Statement of U.S. Attorney John A. Horn, Northern District of Georgia Before the Georgia Senate Opioid Abuse Study Committee

Senator Unterman and distinguished members of the Opioid Abuse Study Committee, thank you for the opportunity to discuss the Department of Justice’s efforts aimed at combatting the growing problems we face with heroin and opioid abuse in our state.  During my fourteen years with the United States Attorney’s Office for the Northern District of Georgia, I have witnessed firsthand the crippling effects that heroin and opioid addiction and overdoses have on all our communities.  As the U.S. Attorney, I am proud that my district has been working aggressively on this problem and I’m pleased to be able to offer our perspective regarding the threats to our state.

The United States is experiencing a crisis in the abuse of, and overdose deaths caused by, heroin and its more potent analogue, fentanyl.  This epidemic is ravaging countless communities, whether large or small, urban or rural.  Heroin overdose deaths quadrupled from 2000 to 2013, with most of the increase occurring after 2010.  As a result, heroin and fentanyl abuse is the number one public health issue for cities such as Cleveland, Baltimore, Philadelphia, as well as more rural communities in West Virginia and New England.

Outlook for the Atlanta Region: Background and Causal Factors

Georgia fortunately has not experienced the exponential increases that are ravaging the Midwest and Northeast, but our situation is precarious.  We began seeing disturbing spikes in heroin distribution and overdoses in the Atlanta region several years ago, and our statistics remain dramatically higher than anything we’ve seen in the last 20 years.  And, our region appears to be tracking the progression of the worst-hit communities, where those addicted to prescription painkillers transition to cheaper and more deadly substitutes, heroin and fentanyl.  The CDC estimates that 75 percent of heroin abusers today begin their descent into addiction with prescription drugs, and five years ago Georgia’s illicit opioid market skyrocketed, with overdose deaths from prescription drugs exceeding the combined overdose deaths from cocaine, methamphetamine, and marijuana.  Georgia therefore offered a broad base of opioid abusers who were at greatest risk to turn to $5 doses of heroin instead of illicit pills that cost $25 or more. 

At the same time, the Atlanta region’s marketplace shifted, as for many years heroin sales were largely limited to specific neighborhoods in downtown Atlanta.  Unfortunately, Atlanta has long served as a distribution hub for Mexican drug cartels, which noticed the increased demand for heroin and immediately began manufacturing and importing higher-quality heroin to service the growing U.S. customer base.  Consequently, heroin has become readily available through these existing distribution channels throughout the region but especially in counties north of Atlanta, giving addicts access to much purer, cheaper, and more potent heroin.  It also is now available in powder form that need not be injected intravenously, removing a barrier for use for some.  A helpful and thorough summary of this narrative is presented in a report published by the Fulton County District Attorney’s Office, and can be accessed at http://www.atlantada.org/Fulton_County_Heroin_Project___Final_Report.pdf.

Outlook for the Atlanta Region: Recent Statistics

The statistics for the Atlanta region may not be as shocking as in the country’s hardest hit communities, but they are nonetheless stunning.  For example,

• Cobb County experienced a growth from 8 heroin overdose deaths in 2010 to 53 in 2014.  Through the first half of 2015, half of the county’s overdose deaths involved heroin.
• DeKalb County had only 9 heroin overdose deaths in 2013, and jumped to 27 in the first 11 months of 2015, with 21 of those involving fentanyl.
• Fulton County recorded 4 heroin overdose deaths in 2010, and jumped to 31 in 2013 and 77 in 2014.
• Gwinnett County experienced a rash of 17 heroin overdose deaths in a several month period during the fall of 2015. 

These statistics are consistent with seizures and interdictions by law enforcement.  On March 1, 2016, agents recorded the largest seizure of fentanyl on record in Georgia, and one of the largest in the United States, during a traffic stop conducted in Bartow County, yielding a total of 40 kilograms of fentanyl. This seizure is even more staggering when considering that fentanyl is dosed in micrograms. 

Creation of the Heroin Working Group

After we noticed the increased heroin activity in our cases about three years ago, the U.S Attorney’s Office convened a Heroin Summit in June 2015, gathering nearly 200 law enforcement and other multidisciplinary participants to take note of these trends, hear from experts in our sister cities, and begin planning our response.  Those who participated expressed interest in continuing the collaborative momentum from the summit, and consequently the Heroin Working Group (HWG) was born.

