BANGOR, Maine — Amanda Higgins was a prisoner of her drug addiction.
Before she entered a methadone treatment program, she spent her days looking for drugs — her favorite was OxyContin — and she spent her nights consuming them.
After she finally was able to admit to herself that she had a drug problem, she enrolled at the Penobscot County Metro Treatment Center in Bangor.
For two years, she traveled to Bangor every day to get her methadone, and just a few months ago she did something that has proved difficult for many: She finally was able to give up taking her daily dose and take a step toward living an addiction-free life.
“It was time,” Higgins, 24, said last weekend, standing in the kitchen of her small Trenton apartment. “I was spending way too much money and time. I wanted to be free of all of it.”
When she was taking methadone, she was one of about 1,600 clients seeking treatment in Bangor. The city’s first methadone clinic opened 10 years ago and served roughly 110 clients in 2001. Today there are three clinics, and the number of opiate addicts served in the city has increased about 1,400 percent over the last decade. Bangor now plays host to 36 percent of the approximately 4,400 people seeking methadone treatment at clinics throughout the state. Bangor’s three facilities are licenced to serve up to 1,900 addicts.
Methadone is a synthetic pain medication that is widely used as a therapeutic substitute for illegal narcotics, such as heroin, and diverted prescription medications such as OxyContin and oxycodone, which are popular with drug users in Maine.
The Acadia Hospital opened Bangor’s first methadone clinic inside its Stillwater Avenue facility in 2001 and now serves about 700 patients with a 900-patient capacity. The Penobscot County Metro Treatment Center opened on Hogan Road four years later and can serve up to 300 patients. The Discovery House clinic opened in 2007 in an almost hidden locale off Odlin Road and recently was allowed to expand from 500 clients to serve up to 700 clients.
A majority of the methadone patients seeking treatment in Bangor do not live in the city.
Brent Miller, program director for the Discovery House, said Thursday that only about 35 percent of his clients are from Bangor and the rest travel to the city from 97 communities all over the region.
Discovery House now serves about 560 patients and 159 of those live in Bangor. About 370 live in Penobscot County and the rest travel to Bangor from surrounding areas, some from as far away as Aroostook County, Miller said.
The hundreds of people who seek methadone treatment in Bangor do so for the same essential reason: It stops the powerful craving for opiates.
“It helps you with withdrawals,” said Higgins, who first sat down with the Bangor Daily News just three weeks after getting on methadone. Over the last 2 ½ years, she has kept in contact with the BDN about her progress.
“It makes it so you can operate. It changed my life.”
The seeds of addiction
In the beginning, Higgins was a recreational drug user who got together with friends and partied on weekends with drugs and alcohol. She said it seemed like one day she was having a little fun and the next she was addicted and had lost control of her life.
“We started by getting an [OxyContin] 80 on Friday, then it was one on Friday and one on Saturday,” she said. “Before you know it, it was every day.”
In 2008, Higgins was living in Bangor with her boyfriend and their 2-year-old daughter. They paid $100 to $120 for each 80-milligram OxyContin pill, nicknamed “hillbilly heroin.”
When asked how the pill made her feel, Higgins simply said, “It would make you feel good.”
But as time went on, everything changed.
“At the end, it wasn’t making us feel good. It was just taking away the edge,” she said, adding the paycheck her boyfriend would bring home on Friday would be gone by Monday.
Higgins’ struggles are the norm for many who seek treatment.
People who walk through Discovery House clinic’s doors “have hit bottom. They are sick of being sick and they are desperate,” Miller said. Around “70 percent of our patients are people who became addicted to opiates through legal prescription medications” that were overprescribed by doctors and abused, Miller said.
Addicts are placed on a daily regimen of liquid methadone that replaces their need for narcotics and allows them to regain a measure of control over their lives and break free from street drugs, he said.
“Its purpose is to provide a quality of life for patients,” Miller said. “It allows them to get their family back, to be employed and to go to school.
“It’s a very effective and very proven treatment, and with counseling it’s even better,” he said.
Miller said he and others at Discovery House often are told: “You saved my life. You gave me back my family.”
Higgins agreed that her methadone treatment program helped her break free of her addiction to painkillers.
“It’s so much better to be strapped to this than the other thing,” she said while enrolled in the program, comparing methadone to street drugs. “At least this is legal, and it’s not as bad for me.”
A year after she started the methadone treatment program it was clear that Higgins, who moved from Bangor to Trenton, was tiring of the daily grind.
“It kind of sucks because you have to be there every day,” she said in December 2009. “If I wanted to go to Hawaii, I couldn’t. I can’t go two days without methadone. If I miss a dose, by nightfall I’m not feeling well.”
