MACHIAS – After years of watching helplessly as prescription drug abuse takes an ever-increasing toll on Washington County, District Court Judge John Romei is beginning to feel hopeful.

Tari Murphy, a substance abuse counselor for the Regional Medical Center in Lubec, shares Romei’s feeling. Murphy has worked with more than 100 opiate addicts over the past four years.

In Washington County, the drugs of choice are OxyContin and Dilaudid, highly addictive painkillers that are snorted or injected. The county has an estimated 600 addicts.

The hope that Murphy and Romei share is based on drug court, an aggressive program of court-supervised drug treatment that will begin in Machias and Calais later this spring.

For convicted drug defendants who are willing to work on their addiction to avoid a lengthy prison sentence, drug court will be the most intrusive experience of their lives, Romei said during an interview last month.

Participants will appear before Romei every Friday, submit to weekly drug tests, meet up to three times a week with Murphy or her colleagues, and regularly attend meetings of Narcotics Anonymous or Alcoholics Anonymous.

“Drug court is the most invasive supervision other than confinement,” Romei said. “We’re monitoring their whole lives and they have no place to hide.”

Washington County will be one of five Maine Adult Drug Treatment Courts, a program that is funded with $750,000 of Maine’s tobacco settlement money.

The other sites are Portland, Bangor, Lewiston-Rumford and York-Biddeford. And while Machias and Calais are the most rural of the new courts, Washington County’s problem with opiate addiction is the worst in the state – completely out of proportion to its small population, the judge said.

“It is just overwhelming and I don’t think we’ve even peaked yet,” Romei said.

The judge spoke to members of the Machias Bay Area Chamber of Commerce on Friday, telling them that half of the child protective cases he has heard in the past few years involve mothers who are addicts. One woman couldn’t even stay awake during the court proceedings, he said.

“And I’ve had law enforcement people tell me that addicts are reading the paper to see when people are getting out of the hospital,” Romei said, referring to the community columns in local weeklies. “The addicts go in and steal the drugs these people need to recover from their surgery.”

The 32-bed Washington County jail, which was usually half-full just nine years ago, has been operating 20 percent over capacity for several years and has been 40 percent over capacity for the last few months.

Practically all of that increase is the result of narcotics, Romei said.

“Literally, we’ve had no success with people who are addicted to prescription narcotics,” he said. “The only drug addicts who aren’t using are in jail.”

But drug courts, such as the Project Exodus trial project that operated in Portland from 1997 to 1999, are successful, the judge said.

Of the 59 people involved in Project Exodus, 35 graduated, a success rate that led Rep. William Savage, D-Buxton, to introduce the legislation that created the Maine Drug Treatment Court Program.

Maine Chief Justice Daniel Wathen advocated for the adult drug courts as he’d advocated for juvenile drug courts. Romei said it didn’t take much to persuade Wathen that Washington County should be one of the sites for the new program.

The chief justice sat in 4th District Court in Machias 21/2 years ago and was shocked at the number of people arraigned on prescription drug cases, Romei said.

“He told me it was something he’d expect to see in places like Camden, New Jersey, Newark or Detroit,” Romei said.

The judge said Washington County has such a desperate need for a way to fight the epidemic that Murphy and the other drug court counselors have agreed temporarily to take on the additional responsibilities of case managers for the program.

The Office of Substance Abuse expects to fill the positions this summer.

But, if Washington County has case management, it immediately can begin taking referrals of people convicted of drug-related crimes, the judge said.

“The other counties are only taking probation violations because of a lack of case managers, but our substance abuse counselors are taking on the extra work,” Romei said.

Only nonviolent offenders can apply for the program and they must be convicted of a drug-related crime – such as a residential burglary involving theft of drugs or of money to buy drugs. And they must be in line for a strict enough sentence that the idea of the jail time will act as a deterrent, he said.

Romei said the judge delays sentencing while the person is in drug court and success in the drug court program will effect the final sentence.

Romei said there are 20 openings for drug court in Machias and 20 for drug court in Calais. Anyone can refer a potential participant – prosecutors, defense attorneys, probation officers. The person being referred is then screened for suitability.

The program received its first referral last week, Romei said.

Murphy said she and fellow drug court counselors Claire Trottier and Greg Schorrs attended two weeks of training in differential substance abuse treatment in Rockland last month.

The treatment groups they will conduct with participants are not therapy sessions, Murphy said. There will be skill-building sessions aimed at changing addicts’ behavior by changing the way they think, she said.

The model was developed specifically for the Maine drug court program by JBL of Canada in cooperation with the Maine Office of Substance Abuse, Murphy said.

“We’ll do everything from budgeting, interviewing for jobs, and access to further education to decision-making, communication, and relationship building skills,” she said. “Building those skills will allow them not only to stay clean and sober, but improve the quality of their life.”

The sessions will be designed around the needs of participants and could include three three-hour sessions a week in the beginning of the program, she said.

Included in the sessions will be role playing, helping participants think through what they can do when they meet someone they used to do drugs with or encounter a situation that could trigger a decision to get high, Murphy said.

“This is research-based,” she said. “Thoughts affect feeling, which affect actions which affect consequences.”

Passamaquoddy tribal Judge Rebecca Irving said the Indian Township Reservation is implementing a drug court for juveniles, and members of the tribe at the Pleasant Point reservation are writing a grant for an adult drug court.

“I think it is a wonderful concept,” said Irving, who attended five days of National Drug Court Institute Training in Alexandria, Va., two years ago.

The drug court concept of “therapeutic jurisprudence” was developed in Miami in 1989 when the city was having an overwhelming problem with drugs and repeat offenders, she said.

There are now 600 drug courts nationwide, and Irving said the country has finally realized the “tremendous cost” of locking people up and then letting them go, only to see them return to drugs.

“Drug courts require the entire legal and judicial system to rethink the problem of drug addiction,” Irving said. “The success rates are terrific.”

What the adversarial-punishment approach failed to recognize was that drugs cause a tremendous biological change, and that change dictates what a person does, Irving said.

“They are no longer able to respond intellectually to a problem that has become physical,” she said. “And if you understand that people are responding to a physical need, it is easier to realize why penalties aren’t working.”

Washington County’s new drug court will begin as soon as there are enough referrals, Romei said.

While neither he nor Murphy expects miracles, both believe that drug court will make a difference.

“I think we will save some lives,” Romei said. “It’s just a question of how many.”