The purpose of the Heroin Working Group is to employ a broad, multidisciplinary approach to understand and address the growing abuse of heroin, fentanyl, and prescription opioids in our community.  Several state agencies are active participants in the HWG.  Certainly, law enforcement has a critical role in interdicting and prosecuting the importers and distributors of these deadly substances, as well as a broader responsibility in deterring and preventing drug abuse.  However, we recognize that a truly impactful solution to this problem cannot be achieved by arrests and prosecutions alone, and instead requires involvement and contributions from the medical, education, public health, emergency response, public policy, addiction treatment, mental health, and other communities.   The HWG fills this need, bringing together participants from all these constituencies to share information and break down the walls that separate these disciplines and allow us to solve these problems together.

The HWG meets every other month, and has created subcommittees for members to focus on research and data collection; medical and treatment issues; education, prevention, and family intervention; law enforcement and criminal justice; and legislative and public policy initiatives.  After meeting for almost a year and a half, the HWG has gained a deeper understanding of the current landscape as well as several strategies and initiatives that will reduce the threats from opioid addiction and abuse.

Working Group Initiatives

While our region certainly is suffering from substantial growth in heroin and fentanyl abuse, Georgia and the south in general have not seen the exponential increases that have simply devastated the Midwest and Northeast.  However, we fear this crisis is creeping further south.  Helpfully, Georgia already has enacted good Samaritan laws and sanctions the use of opioid antagonists such as naloxone to revive those who have overdosed, both of which are critical tools to fighting this epidemic.

There is much more to be done, and the HWG presently is focusing on several initiatives, including:

• The creation of a centralized database to collect cause of death reports from all coroners and medical examiners, as well as medical reports of overdoses from emergency rooms, paramedics, and peace officers.  The lack of such a database prevents us from accurately identifying the scope of the problem and directing the necessary resources to it.  An informal collaborative effort has yielded the bones of a database that contains drug overdose deaths only.  This has provided many of the preliminary (and alarming) statistics quoted above and confirmed our anecdotal information about this problem.  But the reporting is incomplete and often months late, as currently there is no mandatory reporting in the State.
• The creation of a card that will be provided to people who are revived after overdosing from heroin, urging them to seek treatment and providing them with a list of resources to do so. 
• The dissemination of a law enforcement protocol that peace officers can use when responding to an overdose, so that critical investigative facts can be collected and shared among jurisdictions to aggressively identify and prosecute the distributors of these dangerous substances.
• Supporting a strong and effective prescription drug monitoring plan (PDMP) that has been shown in other states to dramatically reduce the availability and abuse of illicit prescription drugs.
• The encouragement of educational and prevention events in schools, universities, and communities.  The HWG has sponsored two community forums, one of which was livestreamed by WSB-TV and via our office’s Facebook page and Twitter. 
• The identification of a comprehensive listing of addiction treatment providers to help direct those in need of services and evaluate whether the inventory of service providers is sufficient to address the current needs.

   

The list of people who are actively involved with the HWG is quite impressive.  What is even more impressive is that these members have contributed time and resources voluntarily, with no funding.  The dedication of these individuals and agencies to address this public health crisis has been extraordinary, and they have accomplished much as noted above.  However, several of the initiatives taken on by the HWG certainly could be much more impactful if they were operated or implemented by a funded entity or by a public policy entity.  There is certainly much more that can be done, and we must stay ahead of the problem before it becomes as pervasive and dire as experienced in the Midwest and Northeast. 

The U.S. Attorney’s Office will aggressively combat the abuse of heroin, fentanyl, and illicit opioids in our communities, and we will continue our ongoing partnerships with federal, state, and local law enforcement agencies to arrest and prosecute those responsible for perpetuating this crisis.  We also are committed to supporting the HWG in a broader, multidisciplinary approach to solving this problem, and welcome and encourage any and all support to achieve this outcome. <END>

For further information please contact the U.S. Attorney’s Public Affairs Office at USAGAN.PressEmails@usdoj.gov or (404) 581-6016.  The Internet address for the U.S. Attorney’s Office for the Northern District of Georgia is http://www.justice.gov/usao-ndga.