Tidal wave of heroin overdoses followed pain doctor raid

MUNCIE, Ind. — Since local, state and federal authorities raided a pain doctor's clinic in Muncie in October 2014, overdoses from illegal opioids such as heroin and fentanyl have exploded.

For most of the decade before authorities raided William Hedrick's pain clinic on Muncie's north side, Delaware County EMS responded to a couple of hundred overdose calls a year.

In the three years since that raid, ambulance runs for overdoses have nearly doubled and are more than four times what they were in the years before that. In the first 10 months of 2017, ambulances rolled on 753 overdose calls and EMS gave 556 doses of overdose recovery drug Narcan, compared to 226 overdose calls and 152 doses of Narcan in 2013.

And overdose deaths as determined by the Delaware County coroner's office have jumped from 41 in 2015 to 54 through in the first nine months of 2017.

National health statistics say that in Delaware County, 35 percent of all deaths of all those ages 15 to 44 are from overdoses, The New York Times reported on Oct. 26.

Authorities say they don't doubt that busting Hedrick's operation forced his patients to turn from dangerously over-prescribed pills and pain injections to heroin and, more recently, the synthetic opioid fentanyl.

"I don't think there's any question it did," Delaware County Prosecutor Jeffrey Arnold told The Star Press. "I have defendants say to me, 'What do you expect? You shut it down.'"

But Arnold said he doesn't regret cooperating with state and federal authorities in busting Hedrick.

"I'm not going to be responsible for somebody's addiction," Arnold said.

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'A huge case'

Physician William Hedrick, who practiced medicine in northern Indiana, opened his Muncie office, known variously as the Center for Pain Relief or Indiana Pain Center, in July 2013. At that time, The Star Press noted that Hedrick had already been placed on a two-year probation by the Indiana Medical Licensing Board.

The Muncie office, in Lyndenbrook, quickly took on patients — sometimes a hundred or more a day — and Hedrick and his staff wrote pain medication prescriptions and administered pain-relief injections, the latter at a cost of up to $1,000 each. Hedrick practiced at several offices in the northern half of the state.

Zach Craig, the deputy prosecutor who oversaw the October 2014 raid and has handled the case since, said Hedrick's office's revenue came in large part from insurance and Medicare and Medicaid reimbursement.

Craig said that as far as he knows, no one has definitively tallied the amount of money that moved through Hedrick's practice. "The number of offices, the number of employees, times 100 patients a day," Craig said. "But I haven't heard a dollar figure."

The raid of the Muncie office resulted in three counts of forgery, three counts of prescribing controlled substances with a surrendered DEA registration number, two counts of unlawful dispensing of a controlled substance, Medicaid fraud and four counts of corrupt business influence being filed against Hedrick.

Hedrick's trial has been postponed several times since charges were filed. The most recent trial date set is March 19, 2018, a revised trial date since August, when his defense attorney withdrew from the case.

But even though the trial date has been postponed, Craig said work on the case has not slowed.

"That never stops our investigation" and determination if other charges should be filed, Craig said.

The prosecutor's office investigation has amounted to "thousands" of staff hours, Arnold said. "That's a huge case for an office our size."

The impact of the case has been great not only on the prosecution, however.

Jump in ODs, Narcan doses

For months, Delaware County law enforcement and emergency services officials have spoken publicly about the impact of heroin and fentanyl abuse, with an increasing number of arrests, prosecutions and overdoses, both fatal and otherwise.

And while Delaware County's EMS ambulance service has, for more than a decade, responded to overdose calls, the number of OD runs only topped 200 beginning in 2012 and instances in which Narcan were administered only topped 100 that same year.

But in 2014, the year of the pain clinic raid, overdose calls nearly doubled, to 402, then increased to 618 in 2015.

In 2016, OD runs for the ambulance service jumped to 703 and Narcan doses increased to 435.

In the first 10 months of 2017, overdoses jumped to 753 and Narcan doses increased to 556.

