Note: This article was originally published on Jan. 7, 2005.
Before he became district attorney two years ago, Jonathan Blodgett thought heroin was a city problem, and one mostly from decades past.
Now he knows better.
One year ago December, Blodgett attended the wake of a 19-year-old from Peabody who grew up with his son. He was a typical teen, a good athlete and student, and never in any trouble.
But he became addicted to OxyContin. Then he tried heroin, just once. The next morning his father found him slumped over his computer, dead.
Blodgett tells the story almost every time he speaks publicly about the area's growing opiate epidemic, which he does often, and with urgency. He recently told the story to a reporter, and despite himself, the burly prosecutor started to cry.
"It can happen to anybody, and that is why I get emotional about it," Blodgett said. "It doesn't matter who you are or where your family is from. It only takes one mistake, one mistake that will follow you for the rest of your life if it doesn't kill you."
A Salem News investigation has reached the same conclusion: Essex County is under siege by opiate abuse among young people. And there is no coordinated battle plan to fight the scourge.
What needs to be done? Leaders say the following steps must be taken:
- Communities need to launch a major education effort to let parents and young people know the dangers of experimenting with prescription drugs.
- The state must better track overdoses so everyone knows the severity of the problem and how to dedicate resources.
- Hospitals need to report overdoses to police. Also, emergency room doctors must accurately record when a person dies of an overdose, instead of trying to spare families the stigma of a drug-related death.
- More money must be spent on treatment. The state is spending less now in the midst of an opiate epidemic than it was 10 years ago.
- The makers of OxyContin need to make a pill that young people can't abuse. Researchers are studying ways to add ingredients to OxyContin that would block the high if the pill's time-release coating was crushed.
- Essex County needs more inpatient treatment centers for teens addicted to opiates. One is planned to open in Danvers in March. It will have 15 beds and only take boys.
But not everyone agrees on what needs to be done, and that's a big part of the problem.
While the district attorney wants mandatory reporting of overdoses, for example, the medical community fears addicts won't seek treatment if police get called. Drug counselors are calling for more education, but some school leaders don't believe the problem is as serious as they suggest.
Calls for help
For more than two decades, law enforcement has waged a seemingly endless war on drugs. But police in Essex County have been struck lately by the feeling that they are moving backward.
Police say they are overwhelmed by the amount of heroin and OxyContin on the streets and disheartened by the ages of this new generation of addicts.
Law enforcement can't handle the problem alone, said George Festa, director of the federal High Intensity Drug Trafficking Area office in Methuen, one of 28 such offices in the United States.
"I wish I could say, 'Hey, we are doing a great job,'" Festa said. "And we are working very, very hard. But we definitely need more resources to tackle this problem."
The solution is not simply to throw more money at police departments so more arrests can be made, he said. Instead, they need schools and parents to acknowledge the epidemic exists and then together warn young people about the dangers of trying opiates.
In Lynn, where police say kids as young as 12 have been found using OxyContin, there were 107 confirmed heroin overdoses in 2003.
Some people dismiss those statistics, saying there is a big difference between Lynn and such towns as Boxford, Marblehead or even Peabody. But about half of Lynn's overdose victims lived outside of Lynn and came from places like Boxford, Marblehead and Peabody.
The numbers frighten the city's police chief, John Suslak, and he has reached a grim conclusion: "We are not going to arrest our way out of this problem."
A new gateway drug
The epidemic stems from kids trying prescription drugs without realizing how fast they can become addicted. But school departments have been agonizingly slow to respond.
The DARE program that grew to prominence in the 1980s has mostly disappeared from North Shore schools. Instead, drugs typically are only addressed in school health classes. But those classes rarely extend beyond ninth grade, and often don't discuss heroin and OxyContin.
"Schools cannot expect to address this with a few health classes over the course of four years," said Alex Packer, president of FCD Education, a Newton-based nonprofit organization that creates anti-drug curriculums for schools.
There is no doubt heroin and OxyContin have made their way into Essex County schools, including the prestigious private ones. In response, Blodgett has spoken to dozens of superintendents and principals during the past year and a half to ask for help.
So far, Blodgett knows of no Essex County school system that has launched any new programs.
In Peabody, 24 people overdosed on heroin in 2003, and four died, including a recent high school graduate. But in April, when Blodgett hosted a forum at Peabody High to discuss the growing drug problem, four parents showed up.
"I do believe there is a disconnect somewhere and we are not getting the point home," said Essex County Sheriff Frank Cousins, who next week will co-host with Blodgett a conference about the area's heroin and opiate epidemic. "I haven't seen anything dynamic that is being taught in a school that is turning this thing around."
The numbers say little
In the past two years, people who treat opiate addicts have begun using the word "epidemic" when they describe the area's heroin and OxyContin problem among young people. But exactly how bad things are here no one can say. Statistics from the state are old and of little use when it comes to identifying the full extent of the problem.
In 2001, 58 people died in Essex County from opiate overdoses, according to the state's Department of Public Health. But the state won't say how many people died last year, the year before or the year before that. The 2001 statistics are the most recent available, and there is no word on when more up-to-date information will be released.
