DuPage coroner: Heroin a 'challenge to our society'
In his 20 years as a trauma surgeon, Richard Jorgensen encountered plenty of tragic deaths.
It wasn't until he took office less than two years ago as DuPage County coroner, though, that he became fully aware of a prevalent cause of death flying under nearly everyone's radar.
"Very quickly, it was apparent we have a serious drug problem in DuPage County," he said. "It was surprising enough for me to start studying the problem."
The drug that concerned Jorgensen most was heroin.
Since then, he has analyzed every number associated with the combined total of 84 heroin overdoses in 2012 and 2013 in DuPage and found no one is immune.
The overdoses took the lives of people in their 20s and in their 60s.
69 males. 15 females. Five teenagers.
Residents from 31 towns.
Three deaths a month, on average, for two years.
That number sticks with Jorgensen the most.
Fifteen -- the age of the youngest person to die from what some are calling an epidemic.
It was troubling enough that Jorgensen started getting vocal about the need to address heroin, even bringing the issue before the county board last September, and alarm began to spread.
Spurring action, however, proved more difficult.
Jorgensen says some schools were reluctant or unwilling to teach specifically about heroin; police response was sometimes limited and sparking public interest was difficult.
"Back then, I do have to say, we were still shuffling it under the rug," he said. "We just couldn't get people to talk about it."
While it was hardly the first time communities were warned about the growing popularity of heroin, it seems seeing the drug's impact through the eyes of the coroner -- who deals with the deaths on a regular basis -- eventually pushed DuPage to take new steps to address the problem.
More than a year later, fatal heroin overdoses are declining in the county, more students are learning about the dangers of the drug, police are equipped with Narcan to reverse the effects of heroin overdoses, and more residents and officials in other counties are taking notice.
Out in the open
Jorgensen said one of the saddest stories he ever heard involved a mother who knew her son was using heroin but "didn't want to make a big deal about it or say anything about it" because she felt it would humiliate her family.
"So, this kid is now dead because you wouldn't embrace the fact that you had a heroin addict in your family because you were embarrassed," he said. "She realized that after it was over. She said, 'It was just a horrible mistake that I didn't talk about it.'"
The mother's attitude mirrors what Jorgensen heard from others when he started speaking out against the drug.
"I was actually told, 'You're embarrassing DuPage County by talking about this.' I said, 'No, embarrassing DuPage County is when a 15-year-old is found (dead from heroin).'
"It does not embarrass DuPage County to admit that we're like everybody else," he said. "Not addressing it and not trying to fix the problem, that embarrasses DuPage County."
Kane County Coroner Rob Russell has tried to emulate Jorgensen's efforts, though he, too, has faced funding problems and some criticism from other officials.
"It's going to take time," he said. "You've got different personalities and attitudes."
In 2012 and 2013, there were 40 heroin-related deaths in Kane County. In the same period, McHenry County had 31 confirmed heroin-related deaths, while Lake County had 60.
Russell said his office collects prescription medications from the homes of the deceased so the drugs that are often used as gateways to heroin don't get in the wrong hands. He also has helped launch a prescription drug collection monitored by the Drug Enforcement Administration and has spoken at heroin awareness forums.
"It is difficult to get parents to these forums because they look at it as not a problem with their family," he said. "They're not people from the inner city that are dying from this, it's our kids."
McHenry County Coroner Anne Majewski said she also has made a point in recent months to speak to middle and high school students about heroin deaths, but she believes she plays only a small part in addressing the problem.
"To tackle the drug problem," she said, "it will take a concerted effort by medical providers, parents, kids, law enforcement, schools, social services and so many others."
'A different drug'
Early last year, Jorgensen tried to host his first community heroin awareness forum in hopes of educating students about the drug. Some schools wouldn't participate.
"I was so upset by that," he said. "Some of the schools would literally say, 'Well, we don't have a problem. We're fine. We don't need that.'"
That summer, Jorgensen and Kent Williams -- the police chief in Bartlett, where the 15-year-old died -- asked DuPage County Regional Superintendent of Schools Darlene Ruscitti if they could talk to area superintendents about the issue.
