BANGOR, Maine — Standish resident Lourdes Watson Carter was a very young woman when she first tried heroin.
The 34-year-old mother of one started using the illegal drug years ago, her father said, noting that every attempt she made to quit it only seemed to tighten the vise of her addiction.
She lost her battle in June at a house party in Portland.
“She shot up and somebody came along and gave her [another] shot and that is why she overdosed,” her father, Mike Watson, said recently by phone from Maryland.
Watson, a retired Amtrak police officer who spent nine years with the train company’s narcotics unit, said his daughter was clinically dead when found by paramedics. They were able to restore her heartbeat but she never regained consciousness and was removed from a respirator on June 12 at a Portland hospital with her family by her side.
Carter’s death is indicative of a startling increase in fatal heroin overdoses in Maine, which jumped from seven in 2011 to 28 in 2012, according to figures on drug-induced deaths released Wednesday by Attorney General Janet Mills and Chief Medical Examiner Dr. Margaret Greenwald.
Marcella Sorg, a University of Maine medical and forensic anthropologist who along with Greenwald has been tracking drug-related mortality patterns in Maine since 1997, said heroin deaths in 2013 are likely to exceed those in 2012, according to the release.
In all, drug overdoses killed 163 people in Maine in 2012 and 2,110 people between 1997 and 2012 — according to the latest data available from the state medical examiner’s office. In each of those cases, one or more drugs were listed on the death certificate as a cause of death or a significant contributing factor.
“Each of these deaths represents a waste of a life, a preventable tragedy,” Mills stated in Wednesday’s release. “The destruction of lives by drugs deserves our intensive intervention and society’s full attention.”
Mills said the problem in Maine is likely to worsen because of cuts to services for addicts.
“The Affordable Care Act now covers substance abuse disorders and treatment, with federal subsidies for those who cannot afford their insurance premiums. But cuts in MaineCare will leave more of the very poor without coverage for these treatable disorders. We may expect more preventable deaths in the future,” Mills said.
Fatal overdoses aside, the cost of substance abuse is high for Maine residents, according to experts.
“The deaths themselves are tragic, but they represent just the tip of an iceberg that includes the negative impacts to public safety and health resulting from drug misuse, abuse and drug trafficking,” Sorg said in a 2012 report for the National Institute on Drug Abuse ’s Community Epidemiology Working Group.
Drug abuse in Maine “doesn’t just affect overdoses. It affects the number of arrests, the number of treatment admissions for addicts. It affects all aspects of life,” Sorg said during a recent interview at the Margaret Chase Smith Policy Center at UMaine.
The cost of drug addiction per person in Maine — including everything from arrests, court time and incarceration, treatment and other costs — reached $1,056 in 2010, Sorg said.
“It’s a hidden tax,” Roy McKinney, director of the Maine Drug Enforcement Agency, said. “That is substance abuse. It has direct and indirect impacts.”
Those impacts include the 927 drug-addicted babies born in Maine in 2013, according to Mills — more than twice the number in 2009 and a dramatic increase from 165 in 2005.
“Each of these babies represents a challenge to Maine’s health care system, Maine’s educational system, Maine’s social services system,” Mills said. “Each of these children will require comprehensive health care that is now no longer available to many in our state.”
The problem of drug addiction and drug trafficking is a public health crisis requiring treatment and support, preventative services and a greater focus on education and creative criminal justice approaches such as Drug Court and Co-Occurring Disorder Courts, the attorney general said.
Tracing the problem
Fatal overdoses from all drugs in Maine rose dramatically beginning more than a decade ago but have leveled off in recent years. There were 34 drug-induced deaths in 1997, according to the medical examiner’s office. The number jumped to 60 in 2000 and to 179 in 2009, for the first time exceeding the number of people who died annually in car accidents in Maine.
Fatal overdoses dipped to 168 in 2010 and again to 156 in 2011, but increased to 163 during 2012, Sorg said.
Statistics are compiled slowly because determining if a death is caused by drug overdose requires extensive testing, which can take months, Sorg said.
The deadliest drugs in 2012 were oxycodone, a narcotic responsible for 29 percent of fatal overdoses; benzodiazepines, sedatives often used to treat anxiety, at 24 percent; and methadone at 20 percent, according to an April 2013 report titled, Substance Abuse Trends in Maine, produced by the state’s Office of Substance Abuse and Mental Health Services.
From pills to heroin
“We’ve got a prescription drug problem,” Sorg said.
