Pubdate: Sun, 12 Aug 2012
Source: Albuquerque Journal (NM)
Copyright: 2012 Albuquerque Journal
Author: Mike Gallagher


First in a four-part series

This isn't Detroit. It isn't Compton, Calif. We don't have overcrowded
and crumbling inner cities.

But when the Centers for Disease Control last November announced that
death rates for prescription drugs had reached epidemic proportions
nationally, New Mexico was at the top of the list.

Our death rate from prescription drug overdoses surpassed even our
traditionally tops-in-the-nation death rate from heroin overdoses.

"This is the time to bring a sense of urgency to parents, schools,
coaches, physicians and pharmacists," U.S. Attorney Ken Gonzales said
in an interview.

"Rio Arriba, Taos, (Bernalillo County's) South Valley, the problem is
ingrained in the lifeblood of the community," Gonzales said. "Its more
than a toehold, more than a foothold."

And Gonzales said communities like Albuquerque's Northeast Heights are
in danger.

"In communities like the Heights, as devastating as the overdoses have
been, it hasn't taken hold in that community, but we have to act with
urgency," he said. "Or we're going to lose it if we don't."

Why New Mexico?

Is it our border with Mexico? Is it the state's high rate of poverty
and the associated social problems? Is it the criminal justice system?

While they may all play a role, the phrase used over and over again in
response to Journal questions over the past eight months was "a
perfect storm" that is leaving a trail of death in its path.

It turns out that in addition to all of New Mexico's social problems,
the state's deadly love affair with drugs is fueled by three factors -
price, purity and availability.

Just how cheap and pure was illustrated last year during a quick and
dirty federal task force undercover operation that arrested 11
user/dealers in the area around Eldorado High School in Albuquerque's
Northeast Heights.

* Undercover agents bought grams of heroin for $100 - the same price
as in 1977. * The purity of the heroin agents purchased was three to
four times the purity level of heroin sold just 10 years ago. * The
heroin was cheaper than prescription opiate painkillers on the street,
which average $1 per milligram. That's $10 for a 10-milligram
hydrocodone pill.

Federal drug agents say the purity of the heroin and availability of
prescription painkillers allow it to be smoked or snorted.

"Kids think they're not a heroin addict if they're not using a
needle," one federal task force agent said.

And those kids can buy heroin or prescription drugs near their high
schools, as federal agents proved in last year's roundup around
Eldorado High School - several of those arrested were former students
supporting their own addiction by selling to youngsters.

Attorney Joseph Riggs has represented criminal defendants for more
than 30 years, including many drug addicts.

"What is shocking today is the frightening availability of heroin and
painkillers," Riggs said. "It is a communitywide problem, no longer
confined to specific neighborhoods."

Dr. George Davis oversees psychiatric services at the state Children,
Youth and Families Department's secure lockups in Albuquerque.

"The opiate overdose, call it suicide, rate is just an indicator of
neglect, child abuse and broad social problems," Davis said. "Abuse by
parents using drugs drives our numbers of residents."

And by any measure, New Mexico's drug problem is widespread.

Among those measures: * Teen drug use in New Mexico - heroin,
methamphetamine and cocaine - is double and triple the national
average, depending on the drug. * The Department of Health estimates
there are 25,000 needle-using addicts in the state. * Department of
Justice statistics show that more than half of the New Mexico inmates
in state prisons and local jails are arrested for drug-related crimes.

Highest death rate

In 2008, New Mexico had the highest heroin and prescription-drug
overdose death rate in the country.

 From 2000 to 2008, overdose deaths from opiates tripled.

Those numbers are not manipulated or estimated. They are counted in
bodies on an autopsy table and in toxicology reports.

The conventional wisdom - testimony at the Legislature, interviews
with law enforcement, families of victims - can lead the public to
believe this epidemic is isolated to young people in their teens or
early 20s.

Heroin and prescription drug overdoses do, tragically, kill bright
young people.

While their tragedies grab headlines, teenagers abusing drugs are not
the cause of New Mexico's national standing in overdose deaths.

The vast majority of New Mexicans dying of drug overdoses are ages 25
to 64.

Out of 2,200 drug-induced deaths from 2005 to 2009, just over 1,900
were men and women 25 years or older.

The median age of those who died of drug overdoses was 43.7

Breaking the statistics down further shows that heroin addicts tend to
die of overdoses in their mid-30s.

Prescription drug overdoses kill more people in their

That indicates to epidemiologists who study the problem that people
become addicted to prescription drugs at an older age, probably
because of health problems.

Heroin addicts tend to start using the drug at a younger age, in their
late teens and early 20s.

The problem of widespread prescription or illegal drug use by teens is
a long-term issue leading to the creation of another generation of

Two drug problems

Prescription opioid painkillers and heroin pose two separate problems
for law enforcement.

Heroin traffickers operate criminal organizations handling everything
from the cultivation of poppies in Mexico to the sale of heroin to
user/dealers throughout the state.

Painkillers are manufactured in the United States legally and
distributed legally through a regulated system. Prescription drugs
become illegal only when the drugs are diverted out of the system.

"We are, from an enforcement and prosecution viewpoint, designed to
deal with drug trafficking organizations," U.S. Attorney Gonzales
said. "Prescription drugs present a different dynamic."

Keith Brown, assistant special agent in charge of the U.S. Drug
Enforcement office in Albuquerque, put it this way: "There is no
prescription drug cartel to target."

But the two drug problems do overlap.