Law enforcement officials say the delay is making their job more difficult. Without the hard numbers, they can't convince people that the epidemic has hit the suburbs.
"With all due respect to the Department of Public Health, it has been a struggle to get them to identify the problem that we see locally," said Suslak, the Lynn police chief. "We have to get the cold, hard, objective data here."
In an e-mail to the Salem News, Charlene Zion, a statistician for the Department of Public Health, explained the delay this way: "It's a very lengthy process from the day a death occurs to the time it is available for use on computerized files, as there are literally multitudes of steps that are necessary."
State officials do acknowledge, however, that some death statistics may not be complete. Sometimes emergency room doctors and medical examiners inaccurately label an overdose a "heart failure" in an attempt to spare families the heartache.
"It is diagnosed, but it is not recorded for what it actually is," said Teresa Anderson, director of statistics at the state's Bureau of Substance Abuse Services. "Even doctors in emergency rooms that we have had discussions with over the years will put 'cardiac arrest,' or they will put 'respiratory failure,' and they won't list heroin overdoses because they want to avoid this stigma."
Under current practices, police departments and the district attorney are often unaware when a rash of overdoses is underway.
State law requires hospitals and medical professionals to notify police when they treat knife or gunshot wounds, but there is no such law for reporting overdoses.
Blodgett wants a state law passed that would force emergency rooms to notify police when an overdose victim is brought in. He said he will make the proposal his No. 1 legislative initiative in 2005.
"We are not going to be handcuffing people to gurneys as they are treated," Blodgett said. "But if there are five overdoses in a weekend that are nonlethal, we need to know that immediately. Some emergency rooms flat out refuse to give us that information."
With it, the police could go after the dealers selling the bad heroin and warn addicts to stay away. They would also have a better handle on the scope of the problem. When asked about privacy rights, Blodgett said he may not need the names of the victims.
But medical professionals were aghast when told of Blodgett's proposal, saying it would almost certainly discourage addicts from bringing overdose victims to the hospital.
"Instead of bringing people to the emergency room, they'll either try to resuscitate them themselves, or dump them outside the emergency room and make a cell phone call," said Dr. Poule LaPlante, the medical director at the Addison Gilbert Hospital methadone clinic. "So two or three minutes might be wasted when a person is not breathing."
Blodgett also wants the state Legislature to implement tougher sentencing rules for dealers and for people who profit from opiate distribution. Right now, dealers typically get 10 to 15 years in state prison for heroin trafficking. Blodgett wants the crime to carry a mandatory penalty of life without parole.
Lack of beds
While law enforcement searches for ways to address the county's OxyContin and heroin epidemic, the medical community has its own problems.
In the past three years, the state has cut $16 million from the Bureau of Substance Abuse Services budget. Six of the state's 22 detoxification centers have closed in the past two years.
In Essex County, there are 11 free detoxification beds available each day — six at CAB Addiction Services in Danvers, and five at the Lowell Community Health Center in Tewksbury. About 60 other beds are available at those two facilities for people with cash, MassHealth or private insurance coverage.
And finding inpatient treatment is particularly difficult for young people.
Most state addiction centers do not accept people under 18, though occasionally a 17-year-old will be accepted with a parent's permission. Generally, anyone under that age must travel outside Essex County to Brookline, Marlborough or Holyoke for treatment.
Many parents are sending their kids out of state to get treatment at private facilities.
"If someone called me today and said, 'Where is there an adolescent detox?' I would have to look it up," said Steve Chisholm of CAB Addiction Services in Danvers. "They are not well established."
Counselors lament the budget cuts, of course, but law enforcement officials are equally concerned. The police are tired of seeing the same people being arrested for low-level drug dealing, shoplifting and identity fraud.
"We have to give people a way out of this hell they are in," said Festa, the area's federal drug investigation coordinator.
There is a glimmer of hope on the treatment front, though.
Kevin Norton, CAB's president, announced plans last month to open a 15-bed treatment center for adolescent boys at its Danvers campus in March.
There are no plans for a female treatment center in Essex County for teens.
Teach your children well
Of all the groups involved in the county's opiate epidemic, parents have perhaps the most important role to play. They must forget what they fought they knew about heroin and the people who use it and start asking their children questions:
What drugs have they heard about in school? Does anyone in school use drugs? Do they have any questions about drugs?
"By asking young people about things, it gives them more of an invitation to come to you," said Jayne Wilson, a nurse who works for a Peabody methadone clinic.
For his part, Blodgett said he will not allow the silence that surrounds OxyContin and heroin addiction to continue to hide the problem.
"I am firmly convinced the only way this is going to stop is to have a huge education effort," Blodgett said. "The only way you choke off the supply of heroin or any drug is to educate young people at a very early age that it is not the road to go down."
Blodgett spoke recently of a phone call he got from the mother of a Peabody fifth-grader. She was upset with the posters that his office had placed in her son's school that showed a graveyard and the words, "Heroin can kill you."
She told the district attorney he was scaring the children.
"His reply: Thank you ma'am."