U.S. Attorney Steven M. Dettelbach addressed the Akron Roundtable about Heroin and Opioids
Remarks as prepared by U.S. Attorney Steven M. Dettelbach to the Akron Roundtable about our community's response to Ohio's heroin and opioid epidemic:
It happens every day in the United States, and every day right here in Akron.
You go in for a minor operation, or medical procedure, or to have a tooth pulled, and everything goes smoothly.
When you’re about to leave, the doctor pulls out his or her prescription pad to give you something for the pain.
Maybe you’re in a lot of pain. Maybe you’re in a little discomfort. Maybe you feel pretty close to fine, but the doctor gives you a script just in case.
Maybe it’s for 20 pills of Percocet. Maybe it’s 40. Maybe it’s 60.
When you get home, you take two pills on the first day. And the next day, you’re feeling better but still have some pain, and you take two more. And the next day, you take one pill, and then it’s time to go back to work and you are pretty much back to normal.
But you still have 55 Percocet sitting in your medicine cabinet. There they sit for a week, a month, a year, without you giving them much thought at all.
Even though you’re not thinking about them, they are sitting in your medicine cabinet like ticking time bombs. Because on July 4th, or at Thanksgiving, or on New Year’s Day, your nephew, or your kid or your kid’s friend is over visiting or home from college, and he goes into your medicine cabinet, grabs the bottle and puts it in his pocket.
Now that nephew or niece, son or daughter is on their way to opioid addiction. An addiction that, more and more frequently, morphs from pills to heroin. And with startling frequency, that battle with addiction ends on a slab at the coroner’s office, a life taken, another family destroyed.
I’m here today to talk about the heroin and opioid problem we all face here in Northern Ohio, and to provide some stark and startling facts about what we’re seeing in the law enforcement community, and to let you know about some of the efforts going on around the state, and in Akron, that provide us with the slightest glimmer of hope.
Some of those efforts involve law enforcement, but many of them involve a broad cross section of the community, including doctors and hospitals, treatment professionals, police officers, parents and PTAs.
The message for you: we can’t do this alone. We need your help, which is why I am happy that so many of you are here today. Thank you to the Akron Roundtable and your president, Jacqueline Silas-Butler, for focusing your attention on heroin and our community’s response.
When I joined the Justice Department in the early ‘90s, the vast majority of our federal drug trafficking cases dealt with cocaine – either powder or crack cocaine. Remember “Miami Vice” and “Scarface” with the piles of cocaine? Those were the cases we did.
But about five years ago, the drug trafficking cases in our office shifted from cocaine to heroin.
What had happened? Well, the drug traffickers saw a shift in demand and adjusted their product to fill that demand.
And why was there a shift in demand? There was an explosion in painkillers being prescribed.
In 1997, there were 7 pain pills prescribed for every man, woman and child in Ohio. Fast forward to 2010 and that figure jumped.
For every man, woman and child in Ohio, there were 67 pills per person. That’s an increase of more than 900 percent! And I don’t think the level of pain in Ohio increased 900 percent during that time.
Ohio has been flooded with pills. Some of these pills were coming from what we call “pill mills,” which hand out pills for anyone with a pulse, in exchange for a fee, of course.
But far more common are the good doctors who prescribe pills for a variety of reasons. Those reasons include patient satisfaction scores or large pharmaceutical companies that incentivize doctors to write with what I call a heavy pen.
Some people become hooked on the pills following surgery or an injury. Others take painkillers recreationally. Others divert the pills to third parties. Either way, the pills are expensive and eventually, people either run out of pills or run out of money.
So what do they do? They turn to heroin, which is also an opioid, which they can get for a fraction of the cost of Percocet or Vicodin.
And we’ve seen that here in Akron.
Chris Jacquemain was a star quarterback at Mentor High School, near Cleveland who came to the University of Akron on a football scholarship. The head of the criminal division in our office was one of his coaches in pee-wee football. Like all the kids who get a Division I football scholarship, Chris was stronger and faster than everyone. But the one opponent he couldn’t beat was heroin.
Chris got hooked on painkillers after a shoulder injury. The need to feed his addiction led to stealing from teammates and eventually Chris was kicked off that Akron football team. He turned to heroin and, after stints in and out of court, in and out of rehab, he on died on Thanksgiving weekend in 2011.
