While increased narcotic drug trafficking across the border with Canada is partly to blame, the relative ease of getting these drugs from doctor's offices and emergency rooms is also part of the problem. As Chris Knight reports, experts say solving the problem won't be simple, and the key is heightened vigilance of both law enforcement and the medical community.
The Department of Corrections will close two more prisons this year, bringing to a total of nine the number...
Law enforcement agencies from across the North Country took part in...
Two years ago, the Franklin County Drug Task Force received a tip that a house in Malone was being used as a trafficking center for prescription narcotic drugs.
Derek Champagne is the county's district attorney. "It was a house that had nonstop traffic," he said. "It came to the attention of neighbors as well as law enforcement. We were able to purchase a number of prescription drugs out of the house (through a police informant)."
But this wasn't just a run of the mill drug house, the DA said. Police set up a wiretap of the house's phone lines and learned that these dealers weren't just doling out drugs, they were also passing along advice.
"The phones were basically nonstop instructions to people on which doctors to go to, how to go to different pharmacies to get hydrocodone and oxycodone," Champagne said. "It really brought a lot of things to our attention becauase it was going on right here under our nose."
The extent of the operation surprised law enforcement, but in retrospect, it was just another sign of a growing problem that Champagne now describes as almost an epidemic: the abuse of prescription narcotic drugs. Police, prosecutors, doctors, pharmacists and drug counselors say narcotics like OxyContin, Percocet and Fentanyl have now become the drug of choice for many people in the North Country.
"I think it's probably rising faster than anything in our line of work right now," said Brent Davidson, a lieutenant in the New York State Police Troop B Bureau of Criminal Investigation, based in Ray Brook.
"Not only do you have the unlawful sale and distribution of these prescription pills, you also have people who are addicted to them who are committing crimes. I would say a large percentage of our crimes are a result of people addicted to prescription drugs.:
Davison also said nine deaths have occurred in Troop B over the last two years that were directly attributed to the overdose of prescription medications.
But it's not just police who are seeing this trend. Melinda Drake, outpatient services director for St. Joseph's Addiction Treatment and Recovery Centers, which is based in Saranac Lake, said more and more people are being admitted into their outpatient clinics because they're addicted to prescription narcotics.
"Across our system, what we're seeing from 2009 to now is a doubling of the number of clients coming in and being admitted with prescription drug abuse as their primary addiction," Drake said.
Asked why prescription drug abuse has spiked, most people say it's primarily because these kinds of medications are easier to come by than harder, illegal drugs like heroin and cocaine. Champagne said large quantities of prescription narcotic pills are being smuggled into the North Country from Canada where they're being sold on the street. Or people can steal them from a family member's medicine cabinet or obtain them by "doctor shopping" at physicans' offices and emergency rooms around the region, often paying for the drugs using Medicare, Medicaid or other public assistance.
"They're much more available and much more accessible," Champagne said. "Certain people almost have it down to a science."
Jennifer Smith is one of those people. A former registered nurse from Port Henry who battled prescription drug abuse for 20 years, Smith said she would doctor-shop at hospitals and medical facilities across the region. "You'd make up an issue they couldn't prove like, 'Oh, my lower back is hurting,'" Smith said. "You can't really prove that, so they give you medicine to make you feel better. You'd go from doctor to doctor. I went from Ticonderoga up to the Adirondack Medical Center (in Saranac Lake) to the hospital in Burlington. I went all over the place, making up things."
At Adirondack Medical Center in Saranac Lake, Associate Emergency Department Director Dr. A.J. Dowidowicz said he was suprised by the extent of the problem after coming here from New York City last year. Part of the problem, he said, is that addicts seeking prescription narcotics have often got what they wanted, with not enough questions asked by medical personnel.
"Working in the ER, I was astounded by the number of people who would come into the ER with what seemed to be minor complaints but demanding that we'd give them large quantities of drugs, narcotics, specifially opiates. Going back through their records I was suprised to find that historic people had been very liberal with the way they prescribe drugs, some older practioners more than others, and that in some way the health care system has sort of created this problem over time," Dowidowicz said.
Most people interviewed for this story say it's largely up to doctors and medical practitioners to help curb the problem by being more vigilant about prescribing narcotic drugs - giving out just 10 pills instead of thirty, checking further into a patient's medical history, and suggesting other pain management treatments.
Melinda Drake said improved communication between doctors and pharmacists has to be a part of that.
"When you have clients going from one doctor to another doctor to another doctor, none of the doctors know what the other doctor has prescribed them," Drake said. "Before you know it, they have so many prescriptions for a certain medication. Until people share that information, it's very hard to address that problem of access."
But sharing that kind of medical information isn't easy these days given federal laws like HIPAA that are designed to protect a patient's privacy.
Nevertheless, prosecutors are finding ways around that. Derek Champagne said his office has been able to work with the federal Drug Enforcement Adminstration to identify and approach doctors in the Franklin County who were prescribing high amounts of narcotic drugs, in comparison to other doctors. Champange has also worked with state Medicaid inspectors to restrict people who've been convicted of crimes related to prescription drug abuse from obtaining certain medications or from going to more than one doctor.
It's a battle that has to be fought on many fronts, the DA said.
"We absolutely don't want to be infringing on a physician's treatment of their patients ... but if we know an individual's going to three different doctors for the exact same problem, then there should be a way for us to let the doctors know that."
"It is a complex issue we're making a lot of inroads on, but I think a huge concern is how many people out there are currently addicted to these prescription drugs."
Dowidowicz said there are many people who have legitimate medical reasons to be prescribed narcotic drugs; doctors and pharmacists don't want to prevent them from getting help. To that end, he said AMC plans to reach out to people who frequently come to the ER with unspecified painful conditions and ask what can be done to help them.
"People who simply don't want the help, they won't respond to us. But I think we need to be more aggressive and reach out to people who truly need our help. And if their answer to that is that is they need opiate detox and rehab, that's very legitimate. That's what we're there for."
Dowidowicz said he hopes other medical facilities and physicans in the region take the same approach.
Others said education about how easy it is to become addicted to narcotic drugs, and encouraging people to dispose of old, unused prescription drugs from their medicine cabinets, are just as important steps to curbing the problem.