IU Health Ball Memorial Hospital's Emergency Department treats an average of 1.5 overdoses a day, the hospital said last week.

The increase in heroin and fentanyl overdoses in Muncie and Delaware County has been widely reported. But the outsized impact on death rates is staggering.

Citing numbers from the Centers for Disease Control and Prevention and the National Center for Health Statistics, As part of a county-by-county national overview of overdose deaths, The New York Times reported in October that 35 percent of the deaths of Delaware County residents ages 15 to 44 are overdoses.

In surrounding counties, Wayne County is closest in number, with 29 percent, followed by 26 percent in Madison and Blackford counties. Other counties in the area range from 14 to 16 percent.

Deaths before and after the pain clinic

According to figures released by Delaware County Coroner Scott Hahn, overdose deaths in the past three years have been spread over a broad demographic.

In March 2017, for example, eight people in Delaware County died from overdoses. Four were women and four were men. Their ages ranged from 20 to 57.

Arnold said authorities know that "pill mills" — medical offices that traditionally are an easy source of prescriptions — create addiction, so it's no surprise that when the supply was cut off, some turned to their family doctors and some turned to what Arnold called "street pharmacies."

"It created a huge void of supply, and that supply was filled by drugs on the street, including heroin, and that was even before fentanyl," Arnold added.

Arnold and Craig said that local, state and federal authorities couldn't stand by and let Hedrick operate: Early on, authorities said his practice caused the deaths of eight people through over-prescribed medication.

Keith Roysdon is the government watchdog reporter for The Star Press. Contact him at 765-213-5828 and kroysdon@muncie.gannett.com.

Delaware County's drug overdose problem by the numbers

In Delaware County, 35 percent of all deaths of all those ages 15 to 44 are overdoses, The New York Times reported on Oct. 26.

Nationally, drug overdoses have increased by more than 650 percent since 1990.

Local overdose response/treatment

In Delaware County, drug overdoses have increased steadily since 2004 but have taken a jump since local, state and federal authorities raided the northside pain clinic of physician William Hedrick in October 2014.

(Note: While overdoses can spring from many sources, including alcohol, the number of doses of Narcan, a heroin overdose recovery drug used to revive overdose patients, is an indicator of how many heroin and fentanyl overdoses that Delaware County Emergency Medical Service personnel have responded to.

2004: 152 Overdose Calls / / Gave 153 doses of NARCAN

2005: 136 Overdose Calls / / Gave 72 doses of NARCAN

2006: 137 Overdose Calls / / Gave 114 doses of NARCAN

2007: 170 Overdose Calls / / Gave 162 doses of NARCAN

2008: 155 Overdose Calls / / Gave 195 doses of NARCAN

2009: 169 Overdose Calls / / Gave 151 doses of NARCAN

2010: 151 Overdose Calls / / Gave 97 doses of NARCAN

2011: 175 Overdose Calls / / Gave 90 doses of NARCAN

2012: 236 Overdose Calls / / Gave 153 doses of NARCAN

2013: 226 Overdose Calls / / Gave 152 doses of NARCAN

2014: 402 Overdose Calls / / Gave 152 doses of NARCAN

2015: 618 Overdose Calls / / Gave 261 doses of NARCAN

2016: 703 Overdose Calls / / Gave 435 doses of NARCAN

2017: Year to date through Oct 24th. 753 Overdose Calls / / Gave 556 doses of NARCAN

Overdose deaths in Delaware County

Deaths from drug overdoses have increased, according to the Delaware County coroner: The numbers below are for deaths attributed to overdoses, although in dozens more deaths, drugs were found in the deceased person's system.

2015 fatal overdoses in Delaware County - 41

2016 fatal overdoses in Delaware County - 42

2017 fatal overdoses in Delaware County (through September) - 54

Overdoses treated at the hospital

IU Health Ball Memorial Hospital treats an average of 1.5 overdoses a day in its Emergency Department.