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. “It’s easier to get heroin in some of these places than it is to get a UPS delivery,” said Dr. Mark Publicker, an addiction specialist here. Here in Portland, better known for its laid-back vibe and lively waterfront, posters warn of the dangers of overdose. “Please,” they say: “Do Not Use Alone. Do a Tester Shot” and “Use the Recovery Position” (which is lying on one’s side to avoid choking on vomit). The city, like many others across the country, is experiencing “an inordinate number of heroin overdoses,” said Vern Malloch, assistant chief of the Portland Police Department. “We’ve got overdose deaths in the bathrooms of fast-food restaurants. This is an increase like we haven’t seen in many years.” Heroin killed 21 people in Maine last year, three times as many as in 2011, according to the state’s Office of Substance Abuse and Mental Health Services. New Hampshire recorded 40 deaths from heroin overdoses last year, up from just 7 a decade ago. In Vermont, the Health Department reported that 914 people were treated for heroin abuse last year, up from 654 the year before, an increase of almost 40 percent. “Heroin is our biggest problem right now,” said Capt. Scott Tucker of the Rutland, Vt., police. One reason for the rise in heroin use is the restrictions on doctors in prescribing painkillers. The tightened supply of pain pills, and physical changes that made them harder to crush and snort for a quick high, have diverted many users to heroin, which is much cheaper and easier to get. Dr. Publicker, president of the Northern New England Society of Addiction Medicine, said that some doctors in the region had been overprescribing painkillers, which can be gateway drugs to heroin. A federal study in 2011 showed that the treatment admission rate for opiate addiction was higher in Maine, and New England, than elsewhere in the country, though communities everywhere are reporting problems. “We had a bad epidemic, and now we have a worse epidemic,” Dr. Publicker said. “I’m treating 21-, 22-year-old pregnant women with intravenous heroin addiction.” Yet the rise in heroin abuse here predated the restrictions on painkillers, leading some officials to blame the simple law of supply and demand. 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. The dealer gets a tremendous profit margin, while the addict pays half of what he might have to shell out for a prescription painkiller. “If the market is flooded with low-priced, high-grade heroin, a significant population is addicted,” Captain Tucker of Rutland said. “That’s the free market.” Heroin is one of the most addictive drugs in the world. About a quarter of everyone who tries it becomes dependent on it. Users can quickly develop a tolerance, prompting them to seek more and more until the pursuit takes over their lives and, often, leads to ruin. Theresa Dumond, 23, who lives on the streets of Portland, said she sells her body three times a day to support her heroin habit. She lost custody of her two young children about a year ago (“I can’t keep track”), and their father died. “I’ve lost everything,” she said as she and a companion, Jason Lemay, 26, walked to an abandoned train tunnel, littered with old needles and trash, to shoot up. “The heroin numbs the pain and makes you not care about life,” she said. Her only concern now is scoring more heroin. She pays no attention to food and sleeps where she is or in a shelter.
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