PAINKILLERS MAY BE FUELING HEROIN BOOM, OFFICIALS SAY

The spike in people addicted to prescription painkillers has evolved
into an alarming new trend: increasing heroin use.

The Waukesha County medical examiner reports more heroin overdose
deaths so far in 2008 than in any recent year, and law enforcement
officials throughout the Milwaukee area say heroin use is on the rise,
an increase they attribute to people addicted to oxycodone or
hydrocodone graduating to the stronger opiate.

Waukesha County Deputy Medical Examiner Kris Klenz said that the most
heroin deaths recorded in the county came in 2006, when there were
three. But this year, there already had been four by June 30. Two of
those victims were 19; the others were 22 and 28.

Milwaukee County has had three heroin deaths through June 30,
according to figures released from the medical examiner's office.
Those who died were 21, 24 and 40.

Klenz cautioned that the number of heroin-related deaths is likely
under-reported in some cases because heroin metabolizes quickly in the
blood. The drug can appear as an overdose of morphine in some
autopsies, she said. Unless a specific metabolite is found in the
body, the most a medical examiner can do is rule that the death was
caused by an opiate, she said.

"We are limited by science," Klenz said.

Law enforcement, however, can link heroin to a death investigation by
other factors, such as the presence of the drug or witnesses at the
scene.

Capt. Charles Wood, who heads the Waukesha County Metro Drug Unit,
expects to see more Len Bias cases, referring to the law that enables
authorities to prosecute people who supply drugs that contribute to an
overdose death. The law is named after a University of Maryland
basketball player who died of a drug overdose in 1986.

Luke J. Bandkowski, 28, of Genesee was charged in April in Waukesha
County Circuit Court with first-degree reckless homicide in the death
of Joshua J. Carroll, 26. According to a criminal complaint,
Bandkowski is accused of supplying heroin to Carroll in December. An
autopsy showed that Carroll died of "opiate intoxication." Wisconsin
mirrors nation

What southeast Wisconsin is experiencing now mirrors a national trend
in which users of highly addictive prescription painkillers turn to
heroin when the "oxy" pill is not available, Wood said.

The difference between drug users today and those of years past is
that users a decade ago may have started with marijuana, then
progressed to more addictive and dangerous drugs, such as cocaine,
before trying heroin -- a process that may take years.

Today, users start with prescription painkillers, then move on to
heroin, which is cheaper than oxycodone or hydrocodone, Wood said.

Oxycontin, which is a brand of oxycodone, costs about $1 per
milligram, making a 40-milligram dose worth $40. Heroin, on the other
hand, costs $10 to $20 per dose, according to law enforcement
authorities.

Drug overdoses overall have increased in southeast Wisconsin, doubling
in Washington, Ozaukee and Waukesha counties from 2003 to 2007,
according to figures released by medical examiner's offices. The
increase of heroin use has not diminished the use of marijuana and
cocaine, Wood said.

What is frightening is that "heroin is an end game," Wood said. There
are few options for someone addicted to heroin -- the result is death
or a difficult rehabilitation with a lifetime of potential physical
problems.

Ozaukee County was hit by a series of highly publicized heroin-related
deaths, including that of 17-year-old Angela Raettig of Cedarburg in
2005, that helped lead to the arrests of Benjamin Stibbe and his
mother, Teri Stibbe, and several others. . The Stibbes were cited in a
federal case as being the primary conduit for delivery of heroin to
users in Ozaukee County.

Dave Spakowicz, a special agent with the state Department of Justice
who heads the federally funded Milwaukee High Intensity Drug
Trafficking Area Heroin Initiative, said heroin use in the area
dropped for a time after the Stibbes' case, especially in Ozaukee
County, but only for a short time.

"That shook a lot of kids and led to some introspection by some of
these kids like, 'I don't want to end up on a slab or (in prison) like
Ben Stibbe.' Unfortunately, there has been a significant increase in
heroin use and heroin-related incidents in the last nine months,"
Spakowicz said.

Spakowicz said officials can only estimate the number of heroin users
in the five-county area. One estimate says the number of heroin users
is typically four times the number of those in methadone treatment.
Methadone is a synthetic opiate used to help recovering addicts fight
withdrawal symptoms.

Spakowicz said there are as many as 1,800 people in methadone
treatment programs in southeast Wisconsin, which would put the
estimate at more than 7,000 heroin users.

Ozaukee sheriff's Detective Jeff Taylor, who is assigned to the
Ozaukee County Anti-Drug Task Force, said the Stibbes have been
replaced by several people.

"As unfortunate as it sounds, I wouldn't doubt that we wouldn't
experience an overdose (death) again. The heroin, OxyContin and
prescription pills are readily available in the county and being used
by a number of younger persons in the county," Taylor said. "I don't
know why we still have kids experimenting with heroin. I think they
have the same 'it's not going to happen to me' attitude."