I’d like to tell you that story outlier, but it is not.
In Cuyahoga County, heroin deaths have increased 400 percent over the past five years. Last year alone, nearly 200 people died from heroin overdose in Cuyahoga County.
Summit County has its own problems. In the past two years, there have been 86 heroin deaths here. That’s 86 people, 86 families, 86 mothers and fathers, countless brothers and sisters.
Just this week, five people have died from heroin in Akron, Ohio.
These fatalities cut across all demographics. Black and white. Young and old. City, suburb and rural. Rich and poor, you name it.
Fatal overdoses are just one way to measure the crushing impact of the epidemic. A staggering amount of crime is related to heroin, whether it’s people actually dealing drugs, or stealing copper to get their fix, or worse. We saw that a couple weeks ago, when your county prosecutor Sherry Bevan Walsh procured a conviction in the quadruple murder that was related to heroin.
The problem is real. And it is – and has been – at crisis levels.
But it’s not just one kind of problem. We have a law enforcement problem, a health care problem and a treatment problem.
And we have to focus more effort on stopping this problem before it starts. Because when it comes to heroin, a gram of prevention is worth 10 kilos of cure, because the grip of this drug is so strong once it takes hold, it rarely lets go, even if people do get help and go into recovery.
I hear about it all the time.
This spring we were at a law enforcement office talking about an opioid arrest and afterward, the secretary there pulled aside someone from our office, and with tears in her eyes and a little bit of shame, she thanked them for our efforts to curb the problem.
This police department secretary explained how her own daughter – who was herself a mother – got hooked on painkillers, which led to heroin. The secretary confided that she didn’t know how it was going to end for her daughter, who had been through rehab. She worried that her daughter was just one mistake, one bad day, away from the morgue. The pain and the anguish that this mother felt were evident.
Because we can cite numbers all we want when you know somebody who deals with this issue, one is one too many.
So we have a multifaceted problem, a problem that affects real people. I submit to you that what we need is a multifaceted solution. And that’s something that we’ve been working on.
First, we turned to traditional partners, like the DEA, FBI and Ohio Attorney General, to try to come up with a plan.
Next, we turned to non-traditional partners, like the Cleveland Clinic, University Hospitals, MetroHealth and the County Medical Examiner, to try to expand the plan.
And now, we’re gathering people who run recovery centers, outreach workers who handle needle exchanges, people in recovery and who lost children to heroin.
Our goal has been to invite as many committed people as we could to try to create an overall plan that would tie together the many efforts already underway to combat the problem and look to fill in any gaps.
We started by meeting in our office but we soon realized that if we wanted to make any progress on this issue, we needed to get out of the courthouse and into the community.
That’s why we put together a daylong summit at the Cleveland Clinic which attracted nearly 700 people, 700 experts, to share ideas.
Let me tell you, when you get 700 people to come to something in the middle of the week, you know you’re touching a chord in the community.
We talked about enforcement. We talked about treatment. We talked about education and we talked about policy.
The result of that summit was what we call the Heroin and Opioid Community Action Plan. You can find a copy on our web site and I have some copies here today.
That day wasn’t the end of our efforts. The group that put together the summit stayed together as the U.S. Attorney’s Task Force on Heroin and Opioids. Both the Task Force and the Action Plan are broken into four sections: (1) Education and Prevention; (2) Law Enforcement; (3) Treatment and (4) Healthcare Policy.
Each group developed a set of goals, both long- and short-term, to help move us forward on fighting heroin. Then have tried to make those goals happen.
So, for example, on prevention we continued and expanded a program started by a Cuyahoga County Judge who had been going out and giving talks at schools and community meetings. These talks were drawing hundreds of concerned parents and students but even a judge can’t do everything alone.
The group also worked to expand the number of prescription drop boxes where people could talk those old pills. Now there is one in nearly every community in Cuyahoga County.
Healthcare Policy was driven by the doctors in the group. They successfully pushed for was the passage of House Bill 170, which allowed first responders and family members to have access to Naloxone, which is basically an antidote for someone who is overdosing on heroin. It literally saves lives.
