In the wake of a heroin bust in Vineyard Haven last Tuesday that led to the confiscation of nearly $70,000 in cash and illegal drugs and the arrest of six people — three from the same family — came warnings that heroin use is a serious problem on the Vineyard.

The Island community reacted to the arrests with shock, sadness and in some cases outrage in reader forums of both Island newspapers. Another reaction was surprise — not only about the amount of drugs seized and number of people arrested, but about the drug involved, heroin.

Dr. Timothy Tsai, director of emergency medicine at the Martha’s Vineyard Hospital, said however there is no question heroin continues to be a problem on the Vineyard.

“I would say in general narcotics abuse is fairly prevalent on the Island; heroin is no exception. I do get the strong impression, based both my own and my colleagues experiences, that the abuse of heroin and prescription drugs is at least more obvious here than other places,” he said.

Dr. Tsai said following a large drug bust like the one last week, there often will be a spike in the number of people arriving at the emergency room suffering from symptoms that might indicate drug withdrawal. Although there were no figures to bear that out, Dr. Tsai said there was anecdotal evidence this may have occurred last week.

Dr. Tsai said the symptoms of heroin withdrawal are recognizable, even if a patient isn’t forthcoming about his or her drug use. He said people suffering from an overdose or withdrawal do not have to worry about being turned over to the police; caregivers are simply interested in treating people.

But due to a lack of information, doctors and caregivers are often are left to treat only the symptoms and not the larger problem of addiction. If someone went to the hospital and asked for help battling their addiction, Dr. Tsai said, they would readily receive the help they need.

“It’s not just a requirement, it’s an ethical obligation. If someone comes in and asks for help, they will get the treatment they need. But they have to want to get better. They have to want help,” he said.

John Early, president of the Vineyard House, a sober house for recovering addicts, said there is a common perception that heroin is either a small problem on the Island or not a problem at all.

“People think we’re removed from that type of drug. They think heroin addiction isn’t a problem here. And I can say from experience it is a problem . . . it seems to be more of a problem here than other places,” he said.

Mr. Early said it was hard to tell why heroin and other drug abuse may be more of a problem here than elsewhere. He speculated that drug abuse in a small community like the Vineyard can have a strong ripple effect.

“Drug use and alcoholism is often cyclical . . . especially in a tight-knit community like this,” he said.

Brian Mackey, former executive director of the Vineyard House who now does clinical work for the Massachusetts Association for Sober Living, said heroin has been a problem on the Vineyard for quite some time.

“I think it’s always been around. That hasn’t changed. Even if a big supplier is arrested it will still get here. If there is a demand, there will continue to be a supply,” he said.

Members of the Martha’s Vineyard Drug Task force executed a search warrant at the Garde home at 139 Spring street in Vineyard Haven just after 6 p.m. and arrested three members of the Garde family and three other suspects for alledgedly running a drug operation out of the home.

Arrested were Caleb Garde, 24, Hannah Garde, 22, Daniel Garde, 19, Garret Gibson, 24, Alexander Carlson, 21 and Rosaline Gaspar, 24. All six defendants were back in the Edgartown courthouse for pretrial hearings on Monday and were assigned December court dates for their next pretrial hearings.

Cape and Islands assistant district attorney Bryan Shea said Caleb Garde was still being held in the Edgartown house of correction on $50,000 bail. Mr. Shea said Hannah Garde and Daniel Garde appeared in Barnstable Superior Court on Wednesday for bail review and both were ordered released with a promise to appear back in court.

The other suspects — Mr. Carlson, Mr. Gibson and Ms. Gaspar — have already been released on bail, he said.

Mr. Shea said he could not comment on whether additional suspects might be charged. He said it was possible that some or all of the charges may be moved up from district to superior court.

According to police, Ms. Gaspar was arriving at the Garde home just as police were executing the search warrant. She reportedly fled in her car and was apprehended two blocks away. A police detail working along Pine Tree Lane last Friday morning reportedly found three small bags of heroin, not far from the Tisbury School playground.

In response to that discovery, officials at the Tisbury School sent a letter home to parents explaining the potential dangers of students finding illegal drugs.

“In light of the recent drug raid, please be vigilant with your children as there may be drug paraphernalia that may have ended up in the yards and in the streets around our building,” said the letter from principal Richard Smith. “Our concern is for students walking to school. Police are continuing their search of the immediate area for any of this paraphernalia.”

Although the relatively young age of the suspects came as a surprise to some, there is evidence that heroin use among young people is increasing both nationwide and here on the Vineyard.

A recent study from the University of Michigan concludes that while the use of illicit drugs by eighth, tenth and twelfth graders is down in recent years, heroin use has remained steady, with just under one per cent of the students saying they had used it in the past year.

The use of most drugs, like heroin, has remained fairly constant nationwide in recent years after declining early in this decade, according to the Michigan study. One published report said recently that federal officials believe heroin use is rising among young adults in suburban and rural communities, particularly in the Northeast.

A study conducted by the Drug Abuse Warning Network, a federal system that monitors drug-related hospital emergency department visits and drug-related deaths, indicates that emergency room visits across the nation involving heroin has risen in recent years.

In 2003, the study concluded, roughly eight per cent of emergency room visits related to illicit drugs involved heroin. In 2005, the last year statistics were available, that figure rose to 20 per cent.

Dr. Tsai said it is hard to tell whether the number of heroin-related visits to the hospital has increased for several reasons; figures compiled do not break down drug-related visits into individual categories and patients are usually reluctant to share information about the drugs they took.