Law enforcement agencies throughout the suburbs are reviewing their strategies in the fight against heroin use amid reports of an alarming increase in overdose deaths in recent months, apparently related to greater purity and accessibility of the dangerous drug.
"We had noticed some changes through the year last year," said Dr. Richard Keller, Lake County coroner, "particularly in December, when we had six heroin overdoses - strictly heroin. It really seemed unusual and concerning."
Although some investigations in the first quarter of the new year remain open, and some of the deaths were in combination with other drugs, Keller attributed "about 20" deaths to heroin overdoses since December.
"It certainly seems to have increased over what we'd noticed previously," he said. "We used to get maybe three or so a month."
"I think it's all over," said McHenry County Coroner Marlene Lantz. In 2006 and 2007, she attributed 16 and 18 deaths to drug overdoses, six each year to heroin, but last year it jumped to 28 overdose deaths, 17 from heroin, and this year already there have been nine, four from heroin.
"I don't know what to do about it," she added. "It's out there, it's cheap and kids are saying, 'I think I'll try that.'"
With disastrous results.
Will County Coroner Patrick O'Neil said he's registered "a significant increase here in the last three, four weeks," including seven deaths in nine days, then three or four more. Previously, he charted one or two heroin deaths a month - when there were any at all.
O'Neil was awaiting toxicology tests to confirm exact numbers, but added, "Certainly the (crime) scenes were suggestive of heroin. ... In Will County, it's taken over as the Number One drug of choice in overdoses."
Keller is awaiting results from two drug samples sent to the U.S. Drug Enforcement Administration, but he said the Department of Justice recently put out a warning that the purity of heroin in the Chicago area had increased, a trend going back to 2007 and beyond.
"As this information is getting out, it's stirring up a number of law-enforcement agencies," he said. "They're all starting to look at it more thoroughly."
"We've seen an increase in the amount of heroin arrests we've made and the amount of heroin we've seized," said Larry Lindenman, director of Lake County's Metropolitan Enforcement Group. "It's been a steady increase for the last three years.
"It's just like fashion," he added. "Drugs come into popularity, and then they taper off. Right now, we're seeing heroin come up."
The reasons for that, he said, are partly historical, partly just new trends.
In the '70s and '80s, heroin was cut so much it had to be injected to have an effect. The AIDS crisis helped scare many off the needle, but dealers responded by making heroin more pure so that it could be used in other ways, and that trend has persisted.
A street mixture that might have been 15 or 20 percent heroin only a few years ago might be 30 percent now, "or more," Lindenman said.
That purity has made heroin a choice for users who might previously have settled for cocaine or Ecstasy, both of which are commonly cut with impurities, Lindenman said.
The purity of heroin, however, is far more likely to have lethal results.
The rise of Mexican drug cartels has fueled the increase as well. Where heroin traditionally was produced in Asia, he said, "the heroin that we're seeing here, a lot of it is coming from Mexico, taking the same smuggling routes as cocaine or marijuana."
The economic downturn has contributed too - not from people seeking an escape from their problems so much as seeking desperate sources of income.
"I think that because of the economy, we're starting to see more and more people dealing," Lindenman said. "The more people don't have steady work, they're going to seek that income elsewhere."
Lindenman said, "Chicago is a major nexus" in the drug trade, as shipments come here from Los Angeles and Texas to be distributed throughout the Midwest, or broken up on their way to New York City. Suburban users have typically driven to Chicago to make deals, but now the product is coming out to them.
"We're seeing an increase in heroin we've seized," Lindenman added, "a fairly large increase."
"It's all over," Keller said of the recent deaths. "We get them all the way from the Buffalo Grove area into Waukegan, but pretty much across all socio-economic areas of the county."
"We have more people applying to our methadone program. There seems to have been a surge in that recently," said Susan McKnight of the Lake County Health Department Substance Abuse Program.
And it's not just long-term users who seek methadone to combat withdrawal symptoms and cravings for heroin or other opiate drugs.
"We are getting a lot of younger people who are coming in," she said. "We're seeing people who are 19, 20 years old, more of them than we've seen in the past."
And it's not just a Lake County problem.
"It seems to be more of a regional phenomenon than what we originally thought," Keller said.
A spokeswoman for the Cook County Medical Examiner's Office said they've noticed no spike in heroin deaths, and a spokeswoman for Advocate Lutheran General Hospital in Park Ridge likewise said there was no increase in its emergency-room traffic for heroin overdoses.
Yet the first hints of increased activity seem to be just hitting DuPage County.
"We have two or three cases in the last few weeks where we have suspicions of heroin," Coroner Pete Siekmann said. "But the lab results aren't back yet."
The DuPage coroner's Web site reports two deaths attributed to single-drug overdoses for both 2008 and 2007, so two or three in the first quarter of 2009 would signal a significant increase.
"At this time, we aren't able to confirm any spike," Siekmann said. "In a few months, as more cases are completed, this perhaps will change."
Kane County Coroner Chuck West said he's already noticed an increase in deaths by heroin overdose, although he couldn't present hard numbers as his office switches computer systems. He attributed the rise in deaths to more purity in the product and "more access to it, out in the area. It's coming out of Chicago."
Local law-enforcement agencies are looking to stem that flow. "Essentially, we're looking for street-level and mid-level dealers," Lindenman said of MEG. "It's really where our niche is. We're like one rung down below the DEA.
"Our job is to identify where it's coming from, to try to stop it and then also to make it difficult for people to sell," he added, but that's getting harder and harder as the trends conspire to make heroin both more pure and more available.