Editor’s Note: This is the first in a periodic series of articles a year in the making that examine the effects of drug abuse in Maine.
Read Part Two: Maine coast drug crackdown makes dents
BUCKS HARBOR, Maine — Nicholas Ames has been a fisherman, a carpenter and a crewman for the Maine Department of Transportation. He is a son, a brother and a father.
Ames is also a drug addict.
The 27-year-old East Machias man is serving a four-year prison sentence at Down East Correctional Facility for breaking into a home and stealing a gun while high on drugs.
He has served more than half his sentence — and has become wiser as a result, he said. And like nearly every inmate, he said he intends to stay away from drugs when he is released just after Christmas in 2011.
“I know I have to walk my road, no one else’s,” Ames said while sitting at a picnic table in the prison yard. “The path I choose is my own path. I’m an absolutely different person now. I’m calmer and I have a new outlook. There is always hope. It is never too late to have hope.”
Yet Ames said he’s scared of what awaits him upon his release.
“I’ll be tempted to go to what I know,” he said. “It’s all I knew before coming here.”
A year ago, Ames first sat down with a reporter in the prison’s visiting room to tell his story — a story that’s becoming more common among youths in Washington County, which statistics show is one of the state’s hardest hit areas in terms of prescription drug abuse.
“The drugs destroyed me,” he said during that original interview, his gray eyes flat and expressionless, his tattooed arms crossed tightly over his chest. “My life spiraled out of control, and I never saw it coming. I lost family, friends … I lost myself.”
While prison is not the place to show emotion, Ames said, he admitted he cried in bed at night for the pain he caused others while addicted.
“I watched a friend overdose on drugs I had supplied. He was on the floor with his eyes rolled back in his head. He was purple and blue and blood ran out of his mouth. He was my friend. But I had $5,000 worth of drugs in my pocket, and I wasn’t about to get caught. I took off. I ran.”
He paused and asked, “What kind of friend does that? I’ve done horrible things.”
The obscenity of abuse
While the problem of drug abuse is severe in the entire state — law enforcement calls it the No. 1 reason behind crime — Washington County appears to be among the hardest hit.
The county has just 2.5 percent of the state’s population, but seizures of prescription drugs here account for 7 percent of all illegal drugs seized in Maine, according to the state Office of Substance Abuse.
“It really seems to be magnified here,” Washington County Sheriff Donnie Smith said. “As large geographically as this county is, everyone knows each other. Someone in Calais likely knows who is dealing drugs in Danforth.”
Leading the list of drugs most abused are prescription narcotics, according to the Maine Drug Enforcement Agency’s Northern Division Cmdr. Darrell Crandall. These include drugs in the oxycodone family such as methadone and suboxone and notably OxyContin, also known as “hillbilly heroin” because of its popularity among poor, rural populations.
In Washington County, children as young as 8 are selling drugs.
“They bring their Ritalin to school and sell it to other students for $1,” Smith said.
“Everyone in Washington County knows someone affected by pharmaceutical abuse,” said Marta Conlin of the Recovery Support Network, which provides housing and other services to addicted women in the county. “There are almost two legal prescriptions written for every man, woman and child in Washington county. That is obscene.”
Conlin recalled a second-grader who was asked by his teacher what he wanted to do when he grew up.
“I want to sell pills on the bike path,” the child said.
“He knew there was money in it,” Conlin said. “He had a very clear plan, and unfortunately, he followed it through.”
The boy grew up to be a drug dealer, she said.
Of the 137 inmates currently incarcerated at Down East Correctional Facility, 57 are there because of prescription drug-related crimes.
Substance abuse admissions to hospitals in Washington County have increased by almost 150 percent in the past 10 years and account for 7 percent of statewide admissions, according to Maine Center for Disease Control and Prevention.
According to a study by the University of Maine’s Margaret Chase Smith Policy Center, Maine ranks in the top 20 percent of all states in illegal drug use in those ages 12 to 17. Statistics from the state Office of Substance Abuse show Maine has the third-highest rate of illicit drug use in the 18- to 25-year-old age group — 29 percent report using drugs.
“This is not the drug capital of the world,” Smith said. “But every home has a medicine chest. We have a serious prescription drug problem here.”
The economics of pills
By age 25, Ames had been in jail twice.
While he was there the first time, his older brother Shane died of a methadone overdose.
While he was there a second time, his daughter was born.
Ames said he knew his lifestyle was going to end either with death or prison.
When he was a teenager, “It was so easy. There were five or six dealers right around East Machias,” he said. “I’d get $10 worth of Oxy[Contin] and sell it for $30. Buy an eight-ball of coke for $150 and sell it for $350.”
“I lived nice, lived real nice,” he said. “I didn’t have to worry about anything but the law.”
When legally sold, a 10-milligram tablet of OxyContin costs $1.25 and an 80-milligram tablet $6. When illegally sold, a 10-milligram tablet of OxyContin can cost between $5 and $10. An 80-milligram tablet can cost between $65 and $80.
This can add up to big money for dealers.
“The majority comes from so-called legitimate prescriptions,” Crandall said. What happens, in effect, is that people with legitimate prescriptions sell some or all of their prescription pills.
