CINCINNATI — The heroin crisis is loud and clear in many Tri-State communities, but a new form of the drug is hard to detect — even for the people who use it.
Heroin, a drug most users inject with needles, is showing up in prescription pills sold on the black market in Ohio and Kentucky, officials said.
“I’m scared. It just adds another front to the (heroin) battle to fight,” said Dr. Mina “Mike” Kalfas, an addiction specialist at Christ Hospital, whose patients have unknowingly snorted painkillers that contain heroin.
This new phenomenon is mostly a counterfeit operation where dealers press heroin into Oxycodone pills, according to officials from the Ohio Bureau of Criminal Investigations.
Heroin is easy to get and cheaper than opiate prescription drugs, which can be a perk for dealers trying to pass off heroin as pain pills -- an 80 milligram Oxycodone pill can cost up to $80, whereas a hit of heroin is usually under $20.
“You can make a pill that’s a lot cheaper and convince someone who thinks they’re buying a Percocet or an Oxycodone tablet," Dr. Kalfas said. "They’re paying more money than this pill is worth."
’They Had An Official Stamp And Everything’
To even the trained eye of a public official or an addict, counterfeited heroin pills look identical to real prescription pills.
To make the heroin pills, officials said dealers get their hands on old pill presses that pharmaceutical companies discard, which means the fake drugs have an imprint, too.
"We don’t know if they are even using one full hit of heroin. They could be using one hit and dividing it four times to make four different tablets,” said Travis Worst, a forensic scientist at the Ohio Bureau of Criminal Investigations’ London, Ohio laboratory.
Until the pills are tested at a criminal laboratory, like the Ohio Bureau of Criminal Investigations or the Hamilton County Coroner’s Office Crime Labratory, not even narcotics officers know if there’s heroin inside a pill.
Some say that’s what makes the pills appealing to users and their dealers.
“It’s easier to just say it’s a medicine if you’re caught. 'This is just my bottle of prescription (pills). I’m on my way home,’" said Ann Barnum, vice president of community strategies at Interact for Health.
When officers in Logan County, near Bellefontaine, Ohio, pulled over Deangelo Harper, 29, and Erin Ratleff, 34, on March 20, they seized about 40 blue Percocet tablets at the traffic stop — or at least that’s what they thought. Even the police report listed the drugs as Oxycodone.
“They had the official stamp and everything,” said Lt. Rick Herring of the Bellefontaine Police Department. “But it was that stamp that gave it away to us that it didn’t look as clean as prescription medication should when they’re stamped."
The Bureau of Criminal Investigations laboratory determined the pills contained more than five grams of heroin, Herring said.
Chris Conners, executive director of the Northern Kentucky Drug Strike Force, said his officers have discovered heroin pills, too. Initially, officers identified the 59 pills seized from a Newport home as Percocet.
Lt. Brad Winall, commander of the Hamilton County Regional Narcotics Unit, said he has not encountered any heroin pills -- but that doesn’t mean they’re not in Hamilton County.
Laura Kimble, a forensic scientist at the Hamilton County Coroner’s Office, said she comes across the pills at least once a month.
“I’ve become very suspicious of tablets anymore,” Kimble said. “There are some things that can give me an indication that they may not be real, like if they are more crumbly than normal tablets.”
Scientists at the Hamilton County Crime Laboratory accept drugs for testing from any agency in the state. It's the only Ohio laboratory that can determine the quantity of substances in a drug.
“We’re talking a trace amount of heroin in these pills,” Kimble said. “From a chemical point of view, you’d have to pop a lot of these pills (to notice the heroin).”
Heroin Pills: What Happens If You Take Them?
Drug users likely wouldn’t notice the small trace of heroin found in the prescription pills Kimble sees in Hamilton County.
“At these levels, it would basically have the same effect on the body as the real ones,” she said.
But that might not always be the case.
That’s what concerns health and law enforcement officials — people who think they’re popping prescription pills don’t know what they’re taking or how much, and they might not have the tolerance to handle it.
“If you’ve got a person with a low-level addiction and they’re only used to snorting a couple pills a day, and they start snorting heroin, they might not have a tolerance and they might end up with an overdose,” Dr. Kalfas said. “It’s kind of a crapshoot."
The real crapshoot, experts said, is whether the drug user will end up with a pill that’s laced with Fetynal.
Fetynal, pain killer often used to sedate patients, is an estimated 30 to 50 times more powerful than heroin.
Van Ingram, executive director of the Kentucky Office of Drug Policy, said the state has seen a few cases of Fetynal pressed into prescription drugs.
“It’s dangerous enough when you know what you’re taking, but when you don’t know what you’re taking, that makes it more dangerous," Ingram said. "Overdoses often occur because people think they’re taking their typical dose of one thing and it turns out to be a higher dose of something completely different."
Kimble said Fetynal has not shown up in the prescription pills tested in the Hamilton County lab.
Drug users who take prescription pills typically crush and snort them or inject them instead of taking them orally.
“Heroin is less absorbed through the gastric lining that oxycodone is. They’d notice less of an effect if they swallowed the pill,” Kalfas said. “Usually for an addicted person to get a buzz off of it, they’re impatient so they will snort it, inject it, chew them up."
Experts warn to never take a drug that is not prescribed to you and to never take more than is recommended by a physician.