On heroin’s trail
The Freeman is taking an in-depth look at
the epidemic of heroin use in Waukesha County with this
series spanning several parts.
TODAY: A look at the scope, the
numbers, and how heroin and prescription pain pills are
Wednesday: University of Wisconsin
researchers played a role in how opioids became so
commonly prescribed in society.
Thursday: Prescription drug maker
Purdue Pharma was part of a marketing campaign launched
directly at doctors.
Friday: A Mexican cartel was
involved in how heroin gets to Waukesha.
Saturday: Heroin addiction as seen
through the eyes of a Muskego girl and a discussion of
the county’s drug court.
WAUKESHA — A lot’s been written
about “heroin in the suburbs.” Many reports are episodic: This
year’s deaths are increasing, authorities have busted a big ring or
another promising young person has died. It’s left pressing
questions: How did heroin become so prevalent here in Waukesha
County? And why? Drunken driving and domestic violence once
monopolized community concern not that long ago. We’re educated.
Affluent. We parent our children (well, most do). Heroin conjures up
images of 1970s skid rows, not Pewaukee or Muskego. The crisis here
happened fast — in less than a decade.
“It’s a different demographic than other drugs,” said District
Attorney Brad Schimel. “It’s the Eagle Scout. The straight-A
student. The star athlete. These aren’t the bad kids.”
The journey to find answers takes surprising turns, from the
University of Wisconsin-Madison to northwestern Mexico. It evokes
Fast and Furious, unprecedented marketing by Big Pharma, and
university researchers who helped lay the intellectual foundation by
launching a national pain movement that changed society and may have
unwittingly fueled an epidemic.
Photos of Tony
Pyszczynski in his mother’s Muskego home.
It often starts with pills
The mythological poison-breathing serpent Hydra had multiple heads.
To properly understand this crisis and its evolution, consider it
Hydra: same body, two heads — heroin and opioid pills, such as
Vicodin, Percocet, the cheaper painkiller methadone, and the
godfather of them all, OxyContin. They are chemically similar,
derived from the same poppy plant, and produce the same high (heroin
was once legally prescribed 100 years ago.) Opioid pills are the
gateway drugs floating around our purses like Tylenol. It almost
always starts there.
“There’s a pill problem in Waukesha County,” Capt. Frank McElderry,
commander of the Metro Drug Unit, said. “It almost always starts
with pills. There are more pills out here than heroin. No one starts
with heroin. You can’t talk about heroin without talking about
Schimel concurs: “I don’t know anyone who started with heroin.”
Parents lock liquor cabinets or mark alcohol bottles but “no one is
monitoring or counting the pills,” he added.
At least 80 percent of heroin users started with opioid pills first,
national research says. While the government gives Mexican drug
cartel leaders distributing heroin most-wanted status, almost at
Osama bin Laden’s level, a Johnson & Johnson subsidiary grows opium
poppies used for chemically similar — and legal — prescription
opioid pills. They’re grown in Tasmania, off the Australian coast.
The website of Johnson & Johnson subsidiary Tasmanian Alkaloids
boasts poppy fields as pretty as the one that put Dorothy to sleep
in “The Wizard of Oz” (the company makes many household-name
products: Tylenol, Visine, Listerine, and Splenda among them).
Two cohorts use heroin, said Dr. Frank Kolodny, a leading expert on
opioids, which refers to drugs — legal prescription pills and
illegal heroin — deriving from the poppy. There’s an aging cohort
still addicted to heroin from the 1970s in urban areas out east,
and, in the last 15 years, a bigger, growing cohort of young
suburban and rural users throughout America. Like here.
Our growing use of prescription opioids is the underreported crisis
and precursor, he said.
“They are essentially heroin pills.”
Kolodny said the number of heroin users who
started with opioid pills would be even higher except it still
includes aging men addicted in the ’70s. He thinks it’s 99 percent
Legitimate pain relief
Despite their nexus to the heroin problem and
their own addictive properties, prescription opioids clearly have a
legitimate purpose also, as anyone who has suffered pain knows.