"They took it seriously, and we started," Jorgensen said. "We've really opened them up to the point that we're doing lots and lots of school presentations."
His key message: Heroin is a different drug.
"People want to talk about medical marijuana, or they want to talk about Ecstasy or something else like that," Jorgensen said. "I go, 'I don't want to talk about that. Because I can tell you, for certain, that heroin will addict you, will extinguish your life, will extinguish your soul.'
"There is not a social heroin use," he said. "You can argue that there is a social marijuana use. I don't want to talk about that. It diminishes the fact that heroin is a different, addictive drug."
In addition, he wants people to know there isn't a "hot spot," or particular towns where heroin is confined. Statistics from several other suburban coroners' offices show that, in fact, it's happening everywhere -- from Aurora and Hinsdale to Crystal Lake and Waukegan.
"I've heard all these things, that it's all the rich kids in Naperville, and it's all the poor kids in West Chicago, and the answer is it's none of those things," he said. "It's not ethnicity based. It's not based on how rich or poor you are, and it's not based on what town you live in."
Picking up the pieces
No matter the background of the deceased, the pain for those left behind is the same.
"We deal with them intimately at a horrible time in their lives," Jorgensen said. "It is extremely raw, painful."
In those moments, he said, his job is a balancing act.
"You're in a situation that is very emotional and very difficult, and at the same time you have to be very intellectually clear to do your job," he said. "Otherwise, you're going to miss a homicide. You're going to miss something else."
The office is called for every suspected overdose in DuPage County. A deputy coroner investigates the scene of the death, talks to family and friends at length and brings the body back to the morgue for an examination and full autopsy by a forensic pathologist.
In addition to an autopsy, a toxicology test is done, searching for about 350 different drugs. Of the 38 people who died of heroin overdoses in DuPage in 2012, 11 also had antidepressants in their system.
"That isn't because they took antidepressants because they make you feel good," Jorgensen said. "It's because mental illness and depression go hand-in-hand with drug addiction."
Many others were taking psychoactive drugs, such as Valium, or drinking alcohol. Sometimes the victims are found with drug paraphernalia at their side, Jorgensen said. In other cases, family or friends clean up the mess and hide evidence -- a well-intentioned but possibly harmful mistake. "The idea that you know how somebody died is erroneous," Jorgensen said. "Oftentimes it's not as clear as you think."
Once, the family of a middle-age woman not known to be a heroin user thought she died from a heart attack when in fact, she had overdosed on the drug.
"The families sometimes go from the 'have no clues,' literally, the parents did not know it … to the other (end of the) spectrum of, 'Yeah, we've been fighting this for 10 years; I've been expecting it,'" Jorgensen said. "Sadly, (there is) also a huge range of how expressive or honest they are about it."
Jorgensen has seen some positives come out of the heroin battle.
There's a single mom, for example, who calls or emails Jorgensen every so often to talk about how she's coped with the loss of her 22-year-old son last year to a heroin overdose. It's a bittersweet moment when he receives her messages.
"I'm all for that," he says of staying in touch with families who were affected by heroin. "I think it's great that we're able to provide a service beyond just issuing a death certificate."
DuPage is among the few places in the nation to have a countywide Narcan training program in place for all police officers, thanks in large part to Jorgensen's willingness to get the ball rolling last year.
This year, 20 lives have been saved because police used the antidote. Lake and Kane counties are in the process of launching similar initiatives.
The number of people dying is going down, too, if only slightly at first. In December 2013, there were zero heroin deaths in DuPage County. So far this year, through the end of August, there have been 24.
"That to me is a concrete sign of success," Jorgensen said.
Still, he urges residents to continue demanding action. And he stresses that admitting there's "a heroin problem" in the suburbs doesn't mean towns or schools or parents are to blame.
"This is a challenge to our society right now," he said. "Rather than shuffle it under the table, we've gone forward. It is a problem, and we're addressing it."