With addiction primed by pain pills, heroin dealers move in
June 12, 2016 12:00 AM
Gary Tuggle, right, the special agent in charge for the Drug Enforcement Administration in Pennsylvania and Delaware, listens in December to medical director Neil Capretto, left, at the Gateway Rehabilitation Center in Aliquippa. Mr. Tuggle said eight out of 10 heroin addicts start out as oxycodone users.
By Torsten Ove / Pittsburgh Post-Gazette
U.S. Attorney David Hickton held a news conference in February to discuss a rash of heroin overdoses and the creation of an FBI-run office in Cranberry where law officers gather intelligence on heroin abuse across 13 counties.
"We have to move faster" in responding to the crisis, he said.
At the very moment he was addressing the media at the U.S. courthouse, a man overdosed in the South Hills.
So it goes in the daily heroin wars.
Last year Allegheny County recorded a record 372 overdose deaths, including 217 from heroin, up from 307 the year before, and the trend appears to be worsening. Neighboring West Virginia has long had the highest per capita heroin overdose rate in the U.S. Ohio is in the top 10, too.
Heroin from Mexican cartels, particularly the Sinaloa organization, is flooding the country and taxing a law enforcement and treatment network that never has faced a scourge like this.
"I have seen the drug du jour," said Patrick Trainor, a veteran Drug Enforcement Agency agent and public information officer for the Philadelphia office, which covers Pittsburgh. "I worked crack cases for a long time, I worked meth cases. One thing that is different is that I have never seen this number of overdose deaths [from one drug]. In Philadelphia County we had 693 overdose deaths last year. That's insane."
Stephen Kaufman, head of the criminal division of the Pittsburgh U.S. attorney's office, has also seen drug spikes come and go, such as the China White outbreak in the late 1980s in which 18 people died in Pittsburgh from injecting heroin laced with 3-methyl fentanyl.
But that was a local blip compared to what's happening now.
"This is a week-in and week-out, consistent flow of overdose deaths and overdoses that are nonfatal," he said. "This is much more pervasive and widespread."
Old drug, new problems
Narcotics trafficking in Pennsylvania has been a problem for a long time, of course.
Fifteen years ago, U.S. Attorney General John Ashcroft came to Pittsburgh with the head of the DEA to announce the results of "Operation Family Store," which dismantled a North Side ring that shipped 25 pounds of heroin and 220 pounds of cocaine from Atlanta and New York to Pittsburgh from 1998 to 2002.
It was considered the largest drug ring ever prosecuted here. But most of what its members were dealing was cocaine, and the heroin was not the high-purity stuff agents are seeing today.
The crisis has grown dramatically since then — driven largely by the nation's addiction to narcotic painkillers.
"What we see now is this perfect storm of a feeder system," Trainor said.
The federal case in Pittsburgh against oxycodone dealer Brandy Bara, a mother of four in Wilkins, illustrates that connection.
Bara, 35, dealt thousands of pain pills supplied from Detroit for her husband, Telano White, while he was in jail.
She admitted that she contributed to the region's heroin problem. In October she said she was "overwhelmed with shame and guilt" for the many lives she ruined by flooding the region with oxycodone.
The judge in her case, Nora Barry Fischer, scolded her for fueling heroin abuse, saying that because painkillers are more expensive than heroin, oxycodone users have switched to heroin in western Pennsylvania and across the U.S.
The DEA and police say an oxycodone pill goes for about $30 or more on the street. But a heroin stamp bag can be as little as $7.
Gary Tuggle, head of the DEA in Philadelphia, said 8 out of 10 heroin addicts start out as oxycodone users.
Opiate trafficking is now "probably the most serious issue facing western Pennsylvania," Mr. Kaufman said before Judge Fischer sent Bara to prison for seven years.
David Best, another drug dealer who drove the illegal prescription pill market here, won't be getting out until 2034.
Best, 30, a former chiropractic student, romanced an employee of a MedFast pharmacy in Beaver County so he could get her to steal oxycodone and other narcotics for him to sell on the street. He also had her steal prescription pads from a hospital where she later worked, then forged doctors' signatures for a dozen runners to pass at pharmacies.
He showed considerable initiative when he burglarized the MedFast, chiseling through the wall of a neighboring restaurant to steal fentanyl, Ritalin, oxycodone and other drugs. On one occasion, he broke into a neighboring hair salon and then burrowed into the MedFast narcotics cabinet.