Some people think that methadone is a way to wean people off an addiction to narcotics, but it’s really a drug replacement program, Higgins said.
“It’s a treatment program, not a recovery program,” she said.
Rob Kornacki, director of development for Rhode Island-based Discovery House, which operates 18 clinics across the country, including four in Maine, said that for some people methadone treatment is a short-term process and for others it is a lengthy one.
“The treatment is really individually based,” he said. “The treatment plan is going to be very different for someone who has been using [illegal drugs] here or there compared to someone who has used heavily for five to 10 or 20 years. It’s certainly not a one size fits all.”
The goal is to help users become “functioning individuals,” Kornacki said.
Beyond merely functioning, the people enrolled in methadone treatment programs don’t have to scour the streets looking for drugs to satisfy their drug cravings or illegal ways to pay for their habit, he noted.
Fears come true
Just as opiate addicts have had to adapt their behavior to undergo methadone treatment, the city itself has had to adapt to the hundreds of addicts who flock to the city every single day to dose.
Peter Arno, Bangor’s deputy police chief, said the Queen City has changed in the last 10 years. One thing, however, hasn’t changed, he said — demand for illicit drugs has not decreased.
“It does nothing to stop the flow of new users,” he said of the availability of methadone treatment.
Arno recalled that there was a large debate when Bangor’s first methadone clinic opened. Opponents argued that the clinics would only substitute one drug habit for another and actually contribute to the region’s drug problems, while proponents said the clinics would help people live normal lives.
Both scenarios seem to have been borne out over the last decade. Bangor created a community advisory board to address issues related to the city’s methadone clinics, and that group has helped city leaders deal with many of the concerns, Arno said.
“Some of the fears that we had were that people would come to Bangor and commit crimes,” and that has come true, the deputy police chief said, giving an example of one shoplifter who admitted to traveling to town for treatment and stealing items while shopping at the Bangor Mall.
Bangor may be the region’s service center, but that does not mean the community should stand alone when it comes to providing services, he said.
“The question [that needs to be addressed] is: When is enough enough for Bangor?” Arno said. “Bangor has three methadone clinics, more than any other city in the state or … in New England.”
That in itself “really is a sign of a bigger problem,” he said.
Maine’s problem with illegal prescription drugs is nothing new, and the rapid increases in the number of drug deaths and arrests related to prescription drug addiction over the past decade are cases in point.
“More people die from accidental drug overdoses than in car accidents,” said Marcella Sorg, a University of Maine forensic anthropologist and lead investigator in two major studies that looked at drug-related mortality patterns in Maine. “The biggest game in town is prescription drugs.”
The number of drug-related deaths in Maine has increased steadily over the past decade, she said, providing figures for 2000, when 60 Mainers died in drug-related incidents, to 2009, when the figure was 179.
Most of the drug overdose deaths in Maine are considered accidental and are the result of the person combining illegal, diverted prescription drugs and alcohol, she said.
As the number of deaths has increased, so has the number of crimes related to prescription drug abuse.
In 1998, 7 percent of all MDEA drug arrests were related to prescription drugs, according to Darrell Crandall, commander of the Maine Drug Enforcement Agency’s Division 2. In 2009, it increased to 42 percent, and in 2010 it’s going to be right around 43 percent, he said.
Those figures mean that nearly half of the people arrested by MDEA agents today are charged with trafficking or possession of illegal prescription drugs.
It’s easy to see by the number of drug-related crimes in the Bangor area that the region has a serious drug problem that has only gotten worse in the last decade, Arno said. He said 75 or 80 percent of burglaries and thefts in the city involve people stealing cash or items that can be converted into cash for illegal drugs.
Bangor’s methadone clinics help those who want to be helped, but the city and surrounding areas are now a breeding ground for criminals who are looking for drugs or to make a quick buck illegally, Arno said.
“The drug problem in the area and this region doesn’t seem to be subsiding, even with three methadone clinics,” he said. “You can have a methadone clinic on each street corner, but it will do nothing to stem the increase in addiction.”
The life of an addict
Higgins knows what it is to be an addict. Before she entered the treatment program, she would spend each day figuring out a way to get drugs, she said. After her boyfriend moved out and she was left with no income, it became even harder.
“That was your day: get up, find money to get some drugs, get your drugs,” she said. “Sometimes that would take all day.”
She added later that she never stole anything or did anything criminal to get drugs, but she knew people who did. After a while, “I couldn’t handle that lifestyle anymore,” she said.
The lifestyle of an addict is centered on obtaining drugs. And even legally obtained prescription drugs can wind up in the wrong hands — for the right price.
There are a number of ways that legal prescription drugs which are prescribed to Mainers get diverted to the streets, the MDEA’s Crandall said.
