Heroin: How We Got Here (Again)

The opium poppy is a source of beauty in gardens and fields all over the country and the world. But it’s also a source of pain relief and when abused, death.  In recent years death tolls from heroin, a derivative of the poppy, have tripled nationwide, and the numbers are just as stark here in West Virginia.

Frontline PBS recently tackled the poppy’s intimate connection to humans, tracing it back thousands of years. It started with the Sumerians in 3400 B.C., who passed it to the Assyrians, to the Babylonians, to the Egyptians, the Greeks, the Persians, the Chinese, British, and in 1905 Congress banned U.S. imports of opium – the derivative of poppy seeds and base of heroin. Little good it did. A black market bloomed thereafter and of course, the 5,000-year-old obsession with the opium poppy continues.

But today our region of the world is in the grips of an especially nasty resurgence of heroin addiction.

The New/Old High

“When you use [heroin] you’re happy, you have no worries, you can just be free. You don’t have to think about your responsibilities. That’s all you think about, that’s all you care about, and that’s all you’re out to get,” said, Ashley, a recovering heroin addict.

Ashley is 24, a mother of three with one on the way, third generation West Virginian, and currently she’s going through a highly structured drug court rehabilitation program. But heroin was her whole world not long ago.

When you use [heroin] you're happy, you have no worries, you can just be free. … That's all you think about, that's all you care about, and that's all you're out to get. – Ashley, recovering addict, 24 years old

“I was 18 when I first started using heroin. I just wanted to try something new. I’d seen everybody else using it and it looked fun. So then I decided to use it. And then when I started using it I couldn’t stop.”

Drug Trends: A Moving Target

U.S. District Attorney for the Northern District of West Virginia, William Ihlenfeld, began paying attention to the drug issues in West Virginia in the mid-90s while he was a county prosecutor. He says before this latest resurgence of heroin, it was synthetic opioids. In 2010, prescription opioids accounted for 44 percent of all U.S. overdose deaths. But law enforcement, legislators across the country, communities, and pharmaceutical companies joined forces to make pills harder to get and harder to abuse.

“And then things started to change,” Ihlenfeld said. “Around 2012 we started to see the shift from pills to heroin. We saw that through what was available on the street, what was being sold. And now, from what I see, heroin causes far and away more death from drug overdose than anything else in West Virginia. And probably other states as well.”

Click here for a mobile-friendly version of the interactive line graph.


Ihlenfeld’s counterpart in the southern district, Booth Goodwin, says throughout Appalachia–over the past 15 years–we’ve developed an intense addiction to prescribed synthetic opioids.

“People think they can take a pill and relieve almost any ailment and its’ just not that simple,” Goodwin said. “And I’ll tell you, this addiction to opiates is as bad as it gets.”

But believe it or not, Goodwin says this shift to heroin may not be an entirely bad development.

“There is a silver lining to it, if you can call it that,” he said. “And that is our young people won’t just start off by shooting up heroin, whereas, they will raid the medicine cabinet, take drugs from friends and family that they believe are safe because they come from a pharmacy and are prescribed by a doctor.”

That’s how many people, young and old, rich and poor alike started falling into the world of drug abuse, according to law enforcement officials. But heroin can also be snorted.

Big Business

Ihlenfeld explained that savvy drug lords responded to the crack down on pills by shifting clientele to unregulated opioids.

“We don’t give [drug lords] as much credit as they deserve as far as their business acumen. The people at the top are like level 500 CEOs. They operate their business just like any major company here in the United States,” Ihlenfeld said.

“They identify places where profit can be made; they identify areas of their industry where profit can be made. And when they see that the ability to get pills has dried up, it’s tougher to get them, they know that heroin can easily replace that.”

U.S. Attorney Booth Goodwin explained that the difficulty in the shift to heroin is the likelihood of overdose growing exponentially.

Overdose: Flip A Coin

Narcotics are precisely measured by drug manufacturers who ship it to pharmacists to be prescribed in exact dosages, Goodwin said. Anyone who reads the label knows exactly how much of a narcotic is going into their body. Heroin isn’t the same.