Best, a drug user himself, said he sold pills because he was "addicted to money." His friends and family packed a courtroom in 2014 in the hopes of leniency, but a judge said Best was a major drug dealer who contributed to the region's pill problem and sent him to prison for 24 years
Heroin fills the void
With so many pill users desperate for a fix, the heroin dealers have stepped in to take advantage of a vast new market.
The federal court docket here is filled with heroin prosecutions: the Uptown Crew in Homestead supplied from New Jersey and Detroit; the Lance Gardenhire ring in Beltzhoover supplied from New Jersey; the Andre Saunders ring in Uniontown supplied from New York and Los Angeles; the Cannon-Pinnix ring in Homewood supplied from California through Cleveland.
While critics of the drug war complain that law enforcement rounds up a lot of low-level dealers who are soon back out on the street, that’s rarely the case in the federal system.
Typically federal cases remove an entire organization and put its leaders in prison for decades, sometimes life.
Last month Richard Bush, 52, a lifelong heroin dealer who processed the drug in his East Hills basement, was sentenced to 25 years in federal prison. He had been one of the main targets in an FBI-led investigation of the East Hills Bloods gang. U.S. District Judge Cathy Bissoon told Bush he was a large-scale dealer who poisoned the streets of Pittsburgh.
Andre Saunders, who lived in a $370,000 house outside of Uniontown despite not having a job, recently went to prison for a decade after pleading guilty to money-laundering and conspiracy. There's no parole in the federal system, so sentences are served out.
But the demand for heroin is so great that the void is soon filled by another group eager to capitalize on a nation of addicts.
Opium-based drugs have always been known as painkillers. Heroin, morphine and other opiate derivatives were all sold legally in the U.S. for many years; heroin at one time was used to treat menstrual pain. But in 1920 Congress recognized the threat and banned the over-the-counter purchase of the drugs.
By that time, however, the nation already had an addiction problem that continues today.
Only now it's been compounded by the development of opiate painkillers such as oxycodone. The drugs had originally been prescribed for treating cancer pain, but in the 1990s doctors came under pressure to prescribe them for routine pain.
Dr. Russell Portenoy, a prominent New York pain specialist, was one of the leading physicians who minimized the risks of opioid painkillers, saying less than 1 percent of users would get addicted. Purdue Pharma, maker of OxyContin, said the same in launching a promotional campaign to get doctors to prescribe.
They did. Doctors wrote 259 million opioid prescriptions in 2012, triple the number two decades ago.
PG graphic: Source of heroin (Click image for larger version)
"This is sort of an epidemic of our own making," said Dr. Brad Lander, clinical director of addiction psychiatry at Ohio State University's Wexner Medical Center. "Our doctors have been prescribing pain medications at a rate that is unfathomable."
At the same time, he and others said, doctors have incentive to prescribe because reimbursement rates are tied to patient satisfaction, which is measured in part by pain.
Bill Ihlenfeld, the U.S. attorney in Wheeling, W.Va., said the problem is two-fold: Patient demand and over-prescription. His state has the third-highest per capita painkiller prescription rate, partly due to a high number of tough, blue-collar jobs in which people get injured.
"Our doctors are writing with a heavy pen," he said.
Some are outright criminals. In December, Dr. Tressie Duffy, 45, who ran a wellness clinic in Martinsburg, pleaded guilty to signing blank prescriptions for painkillers and letting unlicensed staffers issue prescriptions for patients she never saw. The state has seen other major pill mill cases in recent years, as well.
While the nation is flooded in pain pills, the nature of heroin has changed, too. Decades ago, at the height of cocaine's popularity, heroin was seen as a dirty drug, confined mostly to junkies in the inner cities.
Now it's mainstream. What's more, users can snort it, eliminating the need for a needle.
All of these developments contribute to today's unprecedented overdose rate.
Typically the heroin sold here comes from Mexico.
One cartel, Sinaloa, dominates the market in the northeast, the west coast and much of the midwest. A DEA map of cases for each field office shows that Pittsburgh's supply is split between Sinaloa and another cartel, the Knights Templar.
Typically the Mexican heroin is transported to the New York City area and ends up in Pittsburgh through dealers with New Jersey ties, but other large rings here have been supplied through Los Angeles and Detroit.
West Virginia is considered a user state, with local rings supplied from Detroit, Columbus, Ohio, Baltimore and Chicago.