Crandall said the MDEA has been working with doctors and other providers for years to make them aware of the illegal sale of legitimate prescriptions.
Smith said drug dealing manifests itself over a wide range of scenarios — from sales of drugs between users, to a 77-year-old man who trades pills for sex with younger women, to fifth-graders raiding their parents’ and grandparents’ medicine chests.
Smith points out that Washington County is ripe for illegal prescription drug activity with its older population, which is more likely to need prescription painkillers and other drugs, and a high rate of poverty.
Washington County has the oldest population in the state with 17.4 percent of its people over age 65, (the U.S. average is 12.4 percent), and the state’s lowest median income, $29,087 compared with the Maine average of $41,287.
“I believe that with this high rate of Medicare and Medicaid, with the state and federal government paying the bill, folks can easily get a three-months supply of medication here,” Smith said. “This oversupply in the home seems to go hand in hand with how many illegal pills we see on the street. Here we have a lot of doctor-shopping [to get a larger supply of pills]. The pharmaceuticals also come across the border and through the mail.”
Jacqueline Smith, an assistant district attorney in Washington and Hancock counties, said she sees lots of Canadian drugs among illegal prescriptions seized in Washington County.
“That elevates the crime in my mind,” she said. “These people are definitely putting in some effort.” She said pills often are carried across the border in body cavities.
Smith said the rise in prescription drug abuse correlates with easy access.
“Over the last five years, the cases I see start off as legitimate use, an injury or pain management, and then it spirals out of control,” Smith said.
“As a society we are inclined to think that if someone has a prescription, it’s all right,” Carlotta Bassano, the county’s deputy district attorney, added. “People just don’t seem to put prescription drugs in the same column as drugs off the street.”
Bassano said she rarely saw prescription drug forgeries 10 years ago. “We see lots of cases now, including legitimate prescriptions that have the amounts altered,” she said.
Neal Adams, district attorney for Aroostook County, also attributes the surge of illegal prescription abuse to their availability. He said young adults pay attention to who at school is getting their wisdom teeth extracted and might have OxyContin prescribed by a dentist for pain. They also pay attention to who in their community is being treated for cancer and may have prescription painkillers.
Bassano recalled a Washington County case where a family was robbed of its prescription medications while attending a community public supper held to benefit the family, whose father was undergoing cancer treatment.
From thoroughfare to hub
Ames said his life before prison centered on drugs; he existed in a culture of drugs. Drugs were an everyday occurrence, like eating breakfast or checking the nightly news.
“By the time I was 13, I was a pot dealer. By the time I was 15, I knew every drug dealer in Maine. By the time I was 18, I had connections from New York to Canada,” he said.
“I not only got high with my friends, I got high with family,” which led to his attitude that nothing was really wrong with drugs — they were just illegal.
In high school, Ames would bring pot and pills to school. “I didn’t care about an education, only about myself and the money.”
Sheriff Smith said that in the past, Washington County was a thoroughfare — drugs were transported through the county from Canada to more lucrative markets in southern Maine.
“Now [Washington County] is a hub,” he said, with drugs coming into the county from the very southern markets for which it used to be a conduit.
And it has spread.
“We watched the problem migrate to Aroostook from Washington,” Crandall said. “In fact, it is what is driving the majority of crime in Aroostook County.”
Aroostook County District Attorney Adams said he also is seeing many more women addicted to pills than ever before.
“They are clean, there is a known dosage, they are pure,” Adams said. “A handful of pills is cheaper than a package of cigarettes.”
Adams said that in his county he is prosecuting few cases dealing with cocaine or heroin. “Pills are the easiest to get,” he said. “It is a significant problem.”
“We’ve had home care providers steal the pills from their patients,” Adams said. “That tells you the level of abuse — their need is worse than their patient’s pain.”
The ripples
A casual conversation with an office secretary reveals that she is raising her grandchildren because their parents are incarcerated for illegal pill crimes.
Another parent confides that it is easier for her when her son is in jail for drug crimes than when he is out.
“I can sleep at night. The phone call that he is dead isn’t coming,” she said.
Downeast Correctional Facility Superintendent Scott Jones at Bucks Harbor said that for the past several years, 99 percent of his prison’s contraband has been pills.
“People have half choked to death trying to swallow packages [of pills,]” he said.
Visitors come “packing in,” secreting small bundles of pills wrapped in electrical tape in body cavities.
Substance abuse affects not only the user, but also the user’s family and community in the different kinds of stress on the health care system and law enforcement.
In 2007, the last year statistics were available, the Office of Substance Abuse estimated the total court and health care costs for substance abuse in Maine amounted to $898.4 million, equal to $682 for every resident of Maine.
Of that, costs associated with crime were $214.4 million while costs associated with substance abuse treatment were $25.2 million, the smallest proportion of total costs. Compared with the rest of the nation, Maine has both the most law enforcement agencies reporting prescription drugs contributing to property crime (32.4 percent), and the most law enforcement agencies reporting that prescription drugs contribute to violent crime (26.8 percent), according to the National Drug Threat Survey.
