Saturday, March 8, 2014
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A pharmacist counts out Vicodin pills at a pharmacy in Portland last week. Maine was one of the first states to see an explosion of painkiller addiction and it remains among the worst states in the nation for pill abuse. The human and societal costs associated with the epidemic – almost 1,400 Maine people have died from pharmaceutical drug overdoses in the past decade and thousands more need treatment for addiction – are staggering, experts say.
Gregory Rec/Staff Photographer
PAINKILLERS IN MAINE: Stories, video interviews and links to resources.
“Even if there wasn’t something I wanted, I knew somebody who would,” he said.
‘NO FAMILY IS IMMUNE’
The epidemic has affected Mainers of all ages and backgrounds – middle schoolers and senior citizens, clam diggers and doctors.
“No family is immune from this particular issue,” said Troy Morton, chief deputy of the Penobscot County Sheriff’s Office. “They are the youngest of kids, in their early teens, and people in their 70s. They are the poorest of the poor and the richest. There are no boundaries.”
Abuse often starts among teens, who don’t understand the danger and are more vulnerable to addiction. Addiction, meanwhile, is most common among young adults who were in their teens when the pills first flooded into Maine communities.
Thirteen percent of Mainers age 18 to 25 said they abused painkillers in the past year, according to the 2009 National Survey on Drug Use and Health, the most recent available. The rate is 6 percent of 12- to 17-year-olds and 4.7 percent of all Mainers over 12 – a total of 52,000 people.
The overall cost of painkiller abuse in Maine is not known. Through taxes, health insurance premiums and higher medical costs, Mainers are helping to supply the pills, pay for emergency room visits, investigate crimes, lock addicts in jails and provide the treatments to help them get sober.
Opiate addiction treatment alone costs Maine taxpayers millions of dollars a year. The state spends about $12 million a year on substance abuse treatment programs, not including its share of MaineCare coverage for treatment services. Painkiller addiction accounts for about one-third of substance abuse treatment admissions.
However, every dollar spent on treatment saves as much as $12 in medical care and crime-related costs, according to Maine’s Office of Substance Abuse.
Opiate abuse – including both heroin and prescription painkillers – was responsible for 30,451 emergency and outpatient hospital visits in Maine in 2008, a 28 percent increase from the year before, according to a May report.
Pharmacies have banklike security, with surveillance cameras and tracking devices, and still get robbed repeatedly in some cases.
County jails and state prisons are straining financially to hold and care for all the addicts arrested for drug-related crimes.
State government, the medical community, law enforcement, drug makers and others have all taken action to try to contain the problem. There are new prescribing guidelines, tamper-proof prescription sheets, overdose prevention campaigns and collection drives for unused drugs.
Experts say many of the efforts have helped keep the abuse from doing even more damage.
But frustration is clearly peaking after a decade of watching the problem steadily worsen.
“It just seems that if we’re leading the way with this problem, we ought to show some leadership in dealing with it,” said Rep. Jon Hinck, D-Portland.
Hinck proposed a bill in the Legislature earlier this year that would have established new rules for doctors, including a requirement that they check patients’ medication records before prescribing them painkillers. The proposal failed, but lawmakers instead created a study group that is due to propose policy changes by Dec. 1.
McCloskey, the former U.S. attorney, said the state and federal governments have not devoted enough resources to educating kids about the dangers of abuse. “It hasn’t been a priority,” he said.
McCloskey, meanwhile, took criticism himself after leaving the federal government in 2001 and working as a consultant for the maker of OxyContin. McCloskey still maintains the pharmaceutical industry is not to blame for the abuse. “If we don’t reduce the demand for drugs we’ll never be successful.”
Most now agree that pill abuse is so entrenched in Maine’s culture it will take more than doctors or state agencies or police alone to control it.
“People want to point a finger. Let’s blame the pharmaceutical companies. Let’s blame the physicians. Let’s blame the druggies. (Some) people still think it’s a problem of will power,” said Marcella Sorg, a forensic anthropologist at the University of Maine’s Margaret Chase Smith Policy Center. “The reason we haven’t been able to tackle it is because it’s so darn complicated.”
Maine Attorney General William Schneider has invited leaders in government, law enforcement, medicine, education and addiction treatment to attend a one-day summit Oct. 25 and come up with a coordinated action plan.
“It’s staggering,” Schneider said. “I don’t think it’s going to be solved by any one particular tactic, but I think if we choose several different tactics we can make a difference.”
Those who have experienced addiction first-hand have no easy answers, either.
The pills are too easy to get and too powerful, said James Cox, a 31-year-old recovering addict in Jonesboro.
“I don’t think they’ll ever get rid of it,” he said.
Staff Writer John Richardson can be contacted at 791-6324 or at:
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“It’s extraordinary how deep this epidemic has gone,” Dr. Mark Publicker, an addiction specialist in Westbrook, says of prescription pain-pill abuse. “It was eating its way through the culture, and it was diagnosed too late.”
Gregory Rec/Staff Photographer