This, though, creates a vexing dilemma for society — how to balance
competing public health concerns of people’s pain and people’s
addiction — and where the line should be drawn when it comes to
access. It’s a pendulum that has swung back and forth several times
in the past 100 years.
The widespread legal prescribing of opioids for
the broader chronic pain population (estimated at 2 million
Wisconsinites) — as opposed to terminal cancer patients — is a
relatively new thing, dating only to just before 2000.
Now the notion of treating pain has broad
support. Gov. Scott Walker recently declared September Pain
Awareness Month in Wisconsin, saying, “Chronic pain is the leading
cause of lost work days, and costs an estimated $100 billion in lost
productivity every year and results in higher health care costs.” A
cluster of Wisconsin pain groups for illnesses ranging from
arthritis to dementia joined in the pain treatment advocacy.
Chronic pain these days is often treated with an
opioid prescription. A recent news report said the Drug Enforcement
Administration was tightening regulations on hydrocodone and moving
it from a Schedule III to Schedule II drug in recognition of
addiction risks and misuse (preventing refills, creating
manufacturing quotas, and so on).
It wasn’t always so easy to get opioids for such
legitimate but not life-ending pain in Waukesha or the country. Now
it is. And that, experts unanimously agree, is the root of the
heroin crisis here. People usually start with pills that were
legally prescribed for someone else (a parent, grandparent).
A spokesman for OxyContin’s maker points to a
Food and Drug Administration letter that calls chronic pain “a
serious and growing public health problem” that “contributes greatly
to national rates of morbidity, mortality, and disability; and is
rising in prevalence.”
But there’s obviously a
public health cost too from treating pain so broadly.
Killer on the
The epicenter for the epidemic
locally is the Waukesha County Metro Drug Unit, where McElderry has
mapped drug overdose deaths. They’re spread throughout the county.
Medical examiner’s spreadsheets show opioids were found in almost 80
percent of drug overdose victims here since 2003 — either heroin or,
more likely, pills (hydrocodone came up in 27 of the 385 deaths,
heroin in at least 55, and oxycodone in 80). Most ingested multiple
Example: A 53-year-old Brookfield man died this
year after ingesting morphine (an opioid), Venlafaxine (anxiety
drug), Diazepam (anxiety and seizures), and Temazepam (insomnia).
But “counting bodies” — as the mother of one
victim says — “is the least of it.” More people use heroin than die
from it, average age 22.1 (the age for pill use is higher).
“There is no standard person,” said McElderry.
“It might be the athlete with the professional family or the welfare
Rumors abound — this high school football team
uses pills; that school is “Heroin High” — but there’s no fixed
How bad is it? Beds are full at one of the
nation’s top four behavioral health centers, Rogers Memorial
Hospital in Oconomowoc.
“Alcohol used to be No. 1, but now alcohol and
opioids are pretty much tied,” said Dr. Michael Miller, who runs the
addiction center there. As with other experts, he talks about heroin
and legal opioid pills as if they are almost indistinct. Outpacing
alcohol is a tough thing to do in Wisconsin. “Alcohol used to be 5
to 1,” said Miller.
Crime lab cases, heroin offenses? Waukesha is
near tops statewide. Deaths? Up since 2003, spiking in 2012 — opioid
deaths are now higher than traffic fatalities. Prosecutions? The DA
is getting national attention for prosecuting dealers in overdoses.
Most recently, a 17-year-old Oconomowoc High
School junior was charged with reckless homicide using the Len Bias
law for allegedly supplying the drug to 19-year-old Archie Badura
(there have been over 26 such prosecutions here). A cousin who also
used heroin remains in critical condition as of this writing.
