(Graphic by Norine Longo.)
Nick Harris was an addict, and he knew it.

The 23-year-old Hamilton resident had been in and out of treatment for years. He dropped out of Steinert High School because of his addiction to heroin, and had been fighting to get his GED. He liked to go to the beach, to fish, to play disc golf and to work for his family’s business, Harris Moving. He wanted to beat his addiction, and so did his family, who loved how he could light up a room with a joke or a smile. He never gave up, despite the frustration of the addiction cycle—relapse, rehab, sobriety, relapse.

Harris had been working with Recovery Advocates of America, and he became more involved volunteering to help spread the word about addiction. His family did, too, including his brother Dave, a recovering addict who has been sober for a year.

Nick had been sober for two months, and everyone thought this would be the time that he would break the cycle and stay in recovery. He had been doing the things he needed to stay clean, including attending Narcotics Anonymous meetings.

He had been at a NarAnon meeting the evening of July 23. He went home that night, and at some point between 11:30 p.m. and 1 a.m., he overdosed on heroin and died.

Harris and his family are just a few of the local people affected by the heroin epidemic, a trend that’s destroying thousands of American lives each year. Heroin addiction has doubled in the United States since 2002, and heroin-related overdose deaths have nearly quadrupled in the same time period, according to the Centers for Disease Control. The relapse rate for addicts who seek treatment is estimated at 95 percent, meaning addiction is a lifelong struggle for the people and families altered by it.

Mercer County is shaping up as a key battleground in the national fight against heroin. In 2015, 55 people in Mercer County died from drug overdoses, up from 38 in 2014, according to the Opiate/Heroin Taskforce of Mercer County. Trenton is a hub for the drug’s distribution with prices one-fifth that of other cities and with some of the purest heroin in the nation. People come from across the state for Trenton’s heroin, with easy access from the New Jersey Turnpike, Interstates 195 and 295 and U.S. 1.

Even in the cozy suburbs, the impact of opiate use and abuse is being felt. Towns like Robbinsville are getting drug arrests everyday, Robbinsville Police Detective Scott Kivet said, just by doing routine traffic stops. Of the 430 people arrested by the Robbinsville Police for narcotics since 2015, about 65 percent of those were for heroin and opioids.

In a battle where the odds are slim and worsening, every town is trying to do something to deal with the problem.

In Robbinsville, they are doing more. In January, Kivet helped launch Robbinsville CARE, a program introduced as a partnership between Robbinsville’s municipal government, police department, municipal alliance, addiction nonprofits like Recovery Advocates of America and City of Angels, treatment centers and medical professionals. CARE is a systematized approach to dealing with heroin addicts from the first moment of police contact. It seeks to break the cycle of addiction—and the need for police to respond to it—by offering people caught with or using an opioid the chance to speak to an addiction counselor and even to enter a treatment center.

Since Robbinsville launched CARE in January, eight of the 19 arrestees who were offered intervention accepted and received treatment. Three of those eight did not have health insurance, but received aid through Recovery Advocates of America scholarships. The program uses existing resources and nonprofit agencies, meaning there is no cost to the township.

RPD is just one of a growing number of agencies in Mercer County who have sought to do more in the fight against heroin and opioid addiction. West Windsor Police has developed a program similar to Robbinsville CARE, and plans on unveiling it later this year, as do two other Mercer County towns. Hamilton announced a “community response plan” in May that limits the direct involvement of the municipal government, but focuses on offering training to residents through nonprofits and enhancing drug education in public schools. And the Mercer County Prosecutor’s Office has started exploring next steps to its successful effort to arm law enforcement officers with Narcan, an opioid antagonist that can revive an overdose victim. Among those next steps are hosting forums in each town in Mercer County to confront the issue and discuss community-centered responses to addiction.

“The feeling is, we’re not doing our job if we’re just arresting them,” West Windsor Police Lt. Matt Kemp said. “The addiction is still there. Most likely, we’ll see them again. It doesn’t end. We’re not doing the public any favors by just locking them up and throwing away the key.”

A town like West Windsor—with a median household income well above the statewide average and a nationally ranked school district—wouldn’t seem to be a likely candidate for drug problems. But in 2015, the police department had to deploy Narcan 10 times. Three people died of overdoses in West Windsor last year, Kemp said.

In Hopewell Township—another affluent town with a strong school district—two people have died from overdoses in the last year. Eight people died from overdoses in Ewing in 2015. Another 10 died in Hamilton. Two more in Robbinsville. The statistics have shown heroin and gateways like prescription drugs are a big problem that’s affecting everyone.

