MATTHEW TULLY

Tully: In Philip Seymour Hoffman’s death, echoes of a local heroin crisis

Matthew Tully

When Dr. Charles Miramonti heard about the death of Philip Seymour Hoffman, none of the details surprised him.

Not the heroin-related demise of an intelligent and successful parent of three. Not the overdose of a man who, at 46, was older than the stereotypical image of heroin addicts. And, more broadly, not the fact that heroin had caused another tragedy or that it had gained a grip on a man who for years had apparently beaten back his addictions.

Versions of that storyline play out every day in Indianapolis.

Miramonti, chief of Indianapolis’ Emergency Medical Services, has been spreading the word for months about this city’s increasingly disturbing heroin problem. Combined with a related surge in overdoses of powerful pain-killing prescription drugs, it’s a problem that is haunting cities, suburbs and rural areas across the country. Hoffman’s death is emblematic of a troubling trend.

Frontline emergency workers such as Miramonti, who is also an emergency physician at Eskenazi Health, have found that many heroin-overdose victims are in Hoffman’s age group or even older. Many suffered from addiction early in life and, after years or even decades of being clean, fell back into trouble after being prescribed painkillers. Still others, though, now in their 50s and 60s and hobbled by chronic pain, never previously suffered from addiction problems.

“We see folks from all different walks of life,” Miramonti said. “This isn’t a problem you can stereotype. You might not think you would have ever seen a wealthy father of three, a talented actor with everything going for him, dead with a needle stuck in his arm.”

Although prescriptions for drugs such as OxyContin and Oxycodone ignite many of the problems, an increasing number of people are turning to heroin because it’s cheaper and, for those who can no longer get prescriptions, often easier to obtain. And the problem is getting worse. In 2013, EMS crews responded to more than 600 narcotic overdoses — a 17 percent increase from the previous year and likely only a fraction of the true scope of the problem.

Miramonti pointed to one of hundreds of cases in Indianapolis last year. In that instance, emergency crews found a woman in her mid-50s, a mother with a good family and no history of addiction, dead from an overdose. Her case involved the abuse of a powerful painkiller, but Miramonti said that no matter how the addiction starts, many people slide from one drug to another, and from responsible use to abuse, in search of relief from pain or a needed fix.

That slide often takes them to heroin, which is getting easier to find. For those who used it long ago, the drug might seem like a simple solution to problems of pain and addiction. But users are encountering a narcotic that is even more powerful and dangerous than it was 20 years ago.

Meanwhile, heroin use also is surging among the area’s younger residents. After I wrote about the issue late last year, several readers contacted me to tell of addictions that young people in their lives were facing. One man wrote of his neighbor, not too long ago a top student, who has been hospitalized numerous times in the past couple of years. “Somehow,” he wrote, “heroin got hold of him, and his potential for becoming the man he is meant to be has been taken away.”

This problem, he added, warrants “a community solution.” He is right.

Many of us can’t imagine something as dramatic as becoming addicted to heroin. But it’s becoming a crisis in this city; Public Safety Director Troy Riggs recently said it appears more people died from overdoses last year than homicides. And, he said, heroin use is directly related to other crimes that harm the city’s quality of life. He and other public safety and health leaders in town insist the fight against heroin must be a top priority.

But fighting it isn’t easy.

Miramonti noted, for instance, that hospitals in coming months will strengthen efforts to keep drugs such as OxyContin, Percocet and Vicodin out of the hands of people who use emergency room visits as paths to inappropriate prescriptions. That’s a smart move, as the abuse of those drugs contributes to the health and public safety problems Indianapolis faces. But there is an unfortunate downside to the effort.

“I’m concerned that as we do that, are we going to be adding to the heroin epidemic and to the black market?” Miramonti said. “For a while, we probably will.”

Drug addiction doesn’t go away with new laws and policies, and with every new action to stem the drug trade comes other ways around it. There are no easy answers, but awareness is key. Far too many people overdose or fall into addiction, often later in life, after first receiving a prescription for a drug that eases their pain.

“These are folks in many cases who make honest mistakes,” Miramonti said. “You have to be very careful with these prescription pain medications, and you have to take them in close consultation with your doctor.”

That’s crucial, he said, because the potential consequences of not doing so are devastating.

You can reach me at matthew.tully@indystar.com or on Twitter: @matthewltully.