With a tidy mustache and a crisp button-down shirt, Joseph Coronato is an unlikely tour guide into the world of heroin, but on a recent afternoon, he sat at a big wooden desk, shirtsleeves rolled up, with a spread of heroin before him.

“This is one hit,” he said, holding a sealed plastic bag containing a small amount of powdered heroin wrapped in paper. It was about the size of a razor blade and the dealer had stamped with a red “Handcock” brand.

This heroin was evidence from a closed criminal case. Coronato, the Ocean County Prosecutor, has been on the job only about nine months, but he has faced a trial by fire when it comes to heroin. There have been over 100 drug overdose deaths this year in Ocean County alone — nearly double the number from last year — the majority of which have involved heroin. 

“I guess it was about two weeks into my term, there was an overdose death every day for about 10 days straight,” he recalled. “You could see that there was a problem here that was spiraling out of control and something had to be done.”

Price, purity and pills

The deaths in Ocean County can’t be traced to a simple source, such as a bad batch of the drug or new shady supplier, says Coronato. It cuts across all towns in the county and all age groups, though 20 to 28 year olds have been most impacted. The county's proximity to Philadelphia, a major source for heroin on the East Coast, may be a factor. But Coronato and other experts believe overdoses are largely caused by the confluence of three factors that have been driving an increase in heroin use across the country in recent years: price, purity, and prescription pills.

“Heroin over the last 20 years in the U.S. has become cheaper and purer,” said Dan Ciccarone, a professor at University of California, San Francisco.

Starting in the 1990s, Colombia began to displace rival heroin suppliers in Afghanistan, Laos, Thailand, and Vietnam in the U.S. market, especially on the East Coast.

“It did that by coming in with a really high-quality product, a product that people liked and used,” said Ciccarone. “That’s how you get pure heroin at a cheap price, just through competition.”

Pure heroin stregnth makes it especially dangerous for novice users. Additionally, it can be snorted, which may appeal to users who were hesitant to inject the drug.

Additionally, there is a growing pipeline of users coming to heroin after first abusing prescription pain killers, like Oxycontin or oxycodone, said Ciccarone.

An individual might start by using drugs they were prescribed for legitimate reasons, stealing the pills from a family member, or simply buying them on the street. But prescription pills are expensive.

“If you buy prescription pills on the street, it's … like $20, $25 just for one pill,” said Harrison, a 28-year-old recovering heroin user from Atlantic City. He's just four months clean, in a methadone treatment program, and he asked for his last name to be withheld.

Harrison says for just $5 to $7, he could by a bag of heroin that would give him the same high as two pills that cost $50.

“There's no difference,” he said. “[You] go through the same exact withdrawal, same exact feeling when you're getting high. It's something that you don't want to fall into.”

Getting Help

Harrison’s addiction began with a car accident and a prescription for Percocet. When the doctor cut him off after a year and a half, he started buying the pills on the street, then moved to snorting heroin and finally injecting it.

“That scared me most,” he said. It only took a couple of weeks of injecting heroin before he decided to he needed to quit. “I couldn't see myself actually hurting until this one day I just woke up and I was looking around seeing needles on the table,” he said. “I was like, ‘That ain't me,’ so I went straight to go and get help.”

That help came from Oasis, a storefront in Atlantic City run by the South Jersey AIDS Alliance. It gives addicts clean needles and access to tests for HIV, hepatitis and pregnancy. The staff got Harrison into a local treatment program.

Babette Ritcher, a nurse at Oasis, says people come down from Ocean County, up from Cape May. In the last two years, they have distributed 50 percent more clean needles.

“I would say, in the last year, I've definitely seen an upward trend of the younger students, younger individuals coming in seeking help,” Ritcher said. “Today, [users] tend to be more white, young — girls and boys, in their early twenties.”

Looking for solutions in N.J.

With so many different kinds of users and the many reasons they overdose, it's really tricky to tackle this problem. So New Jersey is trying a little bit of everything, making an overdose antidote called Narcan more available. Since May, a new state law prevents legal trouble for those who call 911 to help an overdosing friend.

Prosecutor Coronato also wants to change the way dealers are charged. Right now, it's by weight, but pure heroin is very light.

“You can have one brick, three bricks, probably 500 hits of heroin, and it'll still only be a third-degree crime,” said Coronato. 

For third-degree crimes in New Jersey, defendants typically won’t face jail time.

Coronato has also put drug-sniffing dogs in Ocean County schools, run community forums for drug education, and created pill drops at funeral homes so people can get rid of excess prescriptions after the death of a family member.

However, perhaps most notably, he's also started prosecuting dealers if their customers overdose. He's charged three dealers so far, and he says there's more to come.

On Thursday, Dec. 12, at 6 p.m., the Ocean County Prosecutor's Office will hold a public meeting to discuss the county's efforts to reduce the heroin epidemic. The forum will be at the Stafford Township Arts Center/Ocean First Theater, 1000  McKinley Avenue, in Manahawkin, N.J.