Heroin overdoses on the rise as nation cracks down on prescription drug abuse

Wednesday, May 23, 2012 | 6:00 a.m. CDT; updated 11:15 p.m. CDT, Wednesday, May 23, 2012

COLUMBIA – Two young men, both in their early 20s, died in Columbia during the past year as a result of lethal heroin overdoses.

The latest death was reported in January after a 22-year-old was discovered at his apartment on North Williams Street. Needles and heroin were found in the apartment, as well as signs of intravenous drug use on the young man's body.


What: Heroin: A Community Perspective

When: 6-8 p.m. Thursday

Where: Columbia/Boone County Department of Public Health and Human Services, 1005 W. Worley St.

Details: To bring the community into a discussion about the rise of heroin use in Columbia, the Columbia Police Department is holding a town hall session on the issue. Police will be on a panel with a drug court judge, citizens affected by heroin, physicians and others. Parents of high school and junior high-aged children are strongly encouraged to attend.

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Since April 2011, at least a dozen people in Columbia have been brought back from heroin overdoses when police and medics were able to reach them in time.

"There has been a definite increase in overdoses, as well as possession arrests," said Jeff Rukstad, a vice detective with the Columbia Police Department who specializes in narcotics.

Rukstad recalled more heroin overdoses in the past year than in any other in recent memory.

Use of this powerful opium derivative is becoming a serious problem both statewide and nationally. The trend comes on the heels of the increasing abuse of prescription opiates such as oxycodone, codeine, and Percocet. These painkillers mimic the chemical makeup of heroin and have similar effects.

Once thought of as an urban problem, heroin has followed prescription drug abuse to small towns and suburbs of middle America with devastating consequences. Fueling the trend is the flourishing production of the drug in Mexico and its corresponding lower cost.

According to the 2011 National Drug Threat Assessment, cartels in Mexico have been targeting markets in Missouri, Illinois, New York, Pennsylvania and North and South Carolina. Today, the average cost of a single dose of heroin on the street is $10-$25.

In Columbia, rising heroin use is symptomatic of a problem that has ravaged a number of Missouri communities. 

A health advisory released in February by the Missouri Department of Health and Senior Services stated that fatal heroin overdoses almost tripled in just three years. 

According to the report, the number of heroin-related deaths in Missouri rose from 69 in 2007 to 190 in 2010. Provisional numbers for 2011 show the trend continuing, with 244 fatal overdoses reported.

More than 53 percent of overdose deaths involved individuals between 15 and 35 years old — an age group that makes up only about 27 percent of the state’s population.

While many of the deaths have occurred in the St. Louis metropolitan area, the problem is beginning to impact mid-Missouri.

Jefferson City has recently seen a spike in heroin use and overdoses, especially among young people. In response, law enforcement in the state capital has ramped up operations to combat heroin dealing.

Over a three-week period in February, officers arrested more than two dozen people in Jefferson City for drug charges in connection with heroin distribution.

The multi-agency drug sweep was mounted five months after Merry and Jim Marshall of Jefferson City lost their son, Cody, to an overdose on Sept. 27. He was 20.

In many cases, there is often a connection between heroin use and prescription drugs. According to the Heroin Overdose Prevention and Education campaign in Jefferson City, approximately half of young people who use heroin have used prescription drugs first.   

In April 2011, the White House issued an executive report titled "Epidemic: Responding to America’s Prescription Drug Abuse Crisis," warning that "prescription drug abuse has become the nation’s fastest-growing problem."

According to the report, the use of prescription opiates by Americans from 1997 to 2007 rose from 74 milligrams per year to 369 milligrams per year, an increase of more than 400 percent.

"Prescription drug misuse and abuse is a major public health and public safety crisis. As a nation, we must take urgent action to ensure the appropriate balance between the benefits these medications offer in improving lives and the risks they pose," the report concluded. 

With evidence of the problem growing, hospitals, clinics and pharmacies across the country have begun to crack down on abuse of prescription drugs, Rukstad said.

This cross-country effort has coincided with the rise in heroin overdoses. According to Rukstad, it is more than mere coincidence — people get addicted to prescription painkillers and then, when their supply line dries up, they turn to heroin.   

"A lot of the heroin problem starts with people addicted to prescription medication, painkillers. People are addicted to these pills and need something to take that place," he said.

“Heroin is easier to get and it's cheaper, and you don’t have to go through the fight of going to the ER and trying to sell a story," he said.

Supervising editor is Jeanne Abbott.

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Mark Foecking May 23, 2012 | 8:06 a.m.

"ccording to the report, the use of prescription opiates by Americans from 1997 to 2007 rose from 74 milligrams to 369 milligrams, an increase of more than 400 percent."

What are the actual units of this statistic? A single dose of 74 milligrams of any prescription opiate, for a non-tolerant individual, is an overdose, and for some could be fatal. Could it be milligrams per patient over some time period, or average weekly or monthly amount prescribed for all Americans? Is it in morphine equivalents (a standard way of reporting dose levels - it's a dose or an opiate that gives equal analgesia to a dose of morphine). For example, 100 micrograms of fentanyl equals about 10 milligrams of morphine or 60 milligrams of codeine in pain relieving ability (roughly).

The way it's reported doesn't make a lot of sense. Is there a source for this, or other clarification?


(Report Comment)
Celia Darrough May 23, 2012 | 6:50 p.m.


My name is Celia Darrough and I'm an assistant city editor with the Missourian.

I just spoke with Ben Nadler, the reporter on this story, and was able to clarify the statistic. It is milligrams per American per year. So, the use of prescription opiates by Americans from 1997 to 2007 rose from 74 milligrams per year to 369 milligrams per year.

I have made that clarification in the story.

Thank you so much for bringing it to our attention.

Celia Darrough
Assistant City Editor

(Report Comment)
Darlene Marrocco May 23, 2012 | 10:30 p.m.

I just wanted to say that everything in this article is absolutely correct, my oldest son passed away in 2010. He started on percosets and other pain killers and then led up to oxicotins, then it went to morphine then he started shooting it up. That is what killed him was a overdose of morphine. He was 31 and had a beautiful one year old baby girl, that he loved a lot. But the drugs took over his life.

(Report Comment)
Mark Foecking May 24, 2012 | 7:59 a.m.

Celia Darrough wrote:

"It is milligrams per American per year."

Thank you. That makes a lot more sense. I did find the original paper that was cited in the report linked in the article.

Just as a comment, milligrams of opiate isn't really a good way to give an average amount prescribed, because the potency of these drugs vary widely depending on the drug. For example, 74 mg of fentanyl will kill a person 50 times over, where 74 mg of codeine is a minor and very survivable overdose. It does point out that we are prescribing a lot more of them, and similar to ADD medications, a lot more of the drugs are being diverted to nonmedical use.

Is it better to give addicts standardized pharmaceutical products to manage them, or let them take their chances with street drugs of unknown potency? Don't know if there's a good answer to that.


(Report Comment)

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