A lot of people have asked why we are taking such a public stance on heroin abuse in the City. People have asked “Aren’t you just publicizing our problem?” The answer is yes, but only because I see no other alternative.
There are a lot of misunderstandings about heroin and how it affects a person. We hear a lot “if they made bad choices, why should tax payers foot the bill for poor decisions?” That is a valid question, and you won’t like the answer.
Why? Because you are already paying for heroin addiction in Middletown. The City spent $1.5 million in public safety, health department and indigent burial costs in 2014. We will continue to devote similar resources to this problem until we take some action to stop heroin addiction in the City.
The path to heroin addiction comes in many forms. Some of it is indeed poor choices. Much of it comes from addiction to pain killers started with an injury or surgery that morphed over time into heroin addiction when doctors stop the prescriptions for additional pain killers. The heroin addict of the 1970’s was poor and often minority. The typical heroin addict of 2015 is a white male between 28-35, middle class.
No matter what your stance on how or why people become addicted to heroin, here is what I am told by physicians is the medical fact of heroin addiction. No matter how they started, once they become addicted to heroin, it is a medical issue not a criminal issue, and the addicted person has three choices… and only three choices. First, they continue to steal, prostitute or whatever else is required, every single day, seven days a week, to get heroin and maintain their drug habit. That means typically they are on our streets, committing crimes because they no longer can hold a job and generate enough income to get the heroin. They are overdosing from time to time, requiring public safety and emergency room responses to save their lives. Second, they can get into treatment which historically at best is effective about 65% of the time. With treatment, while they are off heroin, they are not committing crimes in the City. Third, they can overdose and die.
And dying is becoming one of the most pressing problems. Narcan can revive many overdoses, but eventually luck runs out and the addict seriously miscalculates their dose or overdoses someplace where they do not have access to EMS services and they die. In January through June 2014, we had 22 overdose deaths in Middletown. In the same period this year, we have 28 confirmed and 3 additional deaths pending, waiting on the final coroner’s report.
We are also seeing a large increase in HIV and Hepatitis cases from sharing of needles. According the medical professionals, the cost of treating HIV or Hepatitis over a lifetime is more than $500,000 per patient. For addicts who cannot hold a job, that’s your tax dollars at work again paying for treatment.
So… between the deaths of our residents and the astounding local cost of responding to heroin, I felt we had to try to take action to stem the tide. Working with Atrium Medical Center, I convened a heroin summit in January of this year to gather all community resources around the problem. We had over 80 community representatives and groups involved. We separated into several smaller groups to tackle the problem. One group is covering prevention and education. Another is covering identification and intervention of addicts. Another is covering treatment options that we should make available to Middletown residents. A fourth group is working on post treatment recovery. The final group is working on quality of life for our youth to engage them in positive activities that will give them alternatives to being around the drugs in the city.
I’ve asked each group to give us their plan of action with measurable objectives at the July meeting. We hope to have each plan put into action no later than the end of September. My hope is that by the first quarter of 2016, any positive things that can be accomplished through this summit process will be taking effect and showing results in the City.
Judge Wall has taken the proactive step of starting a Vivitrol program in the municipal jail. This drug is a once a month shot that blocks opiate receptors, meaning that the addict cannot get high even if they take heroin. Warren County has tried this approach for about 2 years and is seeing over 80% success in getting addicts off of heroin. This is higher than previous treatment options. The cost of the drug is very high, but the success rate is also very high.
We will be looking at needle exchange programs. I was the first in line to say “why would we encourage drug use by making it easy to get clean needles?” The medical professionals gave me two answers. The concept is to reduce harm while you get addicts into treatment. First, if the addict has clean needles, they are not exposed to HIV and Hepatitis and therefore are not contracting those diseases on top of their addiction, saving the taxpayer $500,000 over the addicts lifetime. Second, the addict must exchange a dirty needle for a clean needle. In places where this has been implemented, addicts cleaned up all of the discarded needles around town, because now a needle is a commodity that has value and can be traded for a clean needle. The parks and parking lots of those towns were clean of discarded needles because of the needle exchange program. We haven’t endorsed this concept, but it must be considered in the total response we make to this epidemic.
I will report to the community as we get the various programs started in the City.
Beyond the social and medical problem of addiction, we are also working on the problem in other areas. We have been working with local landlords on two initiatives.
The first is a background check program that will screen potential tenants for criminal history. This program has been running for several months now, and the background checks have alerted area landlords to undisclosed criminal backgrounds in over 30% of the background checks completed. This allows the landlord to reject potential tenants with violent or drug related criminal backgrounds. The first step in working with rental property is not to rent to problem tenants to begin with.
The second program is the chronic nuisance ordinance. City Council is set to adopt this at their July 7 meeting. Under this Ordinance, if a Middletown property experiences two felony drug incidents or three listed public nuisance incidents over a 6 month period, the property is labeled a chronic nuisance property. With that designation, the property owner is subject to civil fines and must reimburse the city for future city calls for service to deal with chronic conditions.
We worked with local landlords on this issue and they agreed that absentee landlords or property owners that do not deal with chronic issues affect their ability to rent to quality tenants and reduce property values in the neighborhood. To make it fair, we put a safety net into the Ordinance to protect diligent landlords. If the property owner takes all possible action, including eviction, they are not subject to the chronic nuisance designation. As a city, we want the nuisance to stop. If the landlord has properly screened their tenants and they take action when notified by the City of a problem, then the property owner has done all that can be done to alleviate the problem property. This is designed to stop the absentee landlords or local property owners who choose to be a nuisance to the entire neighborhood. We won’t put up with it any more.
Finally, starting in July, we have a task force dedicated in police to attacking and knocking down crime hot spots. We track and map criminal activity and this task force will be responding to flashes of crime, concentrating on specific blocks, houses, people, as needed to rid the neighborhood of whatever is causing the uptick in crime.
No community has solved the heroin issue completely. My hope is that with the initiatives implemented with the heroin summit groups, we will offer the best chance for our residents to get access to treatment to get off heroin and to stop their need to commit crimes in our city.
For those who choose not to get help, we are hopeful that the background criminal checks will alert landlords not to rent to known drug users and that the chronic nuisance ordinance will push property owners to rid their property of drug related activity in the City. The police task force will be tracking and dealing with flare ups of thefts and drug related activity. If you can’t get help for your addiction, you can’t stay here and continue to be a nuisance to the neighborhood and to steal from our residents.
As with many programs, this will be somewhat effective. There is no silver bullet here. As I said, no city has solved this issue completely. We will do everything we can to make the largest impact on the crime in the City and the health and quality of life of our residents.