People who become addicted to prescription opiates often find they can
no longer get access to the drugs, or their habits have become too
expensive. Heroin is often a cheaper and readily obtainable

"You don't have to look for heroin in New Mexico; it will find you,"
Mike Salinas, a heroin addict trying to get clean, said in a recent

Among factors contributing to heroin overdose deaths: *
Multigenerational heroin addiction is part of the cultural fabric of
communities in the Rio Grande Valley. * Mexican cartels have been
marketing cheap, high-quality heroin to younger users in affluent
neighborhoods. * Heroin production in Mexico has been at an all-time
high over the past four years.

'Pill-popping culture'

Federal narcotics agents raid drug dealers, not the family medicine

As a society, we've been trained to take pills, from daily vitamins to
cold tablets.

"We're a pill-popping culture," Jennifer Weiss of the Heroin Awareness
Committee said.

"Once a kid gets addicted to prescription pills, it is a very short
leap to heroin."

"The development of a prescription drug habit is subtle," the DEA's
Brown said. "Parents and family members have no idea what to look for."

Dr. Harris Silver knows just how subtle painkillers can

More than 20 years ago, they almost destroyed his career as a medical
doctor, and now he spends his time educating other doctors,
legislators, parents and anyone who will listen about the dangers of
prescription painkillers.

"People don't realize that one in 20 patients receiving a prescription
for opiate painkillers is at high risk for addiction," Silver said.

"It takes 11 days of daily use for someone to start showing signs of
withdrawal if they stop taking the pills," Silver said. "That's how
quickly addiction can happen."

Silver was the lead analyst on a legislative drug task force report
prepared by The Robert Wood John-son Foun-da-tion Cen-ter for Health
Pol-icy at the Univer-sity of New Mex-ico.

Silver found these contributing factors for prescription drug overdoses 
in New Mexico: * Pharmaceutical companies deliberately downplayed the 
addictive qualities of prescription painkillers in promoting their use 
for more than a decade, until sued by the Department of Justice. The 
lawsuits were settled for almost $1 billion. * State Medical Board rules 
around the country, including New Mexico, put doctors in a position in 
which undertreating pain by failing to prescribe pain medication 
constituted malpractice. As a result, doctors sometimes prescribed more 
opioid painkillers than necessary. * Patients, and for teen patients 
their parents, are unaware or uneducated about the dangers of 
prescription opioid painkillers. * Well over half of prescription pain 
medications used illegally come from family members, according to 
federal studies.

"We are too casual in the use of pain medication," Silver said. "There
are risks with every patient receiving a prescription, and those risks
can be extreme."

Positive steps

The news isn't all bad.

At the state and local level, some positive steps have been taken and
are showing some results. Among them:

* The number of drug overdose deaths were lower statewide in 2009 and
2010, down from a high of 500 in 2008 to 466 in 2009 and 477 in 2010.

* The State Board of Pharmacy voted in June to increase monitoring of
prescription opioid painkiller drugs.

* The State Medical Board is making voluntary guidelines on opioid
drug prescriptions mandatory for doctors and others.

* Harm-reduction programs run by the State Department of Health are
making more inroads into communities where heroin use has been
widespread for decades.

* A U.S. Senate committee is investigating financial ties between the
pharmaceutical industry and "pain" lobbyist organizations that push
back against regulators' attempts to rein in the growth in the use of
painkilling medications.

* Albuquerque Mayor Richard Berry and mayors around the country have
joined in a campaign to educate parents about safeguarding
prescription medications.

* Parents of teens who died of drug overdoses or who are fighting
addiction have joined together to educate other parents and push for
programs and reforms - much like Mothers Against Drunk Driving did
decades ago to fight the state's drunken driving problem.

"I don't need to talk to a gymnasium full of kids," the DEA's Brown
said in a recent interview. "I need to talk to gymnasiums full of
parents. They're the ones we need to educate."

That's not just a cop talking.

Mike Para works for the YDI Inc. Gang Intervention Program and has the
tattooed "cred" and music chops to talk with any teen.

"Parents. Parents. Parents. They're the ones who have to listen.
They're the ones who can provide the structure these kids need.
They're the ones we need to be talking to."

- -----------------------------


Dear Readers:I've been watching drugs kill people for as long as I've 
been a reporter in New Mexico.

In the 1970s, it was heroin. Then, it was speed, methamphetamine
produced by bikers called "crankster gangsters." In the 1980s, it was
cocaine. Later in the decade and into the 1990s, it was crack cocaine.
Then, heroin made a comeback. Then, methamphetamine again, this time
made by Mexican cartels and called ICE. Then, oxycodone and
hydrocodone. And now, we're back to heroin again, with plenty of
prescription drugs mixed in.

Interspersed were drugs like PCP, MDMA and so many others I can't even
remember all of them.

Over the next four days, I'm going to lay out some ugly statistics and
ugly stories about drugs in New Mexico.

Maybe we can start a discussion about what to do.

Various events in New Mexico's drug saga have triggered press
conferences, police raids, headlines and trials.

But there has been one constant: People died.

They died of overdoses. They died of AIDS from sharing needles. They
died of stab wounds and gunshots in arguments over drug debts. Infants
died from neglect. Drug-addled teens died in car crashes. And men in
their 50s died from bodies riddled with hepatitis.

I don't have a lot of answers, but I do know this: Things aren't
getting better. They are getting worse. It's time for a real
conversation about how to break New Mexico's deadly addiction.

- - Mike Gallagher

About the author

Mike Gallagher has been an investigative reporter for the Albuquerque
Journal since 1986. He has been a reporter in New Mexico since 1975,
covering everything from Mexican drug cartels to political corruption.
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