“Some are diverted by people who receive prescriptions, either legitimately because of a medical condition or illegitimately by defrauding a provider in some way,” he said. Smuggling of prescription drugs into Maine from Canada is also a significant problem, as highlighted by a number of MDEA arrests in Aroostook and Washington counties, he added.
The lifestyle of an addict can also include heartbreak.
Four months after Higgins entered the Metro program, she lost custody of her daughter, Karli. The young mother had replaced the street drugs with methadone, but she continued to live in the same social circle, which included drug users, and the Department of Health and Human Services deemed it an unsafe environment, she said.
“It’s no one else’s fault except my own,” she said. “I regret the choices I’ve made.”
The child is staying with an aunt and uncle from her father’s side, and Higgins said she is grateful for the care they’ve provided her. “She’s such a good mom,” she said of her ex-boyfriend’s sister. “She’s really good with her.”
But the pain of losing her child is constant.
“I live with that every day,” she said.
The final dose
It was Karli who helped Higgins embark on her difficult journey to kick her addiction, she said.
After two years of traveling to the Bangor Metro for her daily dose, Higgins decided she no longer wanted to be a drug addict. She started in November 2008 at 20 milligrams of methadone and went up to 70 milligrams at her peak.
Over several months in early 2010 she decreased her methadone intake until she got down to 5 milligrams . On Aug. 1, 2010, she took her last shot of the cherry-flavored liquid painkiller.
“I stopped and it was the worst three weeks of my life,” she said. Her methadone withdrawals “felt like I had really bad flu. It was bad.”
“When you kick pills you got maybe seven days [of withdrawals], but after the fifth day you start feeling better,” Higgins added. “With methadone it doesn’t subside. For three weeks there is no sleeping, your body won’t let you, and your skin crawls. That’s the worst.”
Luckily, “I didn’t have any money, so that was great,” she said. “If I had money, I would have dosed. It was that bad.”
Her daily dose was $14, plus she had to pay to travel from Trenton to Bangor, which cost $165 a week on average, she said.
After her withdrawals subsided, Higgins joined Narcotics Anonymous and got a sponsor. She now attends meetings at least three times a week.
“That really saved my life,” she said. “It’s an amazing program. I can talk to my sponsor about anything. She has provided me a support system.”
There also are people and friends who helped her over the past two years whom Higgins said she would like to thank but didn’t want to release their names.
“They know who they are,” she said.
Brent Scobie, Acadia Hospital’s vice president and chief of clinical services, said it is not easy getting off methadone, but it is a step a number of patients decide to take.
“It starts with a conversation with the medical team,” he said. “There are a couple different options. We try to steer people toward a slow, easy” departure from the treatment program.
“The taper actually looks like a staircase with a few platforms along the way,” Scobie said. The platforms are placed in the step-down process to allow the medical team to assess patients and ensure they are truly ready for another reduction, he said.
“There are people who are on 1 milligram, and to come off would be very difficult and [they] choose to stay on. Some people have very minimal [withdrawal] symptoms, and some people have more,” Scobie said.
“On average, roughly half of our population is in the process of phasing down or phasing off our treatment,” he said. “The majority of people who enter treatment choose to come off” eventually.
“People don’t want to be on the medicine if they don’t have to be,” he added.
Higgins knew she didn’t want to be. But the Trenton woman said the treatment did help, and urged others who are ready to make a change to contact an area treatment facility.
Because of their addictions, many of those people, like Higgins, have made decisions that have hurt those closest to them.
For Higgins, that included her family, and especially her daughter.
“I screwed up. I know I did,” she said. “That is why I got into the [methadone] program and that also is why I got out.”
Higgins said even though she is now addiction-free, she still has to prove to the state and her family that she’s worthy of being a parent again.
“I just want a relationship with my daughter,” she said last week. “I had to do this for me — to get free of the drugs and that lifestyle — but I did it for her.”
“We are also now seeing prescription narcotics being brought to Maine by out-of-state drug dealers who used to bring cocaine and-or heroin,” said Crandall.
Crandall’s Division 2 covers Aroostook, Hancock, Kennebec, Penobscot, Piscataquis, Somerset and Washington counties and “all are reporting a significant increase in the diversions of 30-milligram OxyContin tablets,” he said. “An awful lot of these are coming into Maine in one way or another from Florida.”
What led to Maine having such a bad prescription drug problem is not an easy question to answer, Crandall said.
“There is no hard evidence about why Maine,” he said.
When the national opioid epidemic began in the mid-1990s, “there were high concentrations of abusers in very rural, economically depressed areas of the U.S., including areas of Maine,” and that abuse has only continued, Crandall said.