The heroin picture in Pittsburgh is somewhat unique, according to the FBI, in that some of the trafficking here is more "horizontal" than in other metro regions. A group of city dealers here might be supplied from a group in Duquesne, for example, rather than an out-of-town gang.
The Richard Bush case illustrates the homegrown nature of Pittsburgh trafficking.
Bush and Willis Wheeler of Rankin were the heroin suppliers for the East Hills Bloods, a violent gang responsible for 25 armed robberies and several homicides in 2011. Wheeler, recently convicted in federal court, supplied the raw heroin to Bush, who processed and packaged it with supplies sold by Mayank Mishra, a North Hills headshop owner. Mishra is awaiting sentencing.
At sentencing for Bush last month, Assistant U.S. Attorney Brendan Conway called Bush a "despicable human being" responsible for flooding the streets with more than 90 kilos of heroin.
With heroin comes violence
The heroin trade fuels violence. Police say most of the shootings in the region, maybe 80 percent or more, are driven by feuds over drugs and drug territory.
One example is the Gardenhire ring. Last spring law officers swept through the city's southern neighborhoods, arresting 38 ring members and seizing houses, cars and cash.
The leader, agents say, is Lance Gardenhire, 40, of Zara Street in Beltzhoover. DEA said the gang members called themselves "Zhoove," sold thousands of bricks of heroin and had long battled a rival gang in St. Clair Village.
"The heroin is funding and fueling violence" in the Beltzhoover area, said DEA Agent Michael Johns.
Heroin drives other crimes, too, by customers desperate for money to buy it.
"It's the heroin users who are breaking into houses and stealing jewelry and breaking into houses and stealing firearms," Mr. Conway said when the East Hills Bloods were indicted in 2012.
Federal authorities are attacking heroin on multiple fronts.
One involves the "fusion center," a fancy name for a room in Cranberry with a bunch of agents and cops in it.
Started in January, it's a focal point for the FBI, DEA, state police and their partners to get a handle on the big picture of heroin use and trafficking across 13 counties in western Pennsylvania.
The center is patterned on anti-terror efforts after 9-11 designed to coordinate the work of police, firefighters, paramedics and agents.
Central to the effort is a form that police or paramedics fill out as soon as they show up at the scene of an overdose and send to the center. Where in the past overdoses in rural areas would be handled locally, the fusion center allows agents to better track heroin brands and identify dealers.
The center has been successful in identifying dealers in several overdose incidents who are now under indictment.
Mr. Hickton promised last year that his office would aggressively pursue dealers whose heroin kills or hurts someone, a federal crime that carries a potential life sentence but is hard to prove.
Prosecutors used to have to show only that the drug in question was a contributing factor for a dealer to get the mandatory minimum sentence. But the U.S. Supreme Court in 2014 ruled that a dealer can get that sentence only if prosecutors show that the supplied drug was the one that caused the death.
The distinction is important because drug addicts typically take multiple drugs.
The new higher standard has not dissuaded Pittsburgh prosecutors from bringing the charge, however. "This heroin crisis requires that response," Mr. Hickton said.
His office has indicted 15 people across the region for the crime and last month secured its first convictions when Romar Watts, 34, of Homestead, and Brian Borruto, 40, of Ebensberg, pleaded guilty to distributing fentanyl-laced heroin resulting in death. A third man, Andre Higgs, 32, of Pittsburgh, was going to plead but changed his mind.
The men were accused in the overdose deaths of Stacey Shaw and Ray Smith. Ms. Shaw was found dead March 26, 2015, in the bathroom of a Sheetz store in Cambria County, surrounded by stamp bags. Mr. Smith was found April 3 in Munhall.
Despite such convictions, law enforcement knows it will take more than prosecuting people to stem the crisis.
Authorities are embracing better education about heroin abuse, emphasizing treatment over prison and curtailing doctors who over-prescribe painkillers. Other approaches include equipping first responders with Narcan, an opiate antidote which has been credited with saving many lives.
But some observers take a long-term view, saying time is the real answer.
Dr. Lander, the Ohio State addiction specialist, maintains that the heroin crisis will eventually fade. After 33 years in the addiction field, he said he's seen many drugs come and go.
In the 1980s it was crack cocaine, followed by ecstasy, then bath salts and now heroin.
"We go through waves of different drugs" that are often regional, he said. "Now we have a national wave of heroin and opiates. But before that it was crack. It will never go away but it should calm down. That's been my experience. It will be replaced by something else."
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