COMMUNITY STRUGGLES TO UNDERSTAND DEADLY ISSUE

The signs of a drug overdose become clear to Porter County Coroner
Victoria Deppe before she's ever read toxicology reports and its
multitude of listed drugs.

"When I get toxics back, they are dirty, dirty, dirty," she said.

But before the report come the clues.

Deppe said she's at the point of asking a dead person's family
members -- on every single call no matter what -- whether the person
abused drugs. Several times Deppe has seen prescription medicine in
the house of someone who died from a natural death when that person
never had a prescription for the drug, she said.

Some of the deaths that were ruled natural were even influenced by
drugs. Deppe said one person died from diseases caused by alcohol poisoning.

So while at least 31 people died in Porter County of drug or alcohol
overdoses, the number of deaths related to drugs could be significantly higher.

The deaths reflect a variety of drugs used: heroin, cocaine, alcohol,
morphine, OxyContin, hydrocodone and more. They also show a variety
of ages. The youngest person to die from drugs in 2008 was 18. The
oldest, John Mallas, was 65, and he wasn't alone in his age group.
Seven people who died were 50 or older, and 12 were in their 30s or 40s.

Even with the coroner's statistics, getting a true sense for Porter
County's drug problem is not easy. The number of deaths simply tells
who died in 2008 in the county. It doesn't include anyone from Porter
County who might have died someplace else. That isn't feasible to
track down, Deppe said. It also doesn't touch on how many people in
the county use drugs.

"We don't have what I call pure numbers," Deppe said.

What some officials say is the best data will remain a mystery -- the
number of people admitted to Porter hospital for treatment.

Because of health privacy laws, the hospital won't turn over those
numbers, said Robert Taylor, head of the Porter County Drug Task Force.

Instead, he tries to pay attention to other factors -- how many
people fail their parole drug tests and who's going back to jail. One
that has Taylor's notice is the increasing amounts of drugs people buy.

More and more people are buying ounces instead of grams, spending a
thousand bucks a pop, Taylor said.

More treatment options

One statistic that the county has relied on is the 2004 Roosevelt
University study that said Porter County had one of the highest
heroin-related death rates in the country.

The county has taken several steps since that report, especially in
2008, to combat the statistic. Porter County is now home to a
methadone clinic, drug courts for both adults and juveniles, multiple
support groups, a program focused on treating juveniles and more.

Yet not only is heroin still a problem, it isn't the only problem.

The question then becomes why didn't the programs help bring down the numbers.

Some people point to cost, which is often prohibitive. A daily dose
at the methadone clinic for one client is $12 -- about $4,300 a year.
That's just for the doses; most patients at the clinic also receive
therapy and have to attend group classes.

Pathway Family Center, the program for juveniles that places them
with other families during months of treatment, can cost tens of
thousands of dollars.

An in-patient rehabilitation center would offer patients one of the
best chances to conquer their addiction, Rocco Schiralli, executive
vice president of programs at Porter-Starke, said, but it is so
expensive no one in the county can afford to operate one.

Not all of the programs are so costly, though. Alcoholic Anonymous
and Narcotics Anonymous groups in the county usually cost little if
anything. Some say the groups are too general, though, and that ones
that focus on specific age groups could help.

Ashley, 22, has been through most of the long-time programs, such as
Alcoholics Anonymous, but said she found most of the people going to
the groups weren't her age and she couldn't relate to them.

It wasn't until she joined Frontline, a small program in Chesterton,
that she found peers who could share her experiences of drug use,
along with a clear religious basis.

"Something just clicked," said Ashley, who is now four months sober.

Although Frontline provides a good focus for young adults who are
already hooked on drugs, the county shouldn't forget about those who
are middle-aged or even older, Deppe said. Prevention is important,
but so is providing treatment options to long-time users, she said.

Help must come from outside

Some of the problems simply can't be solved by the county, though, at
least not alone. The county's proximity to Chicago has always been a
reason behind the high usage rates. The more access people have to
drugs, the more likely they are to use, said Harold Holder, senior
scientist at the Prevention Research Center at the Pacific Institute
for Research and Evaluation.

There's little the county can do to stop the flow of drugs, though,
Taylor said.

"Without having complete control of where drugs come from, you have a
hard time shutting it down," he said. "Unfortunately, I don't work in
Texas or Florida or Arizona."

Other solutions will have to come through state and federal
legislation, Schiralli said. Officials can fight on behalf of laws
that will help the county, and Schiralli pointed to a recent one that
is meant to force health insurance providers to treat mental health
issues, such as addictions, just as they would other physical
problems. The final answer, though, rests with people outside the county.

Then there's the No. 1 reason drug addicts give for not seeking
treatment: They don't want to.

Deppe said most people who died did know about treatment options in
the county because in most cases, family members had tried to get them help.

Almost every one of the addicts declined the help.

Despite the lack of signs of improvement, the county isn't
necessarily failing, Taylor said. Part of the problem is that the
county waited so long to start addressing drug usage that it will
probably be some time before it sees any progress.

"We had our heads buried in the sand ... for so long that we've got
to let attrition catch itself up now," Taylor said.