Pill collections? Federal agents incinerated
50,000 pounds last time, third largest nationwide. More American
teenagers now use prescription opioids than marijuana. State opioid
treatment program attendance is up, hospitalizations are up, needle
exchanges are up, using naloxone to stop overdoses is up.
“Heroin has been an extremely serious issue for
six or seven years now,” Mark Manthy, acting director of the
Wisconsin High Intensity Drug Trafficking Area, a seven-county
effort, said. “Public attention is catching up to reality. It’s very
James Bohn, who runs the local DEA office, says
heroin toppled cocaine as the region’s top drug threat. Second?
“One fuels the other,” he said.
Schimel said the problem is “driving everything
else, increases in burglaries, retail theft, organized retail theft,
identify theft, robberies. It used to be rare to have an armed
robbery in Waukesha. Now they’re routine.”
Although county drug overdose deaths dropped in
2013, drugs that can reverse opioid overdoses are more available.
Addicts in drug court tell officials they’ve overdosed seven times.
So many pills are floating around that sometimes undercover drug
cops run out of money.
In Waukesha, “people take their kids to the
doctor,” McElderry said. “We are an overprescribed society.”
We raised our kids on Adderall and Flintstones
vitamins, and filled our cabinets with opioid pills for knees and
backs prescribed by family docs, and then act surprised they don’t
think pills are bad. During Nancy Reagan’s “just say no” era,
messages were clear: Drugs that weren’t alcohol were bad.
Why would pill users switch to heroin? It’s half
as expensive and easier to get. Doctors stop writing prescriptions;
parents finally lock down the pill supply. Pill withdrawal is so
horrible that driving to Milwaukee’s north side to stick a needle in
your arm becomes the better option.
It makes cops’ jobs tougher when dealers are
bottles prescribed to parents and grandparents legally (by dentists
too). Jack Riley, who runs the DEA’s Chicago’s office, said they
stopped the methamphetamine threat here by restricting precursor
drugs. In this case, the precursor drugs are legal pills, often
prescribed to people who really need them. You don’t find many pill
dealers on street corners; bad docs also aren’t the biggest problem,
although there are some.
“The market came to the people. There’s wealth
here. It was the perfect storm,” said Sheriff’s Inspector Eric
Severson, who ran Waukesha’s Metro Drug Unit until 2006.
Linda Lenz lives in an affluent, cookie-cutter
Muskego subdivision — grassy backyard with barking dog, son Tony
Pyszczynski’s senior picture on the mantle.
Lenz talked to Tony about pot and cigarettes.
She drew up a “contract” so he wouldn’t drink and drive. But the
ground had shifted. Tony, a football player, first took pills at
high school parties, like a kid in the ’80s might a glass of beer.
Linda Lenz looks at a
video showing her son in the hospital after a drug-induced
He studied Buddhism and Chinese and liked to
watch “Antiques Roadshow.” He made her artwork, and it’s good.
He filled notebooks with agony.
“One bad decision can lead to this,” said Manthy.
He switched to heroin because he couldn’t afford
pills. He was found shoeless in a Waukesha street. He went to
Rogers. Tony started bodybuilding as if to muscle the monster out.
In a last selfie, he doesn’t look much like that high school kid.
He died in a Milwaukee parking lot of a heroin
overdose last year, just 23. His mother still has his last text; “I
know. Love u too.” She was at Mayfair when an officer showed up with
Lenz is passionate and mobilized. Officials all
know her. It’s hard to know whether Muskego has a bigger problem or
just has Lenz to highlight it (Waukesha records the most overdose
deaths, followed by Menomonee Falls). She videotapes survivors and
runs a group, Stop Heroin Now.
Linda Lenz watches a
video documenting her son's battle with addiction.
“There are 20 houses with addicts in the
four-mile radius around my house, at least,” she says. “Every heroin
addict I know started with pills. Every one of them.”
But why are there so many
pills now? The answer might surprise you.
(See Part 2 of this series in