STROUDSBURG, Pa. (AP) — It could be a minor looking to experience their first high or an older person needing pain relief.
In either case, they get hooked on prescription painkillers, but eventually find it harder to get more to feed their habit.
So, they turn to something easier to get: heroin.
And that is what has fueled heroin's popularity across the country and in the Poconos, according to law enforcement officials.
"Heroin use and related crime (in Monroe County) is growing and has outnumbered all other illegal drug use growth combined," said Monroe County Probation Office Director Steve Houloose.
"It usually begins with the reckless writing and use of legal prescriptions for highly addictive morphine-based painkillers. When the script is no longer easily obtained through a physician or pharmacy, and once users have raided every medicine cabinet they can, the street-level ability to obtain these drugs becomes financially prohibitive, at least $30 to $60 per pill.
"By this time, three or four Percocet or a couple of oxycodone won't satisfy the need," Houloose said. "The former patient now becomes a street junkie, since street-level heroin can be bought for less than one-fourth the price."
Besides the cheaper price is another factor.
No paper trail
"Prescription painkillers leave a paper trail because they're made legally, prescribed out and then monitored to some degree, which makes them more expensive and harder to deal," Stroud Area Regional Police Capt. Brian Kimmins said. "Heroin, on the other hand, is made illegally and transported into the country. There's no paper trail, so it's much more readily available.
"According to the addicts I've interviewed, it's a more powerful high than painkillers, so you get it cheaper and more bang for your buck."
Plus, heroin can be smoked or snorted for a quicker high, said State Police Troop N Public Information Officer David Peters.
So "what starts as a few bags of heroin a day then escalates to many," Houloose said. "For unemployed users, shoplifting, stealing and prostitution or dealing become the only recourse to support their habits."
Kimmins said 95 percent of the heroin addicts he's interviewed started out as prescription painkiller addicts.
"I believe the abuse of prescription painkillers is in direct correlation to heroin-related crimes," Kimmins said.
Connected to other crimes
Heroin use among teenagers has risen, since most teens tend to start off abusing painkillers, Peters said.
"One of the most disturbing trends is the increase in number of high-school-age abusers of morphine-based drugs," Houloose said. "Locally based gangs target young people for use and to obtain drugs."
And then there's the fact that selling heroin and other drugs reap greater profits in the Poconos than elsewhere.
"What may sell for $4 per bag in New York City will sell for three times that here," Houloose said. "Understaffed police forces, along with Interstate 80 providing easy access to bring drugs into our area, create a haven for this type of activity here."
State and local police in the Poconos have reported seeing an increase in crimes involving heroin.
SARP reported 52 drug-related crimes in its jurisdiction between January and April of this year, Kimmins said.
Of that, 42.3 percent involved heroin, up from 36 percent of the 147 drug-related crimes in 2011.
So, how are police addressing this problem?
Peters cited the state police's Safe Highways Initiative by Effective Law Enforcement and Detection, which began in 2004.
The initiative provides advanced training for state and local law enforcement to identify potential signs of drug possession and other criminal activity among highway motorists.
Pocono Mountain Regional Police Cpl. Lucas Bray said his department's patrol officers are trained in narcotics detection.
Penalties typically are more severe for drugs like heroin than for drugs like marijuana, Houloose said.
"Morphine-based drug abusers are the most common inmates in local and state prisons, since the overwhelming need to use outweighs the fear of incarceration," he said.
"Recidivism among morphine-based drug abusers is very high due to the drugs' physically addictive nature, which is why the risk of relapse is very high for those trying to recover."
Heroin addicts struggle in rehab
By ANDREW SCOTT
Heroin abusers eventually go into rehabilitation, whether of their own accord or under court-imposed sentences after criminal convictions.
Addicts tend to be mostly white males, ages 25 to 34, said Executive Director Lee Koplin at Mount Pocono Medical, an outpatient facility that helps those addicted to heroin and other opiates.
"Most people seeking services are using both pills and heroin if they can get hold of both," said Treatment Program Manager Jamie Drake of the Carbon-Monroe-Pike Drug and Alcohol Commission.
The challenge is helping addicts get and stay clean.
"People relapse for all different reasons," Drake said. "Once addicted, their brains are accustomed to the substance being there. They need to learn healthier means of coping without the substances. This is not a quick process."
Many addicts find it easier to go back to using rather than face the overwhelming problems their addictions have caused in their lives.
"They are unemployed, estranged from their families and many face legal charges resulting from their addictions," Drake said. "They're dealing with all this while fighting cravings in their battles to stay sober. This is where counseling comes into play."
The commission's ability to continue serving clients has been threatened in recent years by a reduction in funding coupled with an increased demand for treatment services.
"As a person progresses in their addiction, their tolerance increases, which means they need more of the drug to get the same high," Drake said. "And the more of the drug they use, the worse physical withdrawal is for them when they go through that process. They usually require detoxification or placement in a medication-assisted treatment program using suboxone or methadone to be successful. In many cases, this takes multiple attempts to achieve."
James Shoemaker, a drug and alcohol counselor at PA Treatment and Healing in East Stroudsburg, said a high percentage of the opiate addicts he works with don't even make it to their first scheduled appointments with him after coming out of detox.
"That's how much of a challenge it is to work with chemical dependency to opiates," Shoemaker said.
Information from: Pocono Record, http://www.poconorecord.com/