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Cedar Rapids, Iowa 52401
Heroin's Hold: For some, heroin is 'love at first sight'
What does rock bottom look like?
For Casey, rock bottom was six long weeks spent in the Linn County Jail detoxing from heroin in 2013 after a probation violation.
'That's probably one of the worst experiences of my life,' he said. 'Heroin detox is not fun. It's like the flu times maybe 10 or 20. Going through that is hell.'
Heroin's hold in Iowa
For the next month, Gazette reporters will be taking an in-depth look at the heroin epidemic in Iowa. This story focuses on the authorities trying to combat Iowa's heroin problem.
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Casey's path to heroin began as did so many others' — with prescription painkillers. For a three-month period when he was 17, Casey had a 'steady supply' of hydrocodone, an addictive, opiate pain reliever, to treat his kidney stones.
'It was kind of love at first sight,' he recalled. 'You love the feeling for however much time you're high ...
Opiates kind of slow things down. They make things easier to take.'
But after a while, hydrocodone wasn't giving him the high he craved. Casey switched to OxyContin — the brand name for an extended-release opiate used treat moderate to severe pain — which, at the time, was all too easy to find in Cedar Rapids. He'd grind it down and snort it.
When tamper-resistant pills came onto the market earlier in the decade, Casey had to find a new way to get high. About five years ago, the cousin who had been getting Casey OxyContin introduced him to heroin.
Within a year Casey went from snorting to shooting up. It controlled his life, he said.
'It's what you get up to do,' Casey remembered. 'It's what you go to sleep doing. In the middle of the day, you're trying to get money for it. You're trying to find it. It takes over your life, it really does.'
His addiction got so bad that Casey was using simply to get through the day. He estimates his habit cost him $20 to $100 a day.
'When you get really deep into your addiction, you're not doing it to get high,' he said. 'You're doing the opiates so you can get back to feeling normal. I'm not chasing the high, I'm chasing getting to feel right. Your tolerances can get so high, you're not — in your mind — not trying to get high any more, you're trying to feel OK.'
In July 2011, Casey walked out of a 'shooting gallery' — where addicts go to shoot up heroin — and was arrested by two plainclothes police officers on numerous drug charges. All but one of the charges were dismissed, and Casey was placed on probation. And he kept using heroin.
But as time went on, the consequences of addiction began to show even more. In February 2012, the cousin who got him hooked on heroin was found dead from an overdose. Later that year, a friend was sentenced to nine years in prison for heroin distribution.
In 2013, Casey violated his probation, was sent to jail and went through his detoxication.
About two years ago, faced with seemingly two outcomes for his continued drug abuse — death or prison — Casey decided he was finally read to make a change.
Heroin's Hold: Share your experience with opioids
'I didn't want to die,' he said. 'I don't want to end up in prison. It was slapping me in the face that I could end up there. Either one.'
For about two years now, Casey has been getting methadone at the Cedar Rapids Treatment Center. He's also taking courses though Upper Iowa University. Casey is majoring in human services and hopes to one day help people who, like him, have struggled with addiction.
According to the Linn County Medical Examiner's Office, there were 21 fatal overdoses in Linn County in 2015 from opiates, including heroin and prescription painkillers. In 2009, authorities in Cedar Rapids responded to just nine heroin-related overdoses — fatal and non-fatal. Cedar Rapids police responded to 63 overdoses — including non-fatal overdoses — in 2015.
Authorities warn those are only a fraction of the overdoses in the city. Hospitals in the city saw 85 emergency room admissions, 157 inpatient admissions and 88 outpatient medical patients for heroin overdoses in 2015.
In Johnson County, there were six fatal heroin and opiate overdoses in 2015 — down from 17 the year before — according to the Johnson County Medical Examiner's Office.
And while opiate deaths are down so far this year — seven in Linn County and two in Johnson County — authorities say opiate and heroin abuse remains an issue in Eastern Iowa.
'We're in a decline right now,' said Jerry Blomgren, an Iowa City police investigator on the Johnson County Drug Task Force and the Drug Enforcement Administration's task force. 'I don't think that necessarily continues.'