“It’s so diverse, it’s ridiculous,” Kemp said.

“There’s no lines anymore with this stuff. It destroys everybody.”

Much of the problem stems from two factors. First, more people are using the drugs. According to the National Institute on Drug Abuse, American doctors wrote 207 million prescriptions for opioids such as Vicodin, Percocet or oxycodone in 2013, double the number prescribed 15 years prior. Those prescriptions are the start of the most common path to heroin addiction, where a surgery patient becomes addicted to painkillers and then progresses to the much-cheaper heroin. Mercer County Acting Prosecutor Angelo Onofri said one oxycodone pill sells for $20 on the street; it’s not uncommon to find one bag of heroin locally for as low as $2. Both drugs achieve the same high.

According to the National Center on Addiction and Substance Abuse at Columbia University, teens who abuse prescription drugs are 20 times more likely to use illegal street drugs such as heroin.

The second factor is geography. With proximity to New York City and Philadelphia, Trenton is a hub, and buyers travel to this area seeking what is hailed as the purest heroin in the country. Kivet said business has boomed so much that distribution has spread into neighborhoods in Ewing and Hamilton. Ewing Police Capt. Rocco Maruca confirmed that his department has seen “hot spots” of heroin dealing in Ewing.

“Where there’s buyers, there’s going to be dealers,” Maruca said. “They go together.”

The Prosecutor’s Office Special Investigations Unit—with officers from Hamilton, Lawrence, Ewing, the Mercer County’ Sheriff’s Office and the New Jersey State Police—seized $3.6 million in heroin and $3.9 million in cash from dealers last year. Onofri said the unit has the county well-covered, but the feeling among many in police was they had to pursue more than just enforcement.

“It’s like a revolving door,” Kemp said. “We have to do something different.”

Those efforts started in November 2014 when the Prosecutor’s Office provided Narcan to every law enforcement agency in the county. Since the program’s launch, law enforcement in Mercer County has deployed the drug 122 times; 107 of those resulted in overdose reversals. Of the 122 deployments, Hamilton has had 51 of them. Ewing is the next highest at 14.

But the prosecutor’s office realized even more needed to be done last year, Onofri said, after an incident in Hamilton where police revived the same overdose victim with Narcan twice within 24 hours. Hamilton Police had transported the man to the hospital after his first heroin overdose, but could do no more. The man checked himself out of the hospital against medical advice, went back to using and overdosed again.

“That was the wake-up call,” Onofri said.

Onofri said governments and law enforcement must have a multipronged plan that addresses addiction before, during and after someone uses heroin or an opioid. That includes education to prevent people from ever using drugs, Narcan to assist those who have overdosed, and counseling and treatment options for those who are addicted.

Officers from his agency will be going into schools in Hamilton this year to teach students about the Overdose Prevention Act and Narcan. With the help of the Prevention Coalition of Mercer County, they have distributed packets full of information about recovery and treatment options—called Step To Action Recovery Treatment—to every police department and hospital in Mercer County, as well as to state police officers in the area. Police and hospital staff have been instructed to hand the packet to every person with a reversed overdose they encounter. Onofri said emergency room staff at RWJ Barnabas Health and Capital Health System have gone a step further, offering people a chance to speak with an addiction coach from Recovery Advocates of America or City of Angels.

But, unless a municipality has all three prongs of the addiction plan, there will be gaps, Kivet said. Robbinsville CARE has been built to guide people through the system without interruption, should they choose to take advantage of it. The theory is to not only give someone a second chance, but also ease the burden on police. This includes having to respond to the associated crimes to drug addiction, such as burglary, shoplifting and theft.

The CARE protocol kicks in as soon as someone is found with heroin or opioids.

The person is arrested and brought into RPD headquarters. Once there, Kivet or another trained officer will talk to him about his drug use and try to relate to the person “as a human” about how the drugs have affected his life. The officer will offer the person a chance to speak to someone from Recovery Advocates of America or City of Angels about addiction. This is the ideal time to offer help, Kivet said, because a reversed overdose or a drug arrest acts as a “reality check,” a time when addiction has concrete consequences.

Should the person accept, RPD will place a call to one of the organizations; a representative typically arrives within an hour. In the meantime, the arrested person gets fingerprinted and goes through the typical post-arrest procedure. The counselor and arrestee will then go into a private room to talk, where the counselor will discuss the person’s addiction further and offer the chance to get detox or go to rehab. Robbinsville does not pay for the treatment, but does work with RAA to find scholarships for people who cannot afford it.

