AUGUSTA — Joshua Cote hit countless lows during the years he abused heroin, painkillers and other drugs.

He was expelled from high school in his senior year after handing out a batch of acid that sent one girl to the hospital. When his dad gave him a red, ’88 Chevy pickup, he turned around and traded it for five pills of oxycodone. He went to prison for drug trafficking. He almost died from an overdose.

Kids ask questions of Joshua Cote on May 16 at the Augusta Boys and Girls Club. Cote is among patients who have been recruited by Dr. Roy Miller to speak with young people and answer open-ended questions about their struggles with drugs.

“It was horrible,” Cote said on a recent afternoon, during a talk to a group of teens at the Boys and Girls of Augusta. “Every day is kind of the same. You wake up in the morning, and you wonder how you’re going to get that drug. You wonder how you’re going to get the money to get that drug. And you spend all day thinking about how you’re going to get those things. And once you get it, you do it, and you’re right back to the same thing. It’s a lot of money to live like that, and the way it makes you feel inside is pathetic.”

Now, at 39, Cote has turned things around. He lives in Gardiner and has been in recovery for five years, thanks in part to an intensive substance abuse program at the Kennebec County jail. He runs his own flooring business. Soon, he plans to marry his fiancée, with whom he has a son. And his daughter will soon graduate from high school.

“Things are looking up now,” he told the teens.

Cote was invited to speak at the youth center as part of an informal program started late last year by his physician, Roy Miller.

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Dr. Roy Miller talks to kids on May 16 in the Augusta Boys and Girls Club. Miller has recruited several of his patients who are recovering from opioid addiction to speak to kids.

At-risk teens regularly gather after school at the Boys and Girls Club of Augusta, which is in the lower level of the Buker Center. The club, an independent organization, offers a range of programs to keep kids active and healthy. To educate those teens about the slick slope of addiction, Miller has recruited several of his patients who are recovering from opioid addiction to come to the youth center and answer open-ended questions about their habits.

“It’s easier to keep them from becoming addicts than to treat them on the other side,” Miller said, comparing addiction to a chronic disease like diabetes. “We give the kids questions to ask, and after the 10th question, they start making up their own questions. I really feel like that format gets kids involved and keeps it from being a lecture. It seems to be working.”

The need for prevention programs has never been greater for Maine youth. Across the state, record-breaking numbers of people are dying from drug overdoses, fueled by an epidemic of heroin, fentanyl and opioid painkillers. Overdoses killed 418 people last year, up 11 percent from the 376 who died in 2016, according to the Maine Attorney General’s Office.

Miller started holding talks at the Boys and Girls Club of Augusta in December. Now, he is trying to expand the program by bringing it to Cony High School.

During Cote’s talk, the Gardiner man recounted how trying marijuana had seemed like harmless fun at a young age, but emboldened him to try harder drugs by his early teens. Eventually, it took his heroin source drying up for several days for him to start feeling sick and realize he’d become addicted.

He mentioned the need for the teens to have a group of friends or a space where they can feel safe, such as the Boys and Girls Club, which offers its after school programs for free.

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“I know when I was younger, I didn’t have anyone to look up to,” he said. “I didn’t have anyone looking out for me, saying, ‘Hey, why don’t you come over and play pool or whatever after school?'”

“Has it been hard to stop using drugs?” one of the teens asked him. “Absolutely,” Cote replied “Probably the hardest thing I’ve had to do in my life. It sounds real easy. Stop. Get out. But the feelings inside are not so easy, the things that drive you to use. You may feel lonely, or like nobody cares, and those things are hard to overcome.”

Recruiting recovering substance abusers to give talks is not a new approach, but it can have some limited value, according to Scott Gagnon, a certified prevention specialist and the director of operations at AdCare Educational Institute of Maine, an Augusta-based organization that trains workers in the field of behavioral health.

“There’s people in recovery being used as motivational speakers, sharing their stories in a lot of areas in the state,” said Gagnon, who used to work at Day One, a residential care program in southern Maine that enlisted clients to give such talks.

There isn’t much evidence that those talks, on their own, are a sufficient long-term approach to preventing addiction, according to Gagnon. But when combined with a more systematic approach they can help, he continued.

“Someone speaking at a one-time event could potentially touch one person,” Gagnon said. “It may trigger them to seek help on their own. But we unfortunately don’t really have science behind that. I’m not trying to discount this sort of approach. It’s really cool for people to hear those stories, but it needs to be part of a larger approach. Speakers alone won’t move us. We need to look at prevention programs, like school-based programs that include multiple classes.”

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Gagnon highlighted a 12-hour substance abuse intervention program, called Prime for Life, that is employed in schools around the state and has been backed by research. According to data collected between 2013 and 2014 at eight sites across Maine, participants demonstrated an increased awareness of the damaging effects of alcohol and drugs, as well as reduced motivation to use those substances.

Some Maine communities also employ Drug Abuse Resistance Education, or D.A.R.E., a program that traditionally was organized by police officers and taught children how to resist peer pressure and avoid drugs, according to the program’s website.

In its original form, D.A.R.E. was well-intentioned, Gagnon said, but scientists were not able to prove its usefulness. In recent years, D.A.R.E. has tried to update its lessons to be more interactive and in line with the research on substance abuse prevention.

Peter McCorison, the director of behavioral health services at Aroostook Mental Health Center, agreed with Gagnon that talking about the inherent risks of substance abuse can be positive for both the people in recovery and those listening to them.

But McCorison did caution against presentations that try to scare the audience by focusing too much on the horror stories of addiction, as they can make it harder for the audience to imagine themselves in that position.

Miller is familiar with the staggering costs of drug addiction. After a career in family medicine at Sheepscot Valley Health Center in Whitefield, he is near retirement and devotes most of his attention to helping recovering drug users. For about 10 years, he has been prescribing buprenorphine, a medication that suppresses the symptoms of opioid withdrawal.

Miller is also a volunteer and board member at the Boys and Girls Club of Augusta, and he describes the talks he’s been holding there as “an experiment.” He thinks the talks, which are less like lectures than conversations, can’t hurt and, if anything, might help some kids by conveying vivid examples of the dangers of drug addiction.

“It makes it much more real,” he said. “It seems like low risk. It seems like we can’t be doing harm.”


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