Saturday, July 20, 2013

Heroin addiction takes hold in New England

A few weeks ago, the problem of prescription drug addiction and the rising death rate from it were all over the news following a Centers for Disease Control report highlighting the problem among white women in particular. I wrote this blog post about the phenomenon and its apparently greater impact in nonmetropolitan communities. Now, Katharine Q. Seelye of the New York Times reports on the burgeoning problem of heroin addiction in New England, with something of a focus on small towns and how "spotty" law enforcement there--along with users willing to pay higher prices, especially in northern New England--have led New York City drug dealers to take their wares north. The headline is "Heroin in New England, More Abundant and Deadly; Overdoses Soar as Addicts Confront Limits on Painkillers."

As that subheading suggests, the surge in heroin use is seen as related to crackdowns on the availability and ease of use of drugs like Oxycontin and other prescription pain killers.  As Dr. Mark Publicker, the President of the Northern New England Society of Addiction Medicine is quoted, "We had a bad epidemic, and now we have a worse epidemic." Publicker explains that some doctors were "overprescribing painkillers, which can be gateway drugs to heroin." Many of those users have now shifted to heroin, which is considerably cheaper and easier to get.

Here's the story's lede:
Heroin, which has long flourished in the nation’s big urban centers, has been making an alarming comeback in the smaller cities and towns of New England. 
From quaint fishing villages on the Maine coast to the interior of the Great North Woods extending across Maine, New Hampshire and Vermont, officials report a sharp rise in the availability of the crystalline powder and in overdoses and deaths attributed to it. 
But it is not only limited law enforcement that creates an opportunity for drug peddlers up north.  It is also the law of supply and demand. Seelye writes: 
Distributors in New York see a wide-open market in northern New England, where law enforcement can be spotty and users are willing to pay premium prices. A $6 bag of heroin in New York City fetches $10 in southern New England but up to $30 or $40 in northern New England, law enforcement officials said.
Seelye doesn't explain why these New Englanders are willing to pay more, but she does note that heroin is one of the most addictive drugs in the world.  One-quarter of those who try it will become addicted.  Yet Maine is the first state to limit access to medications such as buprenorphine and methadone, which are effective at treating addiction.  The state took that step in order to save money, but it may be in fact be raises costs as the demand on first responder and other services has risen with the steep rise in overdoses.  Twenty-one people in Maine died of heroin overdoses in 2012, a three-fold increase over the prior year.  Heroin deaths in New Hampshire are up more than five times the rate a decade ago, with 40 deaths recorded last year.  The Health Department in Vermont reported 914 people treated for heroin abuse in 2012, an increase of nearly 40% over 2011.  

I'll close with another quote from Dr. Publicker, which refers to another, very different, rural challenge:  
It’s easier to get heroin in some of these places than it is to get a UPS delivery. 

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