“With heroin it could be 20 percent potency or 80 percent potency and you never know. You’re used to 20 percent potency heroin and you take the same amount and you get a batch of 80 percent and it’s laced with fentanyl, and you overdose and very likely die,” Goodwin explained.

And the numbers are growing. In 2003, there were five reported deaths from heroin use throughout West Virginia, according to numbers from the state’s Department of Health and Human Resources. In 2014,  151 heroin deaths were reported. 

Some, like Ashley, are learning about it the hard way.

“It happened at my sister’s house,” she remembered. “And it was at night. My sister called me and told me that her friend wasn’t breathing. So I went down and when I went into the bathroom she was laying over on the sink. Her airway was getting cut off by the sink. That’s what we thought. Then we moved her and when we did she was still purple and wasn’t breathing. Finally she gasped for air and she was back. And she had no memory of it whatsoever. And she wouldn’t leave with the ambulance.”

Things turned out okay for Ashley’s friend that night. But many law enforcement and medical officials, families and friends in West Virginia know that the coin doesn’t always land heads-up. And many believe this is just the beginning of an epidemic that’s bound to continue to grow in West Virginia.

Digging into the Data: A New Look at West Virginia's Heroin Problem

If you’ve been paying attention to our news output here at West Virginia Public Broadcasting as of late, you’ve probably noticed an increased focus on data and digital journalism. Sure, we tell stories on the radio, but emerging technology and innovations have inspired us to present our stories in a new and interesting way.

As part of The Needle and the Damage Done, we wanted to allow our audience to get a better understanding of West Virginia’s heroin problem.

Coming next week–in addition to stories on the air–is a series of interactive data visualizations and a platform for you to share your own stories. Both of which will truly illustrate where things stand.

So, here are a few things to expect on the digital front in exploring West Virginia’s heroin epidemic:

Credit Dave Mistich / West Virginia Public Broadcasting / via Tableau
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via Tableau

1. Data visualization of West Virginia heroin overdose deaths from 2001 – 2014

Using data provided by the West Virginia Department of Health and Human Resources, we can trace the rise of the heroin problem by visualizing the number of heroin overdoses through the years. Also, you’ll be able to see which counties have the biggest problems and when they began to arise.

2. Data visualization of Naloxone administrations from 2012-2014

After the passage of a bill in the West Virginia Legislature, Naloxone–an opioid antagonist that combats the effects of an overdose–will become more widely available to addicts and their families. Using data from 2012 to 2014, we’ll show you how the use of the drug has paralleled the rise of the state’s heroin problem. You’ll see state totals and a county-by-county breakdown of Naloxone administrations over the course of these years.

3. The ability to share your story with us

The digital component also makes the storytelling process work in two different directions. Of course, traditionally, we tell stories to audience. But now, we’re able to have our audience tell us their own stories. Since heroin seems to affect nearly every single West Virginian, we’re making it possible for addicts, those in recovery, family, friends, and anyone else to contribute to our tumblr or using #heroinwv on Facebook, Twitter, or Instagram. You can also email us text, photos, videos or a voice memo: heroin@wvpublic.org.

Has Heroin Addiction Affected You or Someone You Know? Share Your Story

  Seemingly everyone in West Virginia has been affected by the heroin epidemic in the state. There are addicts themselves, family members struggling to find them help, the doctors, nurses and paramedics on the front lines trying to save lives and lawmakers and law enforcement officials trying to put a stop to it all–no one seems to be spared.

As we roll out our week-long series The Needle and the Damage Done: West Virginia’s Heroin Epidemic, we wanted to offer you the chance to share your story. 

If you or someone you know is facing the realities of heroin addiction, have them tell their story using text, photos, videos or a voice memo by using the hashtag #heroinwv on Facebook, Twitter or Instagram. 

Submit directly to our tumblr in the form below or email us at: heroin@wvpublic.org.

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