Aroostook County District Attorney
Society and the criminal justice system are overwhelmed by crimes associated with prescription drug abuse. Law enforcement is inundated daily with new incidents for review and prosecution, the courts are unable to schedule cases timely, and all are pressured to find alternatives because “the jails and prisons are full.” Drug-related crime has dominated every session of the grand jury for the past two years including this one. In addition to 23 indictments that can be directly tied to drugs, and more that were undoubtedly fueled by drugs, this session reached a more lamentable milestone: four indictments accuse four defendants with providing drugs to a young man in Houlton and a young woman in Caribou, both of whom died after poisoning themselves with the prescription drugs sold or given to them. It would be misleading and understated to claim two persons died from an “accidental overdose of one or more drugs” when the self administration was, quite apparently, intentional. The difference between these fatal self poisonings and the regular self abuse poisoning going on in our communities every day is merely one of degree not of kind.
In these cases, a lethal combination of prescription opiate painkillers and prescription anxiety reduction drugs were ingested, and contributed to the deaths. The dangers of this combination of drugs are well known to doctors, drug agents and even to the abuser community itself. Yet persons continue to ingest such drugs not only in combination but in quantities well beyond any valid prescribed therapeutic levels.
While there is no evidence that anyone forced these young people to take the drugs, those charged did make them available in violation of the law, and are accused of showing disregard for the possible, if not probable, consequences of their actions. Under Maine law, a person may be charged with an “aggravated” offense if the sale or furnishing of a drug causes serious injury or death. The aggravation of some of these offenses, to Class A, permits a penalty up to 30 years in prison.
Dr. Marcella Sorg, a forensic and medical anthropologist at the Margaret Chase Smith Policy Center at the University of Maine, in her written statement to be given before the Maine Justice Assistance Council, reports:
“Maine, along with many other rural states, has experienced an epidemic of drug trafficking and drug-related deaths during the past 10 years, the number of deaths rising from 34 in 1997 to an estimated 160 last year. Since 1997, approximately 1,400 Maine citizens have died of drug-related causes, most of them during the last five years. In fact, the number of persons dying from drug overdose now rivals the number who die each year in motor vehicle accidents, both in Maine and nationally.
“We now know that the enormous increase in these deaths is due primarily to prescription drugs, among those mostly prescription pain narcotics and tranquilizers, frequently in combination each other, with illicit drugs, and with alcohol. In fact, in about 90 percent of drug-induced deaths the cause of death involves misuse or abuse of at least one or more prescription drugs. In comparison, cocaine and heroin are listed as causes in around a fifth of these deaths.
Two years ago the statewide number of treatment admissions for prescription drug addiction began to exceed the number for illicit drugs.”
In Aroostook County, Maine Drug Enforcement Agency’s arrests the past three years show:
For 2006: 23 of 79 arrests or 29 percent were related to prescription drugs; 7 – Possession; and 13 – Sale.
For 2007: 38 of 91 arrests or 42 percent were related to prescription drugs; 8 – Possession; and 25 – Sale.
For 2008: 54 of 84 arrests or 64 percent were related to prescription drugs; 3 – Possession; and 44 – Sale.
While overall arrest numbers have remained relatively constant, the percentage of those arrests related to prescription drugs more than doubled and arrests for the sale of those drugs has more than tripled.
The bottom line is that we need to clamp down on how these drugs are getting from the pharmacy to the street. There is no “silver bullet” or a single answer to the problem, but some mechanisms exist to respond to the crisis.
Maine has a prescription monitoring program, which is a computer based clearinghouse for information from doctors and pharmacists detailing who has received prescriptions and for which drug. It is intended for the medical community, not the law enforcement community, to use. The program is voluntary, but does not appear to be used to its full potential. If it were consistently utilized, it could reduce the level of “doctor shopping” incidents in which drug seeking individuals receive and fill multiple prescriptions at multiple locations.
The medical community is faced with the difficult problem of balancing the duty to treat pain adequately, with the civic duty not to pump dangerous drugs into the drug abuse community. T.H. White may have best summarized that balance: “Everything not forbidden is compulsory.” Pain management contracts between providers and patients are useful, and even more so when the follow up protocols are followed, such as pill counts, urine tests, etc.
Maine also has a first in the nation, statewide, unwanted/ unused prescription return program. This allows residents with prescriptions they no longer want or need to place them into a postage paid mailer and return them to MDEA for destruction. Several Aroostook County police departments accept unused prescription medication from residents, which they then turn over to MDEA for destruction.
One of the hoped for tools to assist the drug treatment community respond to the needs of drug addicted and dependant persons, suboxone, seems to becoming just another traded drug on the street, just as methadone. Clearly if we make it they will come for it. And come for it they do: doctor and therapist shopping, prevailing upon patients with “good” drugs to “dispense” some, robbing and burglarizing those who have such desirable prescriptions but are not willing to dispense them to others.
There is no difference between supplying someone with a prescription drug or other drug, such as heroin or cocaine. Maine law does not recognize a difference, nor does the human body. Merely because prescription drugs come in known doses, purity, and from pharmacies, does not prevent their nontherapeutic use from having consequences as dangerous as known “street” drugs. There is nothing recreational about the abuse of such drugs, unless the game is Russian Roulette.
Editor’s note: Assisting DA Adams in compiling this report were Caribou Police Chief Michael Gahagan, Houlton Police Chief Butch Asselin and MDEA Division Commander Darrell Crandall.
