatment centers that are authorized to use these medications can be difficult to get into because of patient limits set by state and federal governments.

Evergreen Treatment Services typically has a waiting list of 200 people, with an estimated wait time of nine months to a year.

"There is no question that some of those people will not make it," Carney said. "The longer we make them wait, the more difficult it is for them to succeed."

Treatment providers can be especially difficult to find in more rural areas. While Evergreen is working to open a new clinic in Aberdeen, Carney said she currently has about 70 patients in Grays Harbor who must drive an hour or more to Olympia six days a week for treatment.

"If they don't get treatment, you frequently have ongoing criminal behavior, people going to emergency rooms and ending up in jail," Carney said.

Heroin is involved in three quarters of King County overdose deaths, but Banta-Green said opiate overdoses are uniquely reversible.

Opiates can suppress your breathing, Banta-Green said. Over a couple hours, carbon monoxide builds up in a person's body and they die.

But, Banta-Green said if people are trained to recognize the symptoms of an opiate overdose - such as a blue face or odd snoring - they can reverse the effects by breathing for them, rubbing their sternum or injecting them with the drug naloxone.

He urges anyone who knows an opiate abuse to learn the steps they can take to reverse an overdose.

"Heroin users are still human beings," Banta-Green said. "They are not evil, thoughtless people; they don't want their friends to die."

The Washington State 911 Good Samaritan Drug Overdose Law lets bystanders give naloxone if they suspect an overdose. The law also protects the victim and the helpers from prosecution for drug possession.

The greatest lesson Carney said can be learned from Monteith's death is that opioid addiction affects many different people.

"There's a perfect example of how it can hit anybody," she said of Monteith. "It's not a moral choice. It is considered a brain disease by scientists."