It hasn't gone away
Cedar Rapids police Sgt. Robert Collins has been on the narcotics beat only since the beginning of the year but already has seen firsthand the effect opiates have had on the city. Police have responded to 10 overdoses through May.
Part of that problem is opiate abuse cuts across all demographics. Collins said heroin abusers are not the 'hard-core drug user' someone might picture when thinking of an addict, Instead, they are men and women of all ages, races, socio-economic statuses and walks of life, he said.
"Your tolerances can get so high, you're not — in your mind — not trying to get high any more, you're trying to feel OK.'"
Collins recently met a married mother in her mid-20s who had used heroin in her late teens and early 20s and got clean before moving to Iowa. But after getting drunk with some friends in another state earlier this year, the woman used heroin again. What followed was a weeklong binge back in Cedar Rapids that ended with her overdosing in her bathroom.
Related: How Iowan's struggle — and sometimes succeed — in overcoming opioid addiction
'She looked, literally, like any other young mom,' Collins recalled. ' ...
The drug is so powerful that it has a grip on those folks that it doesn't matter. She didn't think about her job, her kids, her family, nothing.'
Collins said when he speaks with a heroin addict, he tries to find out how they started using.
'There's always a gateway,' he said. 'A vast majority of people don't just walk out and say, 'I'm going to shoot up heroin.''
For most addicts, that gateway is prescription drugs. Prescription opiate painkillers are chemically similar to heroin and produce the same high. They also are highly addictive — and when those pills are no longer available, addicts often make the leap to heroin.
Heroin is not difficult to find in Cedar Rapids, Collins noted. The mother who overdosed had never purchased heroin in Cedar Rapids before, nor did she have any local connections. Collins said she simply went to a gas station in Cedar Rapids and waited about 20 minutes before a man approached her and asked if she wanted to buy some heroin.
A tenth of a gram of heroin — a typical dosage — costs about $20 to $40 in Cedar Rapids, Collins said.
Iowa City is seeing similar issues, added Sgt. Zach Diersen, leader of the police department's street crimes unit. As with Cedar Rapids, Diersen said users in Iowa City are starting with prescription pills before moving to heroin.
Prescription drug arrests in Iowa City
Data made available by the Iowa City Police Department
'Heroin is cheaper and, quite honestly, it's easier to get,' he said. 'Is it a real problem here in Iowa City? Absolutely.'
Killing people instantly'
Whenever someone fatally overdoses in Linn County, the Linn County Medical Examiner's Office responds, and its lead investigator Alisha Weber's job to try to find out why they did it.
According to data collected by Weber, overdoses accounted for 32 percent of all accidental deaths in Linn County in 2015, making it the second-most common cause of accidental deaths last year, after falls at 49 percent.
Last year, more people died from overdosing than in motor vehicle accidents.
'A lot of people are basically dying with a needle in their arm,' Weber said.
In 2015, 16 men and eight women died in Linn County from overdoses. In all but three cases, an opiate was the cause.
Their ages ranged from 21 to 55. The 21-year-old died from a lethal concoction of methadone, heroin and ethanol, according to Weber's data. He had been receiving methadone treatment for his addiction.
'How does that happen at 21 years old?' Weber wondered.
Opioids kill dozens of Iowans every year
Show are overdose numbers for Iowa broken down by drug type. The data, which goes back five years, was made available by the Iowa Department of Public Health.
The drugs found in the victims' bodies include heroin and opiates such as methadone, hydrocodone and oxycodone. In nearly half of all the deaths, fentanyl was a factor. Fentanyl is a synthetic opioid painkiller that is 80 times as potent as heroin.
In recent years, heroin dealers are cutting their product with fentanyl, making it more potent and potentially deadly. Authorities said many of the deaths they see are from users taking heroin laced with fentanyl.
'They had no idea it was laced with that,' Weber said. 'You do your normal dose. It was killing people instantly.'
The CRPD's Collins said when he responds to a non-fatal overdose, his goal generally is to get them help and go after a dealer, rather than send them to jail.
'In general, if I'm going to talk to somebody and I want them to cooperate with me with where they got their heroin, I'm not going to be so inclined to have a heroin charge against them,' he said. 'I definitely don't want to take someone who's been in the hospital for a heroin overdose and drag them into jail.'