Of the 163 overdose deaths in 2012, 101 involved pharmaceutical opioids, her data show. But the demand for pills also affects heroin use.
“The increase in heroin is related to the [other] opiates,” she said Wednesday. “These things are comparable because people who are addicted to pain pills can take another opioid [to get their fix].”
Four percent of all Maine overdose deaths in 2011 were related to heroin, and that percentage jumped to 17 percent for 2012, she said.
Bangor police Lt. Tom Reagan said he is pretty sure heroin is on the upswing in his city because diverted prescription pills are harder to come by recently.
“If you can’t get your oxys, you can use heroin to avoid withdrawals,” he said.
“An opiate is an opiate,” McKinney of the MDEA agreed.
Heroin use is on the rise partly because of regulations restricting prescriptions for oxycodone and regulations requiring tamper-resistant packaging of prescription opioids, Mills said. She said the low price of heroin has made the drug much more accessible to people who no longer can get prescription opioids and to people just getting hooked on drugs.
The new state rules, which went into effect Jan. 1, 2013, set new 15-day supply limits on the amount of opioid painkillers — such as OxyContin and Percocet — that physicians can prescribe, shortens the length of time they can be prescribed and narrows the list of pain conditions that warrant the drugs.
The efforts have been effective, McKinney said.
“Pill diversion is still continuing, but the market has been greatly disrupted,” he said.
Lourdes Watson Carter turned to heroin after she was put on Suboxone to get off the diverted prescription pills she was using to get high, her father said.
“It’s pretty cheap on the street, instead of pills,” Watson said. “They turn to heroin because it’s cheap and they stay high for a while.”
Prices of heroin vary across the state, with a “fold” or “bag” of heroin — .05 to .1 gram — costing $20 to $30 in the Brunswick area, according to Brunswick police Detective Rich Cutliffe, an MDEA agent with the Portland Task Force.
The going rate in Bangor is about the same, with a full gram, called “a bundle,” costing between $200 and $250, according to Bangor police Lt. Steve Hunt, a supervisory special agent assigned to the MDEA’s North Central Drug Task Force.
“The price fluctuates depending on what pills are available,” Hunt said. “When oxycodones are hard to get, the price goes up, and that is when heroin use increases.”
Michael Wardrop, Maine’s resident agent in charge for the U.S. Drug Enforcement Agency based in Portland, said criminals willing to bring the drugs to Maine from other states can make good money but also face federal interstate drug trafficking charges.
“New York is more of a wholesale market whereas Maine is retail,” he said, talking about why prices of heroin are higher in Maine compared with the Big Apple.
For the same high, a 30-milligram oxycodone pill costs $30 to $40, Cutliffe said, and “the oxys are more work” because new chemistry makes the pills turn to gel when they come in contact with water, so they are harder to shoot intravenously.
Lives of crime
Heroin is a highly addictive drug that creates a tolerance in users, who must consume more and more of the opiate to get the same high. Carter’s heroin addiction had such a hold on her that by the end of her life she was selling her body to get her daily fix, her father said.
“They didn’t have money so they were using their bodies to get drugs,” Watson said. “It’s hard to grasp what they were thinking.”
The addiction was so bad that even when his daughter was behind bars for drug trafficking, she was still dealing, her dad said.
“Those girls were bringing drugs to her and she was selling them in the jail — that is how bad it was,” Watson said.
Drug addiction in Maine is also showing up in the state’s most horrendous crimes, according to Mills, who said six of the 25 homicides during 2012 were related to illegal drugs.
The slayings of three people whose charred bodies were found in a burned-out car in Bangor in August 2012 are included on the list. The affidavit filed in the triple homicide states the three were killed because one had used a rival dealer.
“People are killing each other over these substances,” Mills said.
The attorney general also noted that her office prosecuted approximately 630 felony drug cases in 2013.
The aggressive capture and prosecution of almost all the addicts and criminals involved in the 50-plus pharmacy robberies in Maine in 2012 have helped slow the state’s pill problem, McKinney said.
“The arrests, the clearance rates, the judges [issuing] significant sentences — all those messages have helped,” the Maine DEA director said.
But the ultimate cost of drug abuse remains stubbornly high in Maine.
It is the family and loved ones of those left behind who really pay, said Mike Watson, who struggled with the decision to pull the plug when doctors told him his daughter was brain dead.
“Lourdes had been in and out of the drug scene for many years,” he said. “She would always go back to it. She would say, ‘Dad, I know I have a problem.’ She wanted to be clean, she would tell me, but she had the appetite for it and couldn’t walk away.”