Pubdate: Sun, 14 Jul 2002
Source: Portland Press Herald (ME)
Copyright: 2002 Blethen Maine Newspapers Inc.
Author: Josie Huang, Portland Press Herald Writer


Snorting OxyContin gave Chad Seelye of Calais the perfect high. But when he 
couldn't scrape together $300 for his daily dose of the prescription 
painkiller, Seelye settled on the next best thing.

Heroin, he said, produced the same surge of euphoria and a packet cost him 
only $25.

"Eventually, heroin is what everybody is going to taper to," said Seelye, a 
20-year-old recovering addict. "People go for the cheapest drug. They go 
for the cheapest high."

Calais and other Washington County communities were the first places in the 
country to identify rampant OxyContin abuse. Now, as law enforcement 
officials and doctors attempt to reduce the illicit supply of the synthetic 
opiate, authorities report more drug users in this poor, easternmost region 
of Maine are using and dealing heroin.

It's suspected that OxyContin primes addicts for heroin, a relationship 
that may be driving this year's sharp increase in drug- related arrests and 
overdose deaths in Maine. The emerging problem with heroin in Washington 
County may help explain how this happens.

For now, it's clear that the popularity of the two opiate drugs has risen 
in tandem.

Statewide, admissions to treatment programs for addiction to synthetic 
opiates like OxyContin have jumped from 73 in 1995 - the year before the 
painkiller was introduced - to 762 in the first 11 months of 2001, 
according to the Maine Drug Enforcement Agency. During the same period, 
admissions for heroin abuse increased from 205 to 509.

It's easy to see how heroin and synthetic narcotics can be used 
interchangeably, said Dr. Stanley Evans. Evans, who treats addicts from 
Washington County at Mercy Hospital's Recovery Center in Westbrook, says 
the drugs' effects are "essentially the same."

Both stimulate the same pleasure pathway in the brain for a comparable high 
and are often mixed with other opiates or alcohol, he said.

The delivery method often varies, however. When first introduced in 1996, 
OxyContin was heralded for a formula that steadily pumps oxycodone over the 
course of the day. Crushing and snorting the pill all at once, though, 
produces an instant, intense high.

Snorting is the most common form of delivery, but addicts who have built up 
a tolerance sometimes resort to dissolving the pills in water and injecting 
the solution into the arm.

Heroin, on the other hand, can be snorted, but is typically injected.

Unlike OxyContin, heroin has negligible pain-relieving properties and 
serves only to get people high. And, Evans said, it puts the user at 
greater risk of respiratory depression - and, consequently, overdosing.

"There is no standardized laboratory where the heroin is being put out," he 
said. "You know the quantity varies from dealer to dealer as opposed to 
OxyContin, which has got standardized doses."

Washington County treatment providers and law enforcement officials say 
drug users have recognized the difference - a big reason why heroin has 
taken longer to catch on despite the county's widespread poverty and 
Maine's highest unemployment rate at 11 percent.

"People are still scared of the heroin. They're afraid of what they're 
getting," said Lt. Mike Riggs, who oversees drug enforcement in the county 
sheriff's office.

And those who use heroin are often frowned upon by other addicts, said Anne 
Perry, a nurse practitioner in Calais and co-founder of Neighbors Against 
Drug Abuse in Washington County.

"There literally develops a hierarchy between the drug addicts - those who 
snort and those who do the (intravenous) drugs," Perry said. "If you start 
injecting, you've gotten to that lower class."

Signs show, however, that heroin's affordability is helping users get over 
the stigma.

In the last year, police have been finding more plastic, postage-sized 
packets filled with heroin during traffic stops and when responding to 
domestic abuse calls. The packets, which are imprinted with cartoons such 
as devils and nude women, have even been turning up in the mouths of 
overdose victims as they are treated in emergency rooms.

Many OxyContin dealers have taken to selling heroin supplied by crime 
syndicates based in New Hampshire, Massachusetts and Rhode Island, 
informants have told Riggs.

Heroin dealers have begun to include the very young. Riggs said he helped 
apprehend a teen-age boy in Machias attempting to deal packets of heroin. 
The boy, who had been staying with his mother at the Machias Motor Inn, 
stashed several packets of heroin in a cigarette pack, only for it to be 
discovered by the motel's owner.

The vast majority of drug busts, however, still involve prescription drugs. 
Last week, 13 out of 16 drug offenders indicted by the Washington County 
grand jury had trafficked OxyContin or other prescription drugs such as 
Dilaudid. Only one person had been caught for transporting heroin.

But to see even one heroin case when there used to be none a year or so ago 
is "significant," said James Cameron, assistant attorney general and 
coordinator of the state's drug prosecutors.

"The story is still prescription drugs in Washington County," Cameron said. 
"But it's beginning to be seen that there's real potential for heroin abuse 
to take off."

The illegal supply of OxyContin is believed to be dwindling due to the 
efforts of law enforcement, legislators and the medical community.

Bad press surrounding OxyContin abuse, authorities say, has discouraged 
doctors from prescribing the drug except to the neediest of patients, 
thwarting the "doctor shoppers" who drive around the state trying to get 
multiple prescriptions.

Meanwhile, lawmakers are trying to cut off the illegal flow of prescription 
drugs from Canada into border cities like Calais by imposing stricter 
penalties on smugglers. As of this year, illegal importation of OxyContin 
is no longer a misdemeanor but a felony, accompanied by a minimum probation 
of four years, Cameron said.

Riggs, however, believes all the rules in the world won't stop traffickers. 
Many have taken to hiding small quantities of pills in body cavities.

That's how important drugs are in this thinly-populated corner of Maine. 
Home to fishing villages and blueberry barrens, it is also where houses are 
burglarized for drug money, women barter sex for pills and "Oxy" newborns 
cry from withdrawal pains. It is where hepatitis C, a chronic liver disease 
most commonly transmitted by sharing needles, was 47 percent above the 
state average in 2000.

Treatment providers would love to see OxyContin go away, but say it won't 
do any good if it's replaced by heroin. Property crimes and prostitution 
will still occur, and overdoses might increase. Also, drug users will have 
another excuse to do drugs, rather than seek rehabilitation.

"I think there's less incentive when there's something to replace the 
(prescription drugs) for people to seek whatever help is out there," said 
Karen Barbee, a Machias social worker.

Seelye agrees. If he had not been arrested last summer for robbing a Main 
Street gas station for drug money, he would still be sampling from a menu 
of drugs including both OxyContin and heroin.

Now, when he sees his old drug buddies around town, scruffy and bloodshot, 
he doesn't talk to them. But he can tell they're hungry for a high and 
don't have a lot of money to burn.

"People will get tired of using Oxy and switch to the heroin," he said. "It 
just all depends on how much money you have."
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