Help, not arrests

Faced with a sharp increase in heroin overdose deaths, the city of Lansing is trying something new: Help instead of jail.

“In most cases, if someone came in and turned in their drug equipment and said, ‘I want help,’ we would not charge. We would not seek charges,” Lansing Police Chief Michael Yankowski said. 

Instead of facing jail time, Yankowski said officers will assist people to get into treatment immediately. And that is a move Lansing Mayor Virg Bernero said he supports.

Yankowski said heroin-related deaths in Lansing are on pace to rival homicides, which average 10 a year.

The chief, speaking in his office on Friday, said what he described as a heroin “surge” was not something the community was going to “arrest its way out of.”

Bernero agrees, saying he has changed his view on how to handle the uptick in heroin use.

“It was mostly a law enforcement lens I was seeing it through,” Bernero said Friday. “But now I see we’re going to need a more collaborative model to tackle this.”

The idea is similar to an initiative started in May by the Gloucester, Mass., Police Department. By August, The Washington Post reported recently, 109 addicts had been helped into treatment programs through the Glouchester Initiative. That program is funded by a partnership between public and private agencies.

With the local increase — the chief said heroin-related fatalities are on pace to rival homicides — Yankowski said he is interested in exploring the Gloucester Initiative.

Since Jan. 1, Lansing has verified 49 heroin overdoses, seven of which have been fatal. Yankowski said those numbers are likely going to be higher as the department processes more information. He also expects that the number of fatal overdoses will double as the medical examiner completes autopsies on additional deaths that have not yet been classified.

In all of 2014, there were 20 overdoses and three deaths in Lansing, while 2013 saw six overdoses and one death.

In the first six months of this year, Linda Vail, head of the Ingham County Health Department, said emergency first responders applied the drug Narcan — a drug which immediately reverses the effects of opioids on the body — 132 times. That’s nearly double the 68 applications of the drug in the first six months of last year.

Yankowski had characterized the increase as an “epidemic” earlier, but he said it is unclear if there is truly an epidemic.

“We are still trying to gather all the data about what is happening, so we know in real time,” he said. The data is being collected by law enforcement, the county health department, local hospitals and medical providers, the medical examiner and fire departments.

Bernero said that he was aware the heroin “surge” was happening, but “it has not been much on my radar.”

“I have not focused on this, but I am now,” he said.

As part of that focus, Bernero said, he is leaning toward creating a multi-agency task force to find solutions to the surge and prevent it from crippling the community, as the drug has in several East Coast communities.

But Bernero cautions that such an approach takes money and committed substance abuse treatment facilities with open access, a problem Yankowski also noted. Bernero said if a person has insurance and access to wealth, they are more likely to get into effective long term treatment programs and facilities. If a person is poor and on Medicaid or a bronze plan under the Affordable Care Act, they might not get the care access they need.

Ericanne Spence, director of substance abuse services for Community Mental Health, said beds are available for heroin treatment in the county. Right now, there are at least 75 beds in residential facilities. If those fill up more are available outside Ingham Country through a network of providers.

But Spence suggested that treatment may not be effective for people suffering from overdoses. “These people are not seeking treatment,” she said. “They tend to be angry and confused.”

Bernero noted funding such an initiative may require reaching out to the Legislature.

But there might be a local solution as well. Voters renewed a millage last year to provide health care for uninsured and underinsured poor residents. The money raised from that program was funneled into the Ingham Health Plan, which cannot spend it all. That agency has a fund balance of $10 million.

Ingham County Board of Commissioners Chairman Brian McGrain said the county would be interested in seeing how it can help.

“The door is open,” said McGrain, an east-side Lansing Democrat, “but we would have to be very cautious about it.”

Vail said the situation is “certainly a public health crisis.” She said she has the power to declare a public health emergency but that it must involve “imminent danger to public health and safety.” Such an order would bring in more financial resources to address the problem and would free up public health’s powerful legal authorities.

Vail said if she found the overdoses were due to the drugs being laced with something — like the drug fentanyl — that might be grounds to declare a public health emergency, she said.

Yankowski said fentanyl-laced heroin is a problem on the East Coast.

Here, he said, a bigger concern is the purity of heroin.

“The heroin purity levels that we were seeing in the area were 3 to 5 percent,” Yankowski said. “Here in the Lansing metro area we are seeing 30 to 50 percent purity levels and in some areas of the country as high as 90 percent purity.”

In Lansing, heroin is replacing crack cocaine as the drug of choice, he said.

Heroin is selling for $10 to $15 a “bindle,” or one hit, Yankowski said, whereas crack crack can run $40 or $50.

The move by Lansing officials received a warm welcome from Ingham County Prosecutor Stuart Dunnings III.

“I think it’s wonderful,” Dunnings said in a phone interview. “I fully support it.

“We cannot arrest and imprison our way out of this,” he added.