Prescription drugs account for six times as many arrests in Maine as those for heroin, more than for cocaine, more than marijuana, more than crack, amphetamines or any other drug.
According to Roy McKinney of the MDEA, diversion of prescription drugs has outpaced cocaine for the first time, and last year, 21,661 pills, capsules and tablets were seized.
Arrests by the Maine Drug Enforcement Agency alone — just for prescription drug offenses — has increased from only 7 percent of their cases in 1998 to nearly 42 percent in 2009, and it is still increasing, according to Maine’s Attorney General Janet Mills, who addressed the issue with the Maine Chiefs of Police in February.
“People are killing each other over these pills,” Mills said, noting that in the past 18 months, at least six of the murders committed in Maine were related to prescription drugs.
Mills said the number of drug-induced deaths from prescription drugs between 2000 and 2008 has more than doubled. There were 154 deaths involving prescription drugs in 2007 and 164 in 2008 — four times the number in 1997. The number of people dying from drug overdose now rivals the number who die each year from motor vehicle accidents.
“Then, of course, there are the robberies, thefts, burglaries, home invasions and assaults of all kinds,” Mills continued. “More importantly, 464 drug-affected babies were born in Maine in 2008 alone. Imagine the impact of these births on our foster care system, on our health care system, on our education system, on the social, medical, economic fabric of our society?”
Clearly the problem spills over from the street to the health care system in a variety of ways.
In Washington County there are 43 certified or licensed alcohol and drug abuse counselors, including 12 in Calais and seven in Machias. There also are 105 social workers who sometimes provide counseling and other services.
“At least one person comes into the emergency department [illegally] seeking drugs each day,” Dr. Cressie Brazier, medical director at Calais Regional Hospital, said. “Some days it is multiple people. Some bring their entire family and friends with them — cousins, brothers, sisters — all lined up to see what they can get.”
Brazier said hospital personnel work with other hospitals, their own files and even names culled from the newspaper to identify and hopefully curb drug seekers. Often they recognize the names of seekers who have come to the emergency room multiple times.
“If we suspect that someone is seeking, we will call all the local pharmacies and ask them to check their records. We will call other hospitals and share our information with them, especially if it is someone from their area,” he said. “I think we do a good job, and it appears that many of the ‘frequent fliers’ have given up on us.”
Brazier said, however, that those individuals just go somewhere else.
A diversion program in Aroostook County similarly provides medical providers with lists of known drug users and dealers to provide an additional tool for those writing prescriptions.
“It gives them a heads up,” Crandall said. “It is one more resource, but truthfully, it is tough to tell if it is working.”
‘It’s just pills …’
Sitting in prison, Ames said he is not optimistic about the future of drug eradication in Washington County or anywhere else.
He said law enforcement will never stop drug use, that it is a social problem long before it becomes a criminal problem.
“When they bust a drug dealer, two more are right there to fill the spot,” Ames said. “There are a lot of people standing in line, ready to sell, coming across the border, hiding drugs in their bodies.”
And it is getting worse, he said. “I’ve seen 12-year-olds using hypodermic needles.”
On this one point, the sheriff and the drug addict completely agree.
Pharmaceutical addiction is a social problem, Smith said. “The police deal with the aftermath. People think if the cops put all the drug dealers in jail, it will stop. It won’t,” he said.
“By the time law enforcement deals with a drug addict, it’s too late,” Smith said. “Look at our jail. It was built in the 1990s and is a 32-bed facility. That was going to be more than enough. But by the time it was completed, the drug epidemic hit. Now we are at capacity and beyond every day. I would estimate that 80 to 90 per-cent of our inmates have a substance abuse problem.”
Crime and addiction are two different problems.
“If you are a dealer, we will eventually catch you,” Smith said. “But we have an addiction problem, and this is what we as a society need to deal with. As long as there are addicts, someone will sell to them.”
Pill addiction can be both a crime and an illness, Crandall said. In cases of possession and use, he has a sense that treatment should be part of the punishment.
“It’s a community health problem,” he said. “However, that doesn’t excuse drug trafficking.”
Crandall said that it is discouraging.
“We somehow, as a society, need to get past the perception that it’s just pills. But someone selling thousands of dollars of oxycodone, well, that is beyond an illness,” Crandall said. “That is pure felony behavior.”
Crandall’s idea of a solution — to which he said there is no clear path — is to stop new users. “But with all the prevention work we do, all the stories in the media, all the overdoses and the arrests, new people are abusing pills every day.”
Ames also worries about the next generation.
“I’m so scared for the kids around here,” he said. “Listen, I’d tell them, here you are 15, 16, out drinking and out smoking pot, out partying. It is going to lead to robbing and stealing. You’ll do anything for a fix.”
He would warn the youngsters on the outside: “It’ll bite you. You’ll pay. Everybody ends up either caught or dead.”
And Ames is thankful he was caught.
Ames now works as part of a road crew outside the prison walls. He said he has earned his high school equivalency diploma and completed other courses in life skills and anger management. He also has reconnected with family members.
“I have a sense of pride. It makes me feel like I’ve accomplished something,” he said. “I’m actually thankful I came into a place like this. I would have been dead.”