February 23

Heroin use climbs in Maine as cheaper alternative to prescription drugs

Today’s addicts are a consequence of years of access to prescription painkillers, an expert explains.

By David Hench dhench@pressherald.com
Staff Writer

Victoria Morris of Portland first used heroin when she was 20. Eight years later, her addiction has cost her her husband, her children and her home.

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Cmdr. Scott Pelletier, head of the Maine Drug Enforcement Agency in southern Maine, points out heroin packets that were seized in the state.

Gabe Souza/Staff Photographer

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She had already smoked crack and done other drugs, but it was a blood clot in her arm that set her heroin addiction in motion.

The hospital gave her Dilaudid. From there, she graduated to heroin because “it was cheaper than Dilaudid,” she said.

Heroin takes her pain away, she said, and staves off the nausea, diarrhea and other withdrawal symptoms. It’s also cheaper than other opiates.

“Oxy 30s are like 40 bucks,” she said, referring to the cost of a 30-milligram tablet of OxyContin. “You can go spend 40 bucks on dope and I can make it last three days.”

A drug kingpin couldn’t have planned it better: Flood the market with a cheap, socially acceptable, addictive drug. Once customers are hooked, reduce the supply, raise prices and offer a cheaper – and deadlier – alternative with a huge profit margin.

That’s what has happened in Maine and across the country as abuse of prescription painkillers has led to opiate addiction, driving some users to heroin as a less expensive alternative.

As Morris said, the commonly prescribed painkiller OxyContin costs $40 for a single pill – if it’s available. That same $40 can buy two, three or even five bags of heroin – enough for maybe three days, depending on its purity and the user’s tolerance.

“For most (addicts), they’re using both opiates and heroin and both give a similar effect,” said Ronni Katz, substance abuse program coordinator for Portland’s Division of Public Health. “If someone is jonesing, they go for either one, but they’ll go with what they can afford and heroin you can get a lot cheaper.”

Law enforcement and the health care industry are cracking down on prescription drug abuse, but are also seeing a corresponding surge in heroin use and deaths from overdoses.

The number of people dying in Maine from a heroin overdose quadrupled from seven to 28 between 2011 and 2012, and estimated numbers put 2013 on pace to surpass that, according to the state medical examiner’s office.

That comes as no surprise to people in the treatment community.

Kenny Miller is executive director of the Down East AIDS Network based in Ellsworth, an area hard hit by painkiller abuse, and now heroin.

“This is the end of the beginning,” he said, noting that today’s addicts are the consequence of years of easy access to prescription painkillers. And the heroin overdose numbers are likely to continue climbing for some time, he said.

Miller said a lot of work is being done to curb painkiller abuse, and those efforts are eventually expected to have a corresponding effect in bringing down heroin abuse. If fewer people abuse prescription painkillers in the first place, the logic goes, fewer will end up turning to heroin as an alternative.

HEROIN – PLENTIFUL AND CHEAP

Prescription painkillers had been almost free for many people through private insurance or publicly funded health insurance programs such as MaineCare. In some long-standing Maine industries like fishing, forestry or construction, missing work because of chronic pain means missing a paycheck. The time-release painkiller OxyContin seemed a blessing.

But by 2000, law enforcement and health care providers were seeing problems with abuse, diversion and addiction. People who couldn’t get a prescription for pain pills would buy – or steal – them from people who could.

People who wanted to use the drug to get high learned how to scrape off the time-release coating to get a quick surge of the narcotic. It was viewed even then as a gateway drug. People who would never think of experimenting with heroin saw OxyContin as less dangerous because of its therapeutic uses. Some began injecting it for a more powerful effect.

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