Lorain was a pilot site for giving Naloxone to first responders. Last November, when a deadly batch of fentanyl-laced heroin hit the streets of Lorain, two people died, but more than a dozen were saved by police officers using Naloxone. Compare that with Pittsburgh, where more than 20 people tragically died from fentanyl-laced heroin in a two weeks.
In Law Enforcement, we’ve also made strides. The first one relates to how police respond to a fatal overdose.
All too often, the old practice was that if there’s a call for a dead body and the police get there and see a needle sticking in the dead person’s arm, they often would just get back in the car and move on to the next call. After all, it wasn’t a murder, right?
Now, working with Cleveland Police, the County Sheriff and County Prosecutor, we have developed written investigative protocols for how to handle and investigate fatal overdoses. And they start the moment the police arrive.
Detectives now treat those sites as crime scenes, looking to gather DNA, check cell phones and texts, talk to people on the scene and try to determine who supplied the fatal dose of heroin. And a prosecutor responds to every heroin death in Cuyahoga County. That’s because, when it’s appropriate, we bring either manslaughter charges in the state system or federal charges with what we call a “death resulting enhancement” which carries a 20-year mandatory minimum sentence.
We have brought a few of those cases already, including one here, in which an Akron man sold heroin that resulted in the death of a man on Christmas Day in a motel in Green. That case is pending.
We could not have done that case without the fine work of the Akron Police Department and the Summit County Prosecutor’s Office.
In fact, your chief -- Chief Nice -- created a dedicated heroin unit looking to track the source of the drugs and bring manslaughter charges when the facts allow it.
I’m proud to say that some of the costs of the project are being paid for by a Justice Department grant.
I hope you’re also seeing the billboards and hearing the public service announcements in Summit County. They are also conducting a public awareness campaign as part of the effort.
Akron is doing something they are not yet doing in Cleveland. Akron Police have partnered with the Summit County Alcohol, Mental Health and Drug Board, and the ADMs Board will now send intervention specialists to emergency rooms when there is a non-fatal overdose.
Such a simple idea, but so powerful. The research shows – and it makes sense – that when somebody overdoses and survives, there is a window then the addict will consider going into treatment. This immediate response simply seeks to capitalize on that window.
The goal will be to engage the user – and the user’s family – and get them to agree to go directly to rehab. It’s a great idea that came from here and I plan to tell everyone I can about it in the hope that they’ll copy it.
We will continue to enforce the law. My branch chief Bob Bulford and Assistant U.S. Attorney Sam Yanucci are here today, taking a quick break from the dozens of large-scale drug trafficking investigations they handle on a daily basis.
The efforts of these career Assistant U.S. Attorneys and the agents they work with has resulted in indicting nearly 200 people on heroin charges since just last year.
But as all of us will tell you, we cannot simply arrest our way out of this problem.
The solution cannot be justto arrest drug dealers – although that is part of the solution.
The solution cannot be justto make more treatment beds available – although that is part of the solution.
The solution cannot be just to require doctors to check to see if a patient has been doctor shopping – although that is part of the solution.
The solution cannot be just to get in front of every parent and teacher and child and warn them that making the mistake of trying heroin just might be the last mistake they ever make – although that is part of the solution.
We need is what I call an “all of the above” approach.
We need vigorous law enforcement.
We need more treatment options.
We need to get control of the stream of prescription pills being diverted to addicts.
And we need to come together as a community to stop people from experimenting with these drugs in the first place.
It is shocking to me to understand how heroin of all drugs could become the “popular” drug.
We all remember heroin was a dead-end drug for the hopeless. It was the last stop on a trail of misery. And it still is.
But as we have begun our work on this epidemic, I am struck but how often good people come up to me or someone in the U.S. Attorney’s office with a tragic story of their own.
We had a news conference last month and one of the TV cameramen approached afterward and confided that he was in recovery from heroin.
A nursing student who graduated from the same suburban school my children attend who fatally overdosed. People from all backgrounds, all races, all socioeconomic classes, will tell us about a niece, a son, a daughter.
These are our kids. They are our neighbors who are dying. And they are dying in record numbers. This is truly everyone’s problem.
The Action Plan we’ve come up with is just a model, a good start.
Words like “crisis” and “epidemic” get thrown around a lot. But in my five years as U.S. Attorney, I can’t think of a problem we’ve encountered that comes close to the death and destruction that has been visited upon us like heroin.