Kivet will later follow up with the addict to reinforce that their “job is to get better.” The person will then send RPD certified letters verifying the dates they will be in rehab, and RPD will then work with the courts to ensure the dates do not coincide with the person’s treatment.

This is a crucial part of Robbinsville CARE. Should people attempt to go to rehab outside of a program like Robbinsville CARE, there is no guarantee they will be out before their court date, Kivet said.

“When we arrest somebody, they still have to go to court,” he said. “We’re not dropping the charges. You make the bed you sleep in. But I’m not going to take somebody out of rehab because they have to go to court, where they’re not focused anymore and get depressed. What we do is work with the court. And that’s an important factor. It’s all about the program, and you can’t do it half-assed.”

Robbinsville is the first municipality in Mercer County to have this kind of plan, but the program and the problem it addresses are not unique. New England faces a similar crisis with heroin, and towns in Massachusetts have led the way, first with Narcan and now with providing a link between addicts and treatment. Gloucester, about 30 miles outside of Boston on Massachusetts’s North Shore, introduced a program in June 2015 that entered 30 people into treatment in its first 30 days. Police in Brockton, 25 miles south of Boston, assisted 22 people in entering addiction-recovery programs in the first month of its initiative, launched in late February 2016, according to The Brockton Enterprise.

Some in Mercer County have jumped at the opportunity to add similar programs. In West Windsor, police had already been kicking around the idea of a program like CARE before Robbinsville launched it, and have begun to meet with Recovery Advocates of America, City of Angels and community groups like the religious leaders of West Windsor. Kemp said once he has community buy-in, WWPD will meet with RPD to see what has worked and what hasn’t with CARE. WWPD will then adapt the program for its community.

Hopewell Township Police Chief Lance Maloney also said he has been in touch with the Robbinsville Police about CARE, and wants to see if the program makes sense for his municipality. Maloney said he has received a packet of information about CARE from Robbinsville Police Chief Chris Nitti, but has yet to review it.

“I have to take a look at that,” Maloney said. “[Instituting CARE in Hopewell] is an option.”

But the two suburban towns that have had the most issues with heroin statistically—Hamilton and Ewing—have not yet come on board to address the treatment side of the equation.

In the last four years, Ewing and Hamilton have most overdose deaths outside of Trenton, 18 and 29 respectively. (Ewing, with less than half the population of Hamilton, has a worse rate.) And the towns also lead the way on Narcan deployments, which essentially would have been overdose deaths had Narcan not been used.

In Hamilton, police, like all law enforcement agencies in Mercer County, use Narcan to reverse overdoses and distribute START packets to overdose victims or their families. Mayor Kelly Yaede, along with other township officials, also has received training on how to administer Narcan.

But the majority of the focus has been on education and prevention. In March, Hamilton unveiled a permanent prescription drug collection box at police headquarters. Yaede said in the first five months of the box, Hamilton Police have collected 507.2 pounds of prescription medication. Hopewell Township, Lawrence, Princeton, Robbinsville and West Windsor have similar boxes. As part of the township community response plan released in May, the municipal government also has worked with the school district to add emphasis on heroin and opioids in the existing school drug curriculum, as well as to provide guest speakers to address the issue during existing drug awareness weeks in the fall and spring. Hamilton already has an active municipal alliance and an in-school program run by police called Law Enforcement Against Drugs that also focuses on prevention.

Onofri gave Hamilton credit for its education efforts, calling Yaede a “superstar” in pushing prevention as a way to combat the heroin epidemic.

Ewing, meanwhile, also has a municipal alliance, and has been primarily focused on stopping drugs on the street. EPD’s Community Response Unit deals with narcotics, arresting street-level dealers and using tips to crack down on areas with a lot of drug activity.

Maruca, the EPD captain, said the department doesn’t have anything like CARE in the pipeline currently, but “it probably is something we will look at.”

Kivet said prevention, education, Narcan and enforcement are all excellent tools in the fight against heroin. But he wonders why municipalities and their police departments have yet to treat a drug arrest the same way they would a DWI—with some sort of follow-up and counseling for the person after the arrest.

In his mind, it’s vital that governments, first responders and the community come together with a comprehensive plan if Mercer County ever hopes to rid itself of the heroin and opioid crisis.

“The problem’s not going to cure itself,” Kivet said. “There’s not going to be a medicine, where it’s ‘take this and you’re done.’ It’s not going to work that way. We are the medicine.”