Boone County authorities believe report underestimates heroin problem

Told that the Robert Wood Johnson Foundation had used insurance codes to estimate the death rate, both said they think that rate is too low.

Boone’s estimated overdose fatality rate in 2014 was 10.1 to 12 for every 100,000 people, said the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute in the seventh annual County Health Rankings, released earlier this month. The figure was based on an analysis of International Classification of Diseases codes that are used to categorize poisoning caused by the use of and exposure to certain drugs, the foundation said.

The RWJ Foundation’s estimate agreed with federal Centers for Disease Control and Prevention data, which placed Boone’s drug poisoning mortality rate from 2012-2014 at 10.1 to 12 per 100,000.

“I just totally disagree with it,” Nielsen said.

Nielsen believes that overdose deaths of county residents are under-reported — and the rate has only grown higher.

“It’s sure not what I am seeing,” he said. “I am seeing much more than that.”

Meyer and Nielsen noted that many overdose patients are taken to Indianapolis hospitals, where their deaths are included in Marion County data.

Eight counties had lower rates than Boone’s, the RWJ Foundation estimated, but only five counties had death rates in single digits. LaGrange County, in northern Indiana, had the state’s lowest death rate at 4.0-6.1. LaGrange County has the nation’s second-highest population of Amish at more than 14,000, according to the Indiana Business Research Center at Indiana University. In 16 counties, the overdose death rate was 20 or higher. Indiana’s overall rate was 18.

Nielsen believes Boone County’s rate is nearer the 18.1 to 20 figure that the Robert Wood Johnson Foundation reported for Clinton and Montgomery counties. “I think we’re right up there,” he said.

A review of overdose-related police, fire and EMS runs in Boone County suggests Nielsen could be right.

In the last three years, Boone County EMS responded to 155 overdoses, according to activity logs provided by the Boone County Dispatch Center. Lebanon has the majority of Boone’s overdoses. Between February 2014 and mid-March 2016, overdose runs by fire department — perhaps a more accurate measure — were 91 for Lebanon, 54 for Zionsville, 17 for Thorntown and 14 for Whitestown.

This year alone, eight of the county’s 12 reported overdoses were in Lebanon.

Whether those persons survived, whether those overdoses were accidental or intentional, and whether those overdoses were caused by heroin, is not easily determined. Local police, though, believe that heroin use caused many of those incidents.

”Heroin is a serious problem not only here in Lebanon, but statewide,” Lebanon Police Department Chief Tyson Warmoth said. “After so many overdose deaths in our community, my prayer is that it will scare the next generation away from even contemplating trying it.”

“This drug kills — that is the message we need to get out,” Warmoth said.

Nielsen attributed changes in society and in parenting to the rising rate of drug abuse.

“I think that a lot of parents today want to be friends before they are parents; I think that’s part of the problem,” he said. “I think we have lost our way when it comes to faith.”

Nielsen interviews every inmate who is booked into the Boone County Jail when he believes there are drug-related issues, and he has found a troubling consistency.

He asks each inmate three questions: How old they were when they became addicted to heroin or opiates, what drugs they were using before turning to heroin, and how many times they used heroin before becoming addicted.

The typical first use starts at 14 or 15, he said. Their path to addiction began with tobacco, followed by marijuana, prescription pills and then heroin.

“Ninety-eight percent of the people I interview say it’s one time, once they took the heroin and they couldn’t stop,” he said.

“We’ve got to get at these kids who are trying opiates at the age of 13 or 14 years old; we’ve got to get at them and show them that you’re either going to end up in a penal facility or you’re going to end up dead, and the probability of your ending up dead is very, very high,” Nielsen said.

Preemptive action by local police and fire departments has likely kept the number of heroin overdose deaths from being higher.

At least 10 heroin overdose victims have been revived by police through the use of the nasal spray naloxone, also known by the brand name Narcan. The drug reverses the physical effects of heroin and certain other drugs.

“The problem is real and efforts to combat it need to be a priority,” Meyer said. “My office will do everything it can to assist in that endeavor.”

More than 100 heroin-related criminal cases have been filed by his office since March 1, 2014, Meyer said. “That’s a significant increase from years past.”

More than the court cases filed by his office have him convinced that heroin abuse is epidemic in Boone County.

“Over the past nine months I have personally found two hypodermic needles just lying on the sidewalk,” Meyer said. One he found while jogging in a local cemetery. The other he found on a downtown Lebanon sidewalk between his office and the Boone County Courthouse.

“Think of the danger this poses to young children who are innocently just playing outside, happen upon one of these needles, out of curiosity picks it up, and accidentally pricks themselves,” Meyer said. That act of curiosity could lead to the child contracting a sexually transmitted disease, he said.

Heroin and prescription drug overdoses in 2014 killed more than 28,000 Americans, according to the federal Centers for Disease Control. Heroin use more than doubled among people 18-25 between 2002 and 2013, according to the CDC.