"A lot of people are basically dying with a needle in their arm."
But going after heroin dealers is 'like a game of Whack-a-Mole,' Collins said. 'You whack one down and another pops up. We can't arrest our way out of this situation. We can go after the drug dealers, but there's always going to be someone willing to come out and sell this stuff.'
Police say most of the heroin sold in Iowa comes from Mexican cartels by way of distribution hubs in the United States, such as Chicago.
Authorities in both Cedar Rapids and Iowa City have delivered heavy blows to heroin dealers in the past year, however. In March, a federal jury in the Northern District of Iowa convicted 35-year-old Max Wright of Chicago of two counts of distribution of fentanyl and one count of conspiring to distribute heroin, crack cocaine and fentanyl that resulted in six serious bodily injuries and two deaths. Wright, who has not yet been sentenced, faces life in prison.
Collins said Wright was moving an 'astronomical' amount of drugs into Cedar Rapids from Chicago. Evidence presented at the trial showed Wright brought large quantities of heroin, fentanyl and crack cocaine into the city and sold it with other subjects. All the overdoses attributed to the drugs Wright distributed occurred between late February and mid-May 2015.
In April of this year, a federal jury for the Southern District of Iowa found Alfred L. Jackson, 25, of Iowa City guilty of one count of conspiracy to distribute at least 100 grams of heroin. Blomgren, the Iowa City police officer and DEA agent, said Jackson was the primary source of Iowa City over the past several years. One person interviewed by investigators said Jackson supplied him three kilograms of heroin over three years.
'Three kilos of heroin is an astronomical amount of heroin,' Blomgren said.
Blomgren said the distribution network in Iowa City was large and sophisticated. Members of the network referred to color-coded plastic bags that represented specific amounts of heroin at set prices rather than the heroin itself.
'It allowed them to communicate without using the word 'heroin,'' he said. 'It was a pretty novel idea. We found all kinds of color-coded plastic bags.'
Jackson and another conspirator, Curtis L. Kemp, 49, of Iowa City, are to be sentenced in August. Jackson faces 40 years in prison. But while the heroin trade took a hit with that case, Blomgren said it's likely only a matter of time before it comes back.
'Unfortunately people backfill those positions,' he said. 'We just haven't seen that yet.'
Nonetheless, Collins — who also has officers that work with the DEA — said police will continue going after dealers as they arise.
'It's the right thing to do and it sends a message to would-be heroin dealers, 'Don't come sell your stuff in Cedar Rapids,'' he said.
'A more positive life'
Casey hasn't used heroin in a year and a half. He said he thinks hitting rock bottom and seeing what his life could become helped him find the strength to get clean. He also credits the Cedar Rapids Treatment Center, where he gets his daily dose of methadone.
'Being here has enabled me to live a more positive life,' he said of the center. 'I'm not out there chasing the money, chasing the drugs every day. I can come here, get what I need to make me feel OK and then go about my day.'
Casey said he knows addiction is something he'll likely have to deal with for the rest of his life. And while that can be daunting to think about, he said he's choosing to focus on the goals he has for the future.
'I want to finish school,' he said. 'There are things I want to do in life that I feel like I've put on hold because of my addiction.'
As a rule, The Gazette does not report stories that do not use the full names of a principal subject. We believe including a person's entire name goes to the credibility of what that person has told us, and what we then relay to you in the paper and online.
In the case of this story, we have made an exception. We did not take this decision lightly.
Casey was referred to the Gazette by the Cedar Rapids Treatment Center, where he has been receiving methadone and counseling for more than a year. Casey spoke with Gazette reporter Lee Hermiston for more than an hour at the clinic about his 10-year addiction to opiates, including prescription pills and heroin.
Where possible, Casey's account was verified through state and federal court records, jail incarceration records and an obituary.
The Gazette agreed with Casey's request not to use his last name. Casey is close to completing coursework at Upper Iowa University. While he understands that his arrest record will be subject to examination by potential employers, he does not want the details of his decade-long struggle with opiates to prevent him from finding employment.