Maine leads the nation – by far – in the percentage of residents being treated for addiction to painkillers, according to new federal data covering 1998 to 2008.

The distinction comes as no surprise to Maine law enforcement officials or addiction specialists, who say a growing epidemic of abuse of OxyContin and other pain medications is driving crime and filling a growing number of treatment centers.

The latest federal statistics, released last month, show that in Maine, painkillers are even gaining on alcohol as the No. 1 drug addiction for which Mainers seek treatment.

Experts say there is no single explanation for Maine’s extreme treatment rate, but there is no doubt that the numbers reflect a surge in abuse and addictions over the past decade.

Other statistics confirm that Maine ranks at the top in its rate of addictions, whether people are being treated or not, experts say.

Dr. Mark Publicker, an addiction medicine specialist at the Mercy Recovery Center in Westbrook, said abuse of prescription painkillers is growing among both adults and children, who face a higher risk of lifelong brain damage.

“It’s 10 (percent) or 15 percent of high schoolers who have used opioids in the last month,” he said.

“It appears in many cases (that) opioids have become the gateway drug, not marijuana.”

In Maine in 2008, 386 of every 100,000 residents age 12 or older were admitted for treatment of painkiller addiction, according to the Substance Abuse and Mental Health Services Administration report.

That was more than eight times the national rate of 45 per 100,000 people.

The opiate painkiller category includes hydrocodone, oxycodone, morphine and other drugs with morphine-like effects. Oxycodone is the active ingredient in OxyContin.

Vermont is the only state to come close to Maine, with a treatment rate of 331 per 100,000 residents in 2008. No other state topped 150.

By comparison, Maine’s treatment rate was 119 per 100,000 for marijuana and 111 for heroin. The only 2008 treatment rate to exceed the painkiller rate in Maine was alcohol addiction – 399 treated per 100,000 people.

That does not include Mainers who were treated for multiple addictions, including alcohol.

The addiction explosion has fueled crime, including murders, robberies and home invasions, said Roy McKinney, director of the Maine Drug Enforcement Agency.

“Our DEA’s arrests for controlled prescription drugs was in the low single digits (in 1997). Last year, 42 percent of all drug-related arrests was related to controlled prescription drugs,” McKinney said.

In 1998, Maine’s treatment rate for painkiller addiction was 28 per 100,000 residents.

Even then, however, Maine was tied for the highest treatment rate, with Rhode Island.

“It’s been something we’ve been tracking for a long time,” said Guy Cousins, director of the Maine Office of Substance Abuse.

The office has worked with law enforcement, doctors, patients and others to prevent abuse and reduce addictions, he said.

While it’s the clear leader, Maine isn’t the only state to experience a surge in painkiller addiction.

“The misuse of prescription drugs such as narcotic pain relievers is probably one of the fastest-growing drug problems in the country right now,” said Peter Delany, head of the research office that produced the federal report.

The national rise in abuse is considered a side effect of opiates being used much more widely by the medical community as a way to improve the treatment of chronic pain.

The increase in prescribed use has made the drugs more available to be diverted for abuse.

“We’ve made some major strides in the last 20 years in addressing pain in this country,” Delany said.

“The question is, how do we make sure people are taken care of from a pain perspective and at the same time prevent access to other people?”

It’s not known for certain why Maine is first in the treatment rate, although there are some theories.

Maine has more addiction treatment options than some other states do, Cousins said. But the state still can’t treat all of the addicts who want help, he said.

Publicker, the addiction medicine specialist, said he believes the regions of the country that have the higher rates – New England and southern Appalachian states – are the markets where OxyContin was first introduced.

“These states were more heavily marketed for OxyContin by Purdue,” he said.

Purdue Pharma LP, the maker of OxyContin, paid a $634 million fine in 2007 after officials pleaded guilty to misleading the public about the drug’s risk for addiction.

The nation’s painkiller addiction clearly began more than a decade ago in rural areas, including northern and eastern Maine.

That was largely a factor of the drugs’ ready availability in those places, unlike illicit drugs, which are not stocked in pharmacies or legally prescribed to friends or family members.

Cousins and others said painkillers may also have become more available in a rural state such as Maine because its work force, including loggers, fishermen and other physical laborers, is more susceptible to work-related injuries and chronic pain.

Maine has had a relatively high rate of painkiller prescriptions, Cousins said.

McKinney, the DEA director, said Maine may be a leader in painkiller addictions simply because it had a head start.

“Prescription drug abuse was seen as a pretty low threat except for certain rural states such as Maine. And then it just exploded across the country,” he said. “We’ve certainly had that experience much longer.”

 

Staff Writer John Richardson can be contacted at 791-6324 or at:

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