Carbon County doesn't have a major city, but it does have a major drug problem, the county medical society heard this week.

Deputy Sheriff Anthony Harvilla said, "We are tucked in a corner of the state away from Philadelphia and Allentown, but we still have a major drug problem."Harvilla served as a probation officer before coming to the Sheriff's Office.According to a 2013 Arrestee Drug Abuse Monitoring program, 50 percent of drug offenders tested positive for more than one illegal drug, 69 percent never participated in a substance abuse treatment plan, two-thirds had a high school diploma, less than 10 percent served in the military and more than half had health insurance.Carbon County's statistics follow similar trends, according to Harvilla. In the county, 28 deaths were attributed to drug-related problems.Driving under the influence of drugs is more prevalent than DUI alcohol offenses according to Engler."We have one of the more liberal drug attitudes in Pennsylvania, anyone who wants to enter a substance abuse treatment program and is sincere about quitting will be given a chance," said Carbon County District Attorney Jean A. Engler.In her discussion, Engler presented an informal study."One of the county judges took a non-scientific study and estimated that 85 percent of the cases that come before him are drug related."Even if the case isn't classified as a durg case, the crime often stems from an addictionFor example, Engler said a forged prescription is logged as a forgery. Retail theft is often related to someone stealing merchandise to drugs.Engler identified "Route 93 pipeline" out of Hazelton where drugs are sourced and brought into the county. "Dealers can get in and get out of the county quickly," she said.In Carbon County, Harvilla reported 1,300 prison admissions in 2014 with an average jail population of 206.The county has a work release program with 94 participants."A probation officer has a case load of 172 … there isn't enough time to delve deeply into psychological problems of each offender," he said. A quarter of the offenders under probation return to the prison system.The new emphasis in the county is a re-entry program where offenders are introduced back to society with support from skilled practitioners. The program has benefits, but is a costly adventure."We hate to say that we lack funding on these programs," Engler said.The drug of choice in Carbon County is heroin. "(Heroin) is an opiate-based drug similar to prescription drugs, only cheaper," Engler said.According to Engler, abusers sell prescription drugs and get money to buy heroin. A drug abuser can get four times the amount of heroin for the same price as prescription drugs.It is a tough problem to deal with because the medical profession is not geared to deal with high levels of abuse."If someone comes to us with pain, we are obliged to give them some relief," said Dr. Shaukat Khan, Internal Medicine at Blue Mountain Health System-Palmerton. "We created a monster with pain management programs."Although there is an argument that pain medication is over-prescribed, there is often little recourse. "Patients know how to circumvent the system," Hasan said.If a pain prescription is canceled, patients often turn to heroin."We see instances where someone comes in late on Friday and says their doctor's office is closed and they need a prescription for pain," Hasan said.To counteract abuse, some care centers now take a quick blood test to see if there are traces of the drug. If no trace of the drug is found, the patient probably intends to sell the drug.Another complication involves the Veterans Administration. Prescribed drugs are not coordinated with local facilities.Nancy Hersch, director of behavioral health for Blue Mountain, expressed her frustrations with repeat offenders.Hersch estimates that 70 percent of the behavioral illness cases she deals with are drug related. Harvilla agreed. "We have people that do well on supervised programs. Once they are released, they go right back," he said.A list of drug offenders is not really possible with the national emphasis on medical privacy, she said.Hasan said the solution is for people to understand the problem and working together toward a common goal.