Maine’s serious drug problem

Maine is experiencing a quiet epidemic, one that is undermining the health and well-being of many of our residents, particularly teens and young adults. The epidemic I am referring to involves the abuse of opioid drugs and the ever-growing population of opioid-addicted individuals in our state. Examples of opioid drugs are: heroin, and prescription painkillers such as vicodin, oxycodone, and percocet. Many people refer to these drugs as opiates.

The fact of the matter is that Maine is one of the most opiate-addicted states in the nation. In the United States as a whole the opiate-addicted population averages approximately 2 percent; in Maine the average in regions like Bangor and Washington County approaches 9 percent. Although the average age of first opiate use across America has gotten increasingly younger, the trend in Maine is even more startling. The rate of persons entering treatment for opiate dependence under the age of 25 in Bangor is twice the national average.

Half of these young patients are women. Many are parents of young children. Seventy to eighty percent of these patients have a liver disease called Hepatitis C. Damage done to the liver by Hepatitis C is the current leading cause of transplant in the United States. When you add to this all the other potential health problems associated with chronic opiate dependence such as HIV infection, overdose, blood infections, poor nutrition and lack of appropriate self care, the public health implications for Maine communities are enormous. Our patients are mostly local residents who will remain in the community with these health problems. The more people that enter treatment early in the addiction cycle the more people will avoid these long-term health problems.

When Acadia opened its methadone program in 2001, we planned for a census of 150 patients. That filled quickly, and today we have developed the ability to treat 700 patients. That doesn’t include another 170 addicted patients we are treating on a daily basis with methods other than methadone including intensive counseling services and the new medication, Suboxone.

Certainly patients come to opiate dependence from a variety of directions. Some were exposed to and became dependent as a result of legally prescribed medications for a legitimate medical problem. Others became addicted when engaging in a seemingly harmless flirtation with recreational use. A significant number of the patients in opiate treatment have serious underlying psychiatric problems or histories of trauma. It is clear that these underlying problems create a special vulnerability to becoming drug dependent. It is also clear that these underlying issues must also be appropriately treated if a person is to have a reasonable chance at recovery.

No matter how a person initiates opiate use the course of their dependency is all too predictable. The “window” of recreational use of drugs like heroin or oxycodone is extremely small for most individuals. While it can take years of consistent use of drugs like alcohol or marijuana to create a serious pattern of addiction, that timeframe melts away to months for those using opiates.

Within six months to a year of regular opiate use, significant changes occur in the brain that do not easily or quickly reverse themselves. The user must use in order to feel normal; they must use to avoid the intense “dope sickness” that accompanies withdrawal. Withdrawal then often leads to long-term feelings of depression, anxiety, and craving for the drug, which drives the addicted person back to opiate use in an attempt to feel normal.

This “brain disease” is chronic. Like other chronic diseases such as high blood pressure or diabetes, it does not go away, so our addicted neighbors and employees will be with us throughout our lifetime. We need to assist them with managing this disease of opioid dependence across their lifespan so that they can have the best possible medical and social outcomes. We need to do this not just because it is the right thing to do for those suffering with an addictive disorder, but also to help ensure the health of our community as this disease process moves forward. Without taking a proactive stance the numbers of affected individuals is bound to grow and the negative impact on the health and economy of our region will continue to increase.

While we don’t understand everything about the brain and why some people are more easily addicted than others, we do know one thing. Educating young people and their families about the dangers of addiction is currently our best hope to prevent a youthful indiscretion from becoming a lifelong, chronic disability.

The Acadia Hospital is proud to be a leader in a multi-year campaign called “Close to Home” that is about to be launched to educate Maine citizens about the dangers of opiate abuse. On the prevention side, we will be providing important preventive messages in various media, as well as our new website, www.closetohome.org. We will also be sponsoring educational initiatives for young people, teachers, care providers, business leaders, and parents. It is our fervent hope that we can educate our young people on the horrible consequences that can result from experimentation with addictive drugs.

Part of the campaign’s strength lies in the many organizations that have agreed to partner with us. You can see the complete list of partners on the aforementioned web site.

It will not be an easy journey, but only with the involvement of the entire community can we manage this problem and start reducing its effect on future generations.

Dorothy E. Hill, RNC, is the president and CEO of The Acadia Hospital