City police Chief Dino Sgambellone spent more than five years fighting the heroin problem as commander of the METRICH Enforcement Unit.

He knows there are no easy answers.

“The problem from a community standpoint is when a drug is introduced to the level that heroin has risen, it’s not just about law enforcement,” Sgambellone said. “To adequately address the problem requires social service agencies, treatment providers, medical personnel. We’re making steps in the right direction.

“To truly, effectively manage the problem, we need a concerted effort from all community stakeholders.”

The heroin issue has skyrocketed in recent years. In 2005 and 2006, METRICH officials recovered 73.17 and 70.34 grams of heroin, respectively, in the 10-county region.

By 2008, the amount had jumped to 613.3 grams. The high point was 2011 with 747.75 grams recovered. Last year’s amount of 707.95 grams was comparable.

In 2011, Richland County had 10 fatal overdoses involving heroin. That number dropped to six in 2012, but there have been six fatalities already this year. Four or five other cases are pending, coroner’s investigator Tom Stortz said.

Shelby police Capt. Lance Combs agrees with Sgambellone in facing the issue.

“We’re not going to arrest our way out of this problem,” he said. “Over the course of time, it’s become a multi-faceted approach. Law enforcement can’t be the only participant.

“We’ve gotten more involvement from other agencies. I think we’ve changed the overall approach.”

Gradual evolution
In 2005 and 2006, crack cocaine was the drug of choice in the area, according to METRICH Commander Lt. Keith Porch.

“Crack dealers have now made the switch,” he said.

Porch said some heroin dealers throw in crack when making a transaction. He added it’s harder to get off heroin than crack.
Heroin also is cheaper than prescription pills, which many people start off taking before advancing to heroin.

“They get so expensive that they make the jump to heroin,” Porch said.

The lieutenant said a single prescription pill can cost $35 to $45, while heroin goes for $1 a milligram. He said users and traffickers are transient throughout the METRICH region.

“It affects all,” Porch said. “There’s no races, no rich or poor. There’s no demographic that it affects more than it affects another.

“The sources continue to be connections through Chicago, Detroit, Cleveland and Columbus. We have people who make daily trips to Columbus.”

Porch said the desire for heroin drives up burglaries and thefts.

“The community is a stakeholder,” he said. “It will affect the whole community.”

Despite the heroin problem, officials say it’s not as dire as it was depicted in a 2008 report on “The Oprah Winfrey Show.” Reporter Lisa Ling said there were hundreds, if not thousands, of addicts in Richland County.

The report focused on a Shelby family.

“I don’t think that it’s any different than anywhere else in the country,” Combs said.
Shelby’s numbers have been erratic the last few years. In 2006, Shelby police seized 43 unit doses of heroin. That number was no higher than 10 for the next four years before jumping to 32 unit doses in 2011 and 91 last year.

“Some is attributed to enforcement,” Combs said. “In addition, some of these are multiple recoveries in one arrest, not indicative of how many people were arrested and charged with a drug offense.”

Mansfield police Capt. Ken Coontz, formerly the METRICH commander, said heroin users are chasing more than a high.

“They continue to abuse not only for the benefits of getting high but because the withdrawal symptoms are so painful,” he said. “Once they’re addicted, it’s very difficult to come off of it.”

Treatment options
The area lost its only detoxification center in 2004 when Freedom Hall in Crestline closed.

Joe Trolian, executive director of Mental Health & Recovery Services, interned at Freedom Hall.

“Detox is just not self-sustaining,” he said.

But that doesn’t mean heroin addicts in Richland County can’t get help.

“All I hear is there’s nothing in Richland County. No matter how many brochures we put out, I hear that,” Trolian said. “We have plenty of rehab.”

Trolian listed New Beginnings Recovery Services, Mansfield Urban Minority Alcohol and Drug Abuse Services, Three C Counseling and Family Life Counseling as treatment options.

“If people have decent family support, we have outpatient agencies,” Trolian said. “UMADAOP works with criminal justice. Three C Counseling has intensive outpatient services. They will accept Medicaid, third-party payers and will work on a sliding fee scale.

“Family Life Counseling has intensive outpatient, (regular) outpatient and aftercare. New Beginnings, that’s our intensive program.

“For a county of 125,000, to have these is pretty good.”

Coontz added rehab centers are to help users stay clean, not to handle withdrawal symptoms.

Trolian said the agencies work closely with the courts. People also can self-refer.

“For the general population, drug service is voluntary,” he said. “The agencies are not going to make the appointment because Mom called. Son has to make the call.”

Trolian said the goal is to get people back to work.

“It (treatment) is not just a certificate and a handshake,” he said.

Sgambellone and Trolian both say the goal should be to get treatment for people before law enforcement becomes involved.

Trolian admits most area treatment facilities are at capacity.

“The problem is they will prioritize. The pregnant IV drug-user is top priority,” he said. “(But) that doesn’t mean we can’t find them a bed someplace.”

Other options
Drug courts have proven highly effective in Richland County.

The version in common pleas court, run by Judge James Henson, started in April 1997 through federal funds. It offers abusers a second chance. Richland County’s drug court was one of the first five in Ohio.

Drug court usually is for first-time, low-level offenders. Those involved have to get a job, attend meetings, follow a curfew and see their probation officers. They also meet twice a month in Henson’s courtroom.

Completing drug court takes at least 18 months, but it can last three years. Reasons for getting kicked out include relapsing and absconding from supervision.

Municipal court’s version started in 1997 with 15 participants. It has gone to more than 300.

Most people on municipal court probation meet with their probation officer once a month. Those in drug court have weekly meetings, get tested up to three times a week and report to court every two weeks.

Judge Jerry Ault said the city saves at least $13,000 for each person who successfully completes the program.

“Drug court has helped,” Combs said. “Probation and parole have helped immensely. I don’t think they get enough credit for what they do.”

Such services are vital to heroin addicts, according to Orman Hall, the director of the governor’s cabinet opiate action team, part of the Ohio Department of Mental Health & Addiction Services.

“It’s a pervasive issue across our state,” Hall said. “Ninety percent will relapse without effective intervention. Relapse is higher than any other addiction.”

Hall said heroin is a direct function of a longer-standing prescription opioid problem in the state.

Brad DeCamp, of the state opioid treatment authority, said heroin is more readily available and provides a stronger high.

“As the individual builds a physical tolerance to medications, they might need something like heroin,” he said.

Sgambellone said he would like to see even more resources available.

“The goal of any community should be to not only prevent people from starting to use, but having the resources available to those that are ready for treatment and to be able to facilitate that treatment in a timely manner,” he said. “It’s prevention, treatment and enforcement and finding the right balance between all three.”

Hall put it another way.

“It is a complicated problem,” he said. “We’ve got a lot of work to do.”

Originally published in the News Journal on July 28, 2013.