Addiction

Prescription drug abuse a 'silent epidemic' in Montana

2013-05-04T22:00:00Z 2014-08-10T11:51:56Z Prescription drug abuse a 'silent epidemic' in Montana missoulian.com

Of all the substances Sam Martinez has abused – and there have been many – pills were the easiest to score.

She just went to her usual dealers: old people.

“A lot of elderly people that need extra money and that don’t use all their meds sell them,” said Martinez.

Martinez, 26, has abused various substances, starting with marijuana, since her teens. For a while, she smoked weed and used meth and pills daily.

She knew the dangers of meth. “Not even once,” she said, parroting the theme of the Montana Meth Project’s in-your-face ads.

But when it came to pills, not so much. Prescription drug abuse tiptoes under the radar, cloaked in the white-coated respectability of a doctor’s office or pharmacy.

“The biggest problem we have to overcome is (the attitude that), ‘It’s just a pill. ... It’s safe. It’s prescribed by a doctor. It’s not being made in a truck in the backwoods,’ ” said Missoula Police Detective Dean Chrestenson, the department’s first full-time prescription drug diversion detective.

The problem cuts across age and class, from honors students chasing better test scores to junkies chasing a high that became more elusive during the meth crackdown. Doctors tend to addicted newborns whose mothers used, and also nursing home patients who popped Valium in the ’60s and now maintain their addictions with painkillers.

“We’ve had older couples drive from the north side of the state to Missoula to sell pills ... and young people in high school trading pills they get from home,” Chrestenson said.

Coroners deal with the worst cases, a sad statistic whose numbers have risen steadily since 2000.

Missoula County’s cavernous evidence locker is awash in pills, a majority of them from coroner cases, said Missoula County Sheriff’s Detective Jason Johnson. Pills didn’t cause all of those deaths; because of the danger that the medications will fall into the wrong hands, though, law enforcement officials now routinely confiscate prescription drugs from the scene of an unattended death.

“They’re probably the deadliest medication out there,” said Dr. Marc C. Mentel, medical director for the Community Physician Group at Community Medical Center.

Martinez herself said that “I can’t believe I’m still alive, some of the things I’ve done.” She described taking 30 milligrams of the attention deficit hyperactivity disorder medication Adderall just to get herself out of bed in the morning, and then meth and pills – the painkiller Lortab, say – the rest of the day, a mix-and-match combination that left her feeling like her “heart would explode.”

And nothing, not even meth, has a worse comedown, she said of the sweats and chills, vomiting and diarrhea, that the innocuous-looking pills produced.

Worst of all, she said, nothing has been harder to kick.

“I still have dreams about using – and being caught,” said Martinez, clean nine months now – which is a good thing, given that she’s six months pregnant.

Nationwide, said Mentel, the prescription drugs whose use rose sharply a decade ago as physicians with the best of intentions tried to better deal with patients’ pain now claim more lives each day than the number of American soldiers killed daily in the Vietnam War.

“You see what Vietnam did to mobilize a nation,” he said.

Yet when it comes to prescription drugs, there’s no public outcry, no protest marches.

“It’s a silent epidemic,” said Mentel, who’s working on a citywide program to persuade doctors who prescribe painkillers to sign contracts with their patients to help prevent even inadvertent abuse.

Over the past few weeks, reporters from the Missoulian and KECI-TV have interviewed physicians and law enforcement officers, students and counselors, addicts battling their disease and the families of those who lost that battle.

Here’s what they found:

***

The schools

Unlike street drugs, prescription drugs are government tested and approved, which is one reason teenagers find them so appealing. Missoula teens say if you know what you have, you can research the drug and find out what other drugs may mix well for an intended result.

During finals, some students like to get amped up for the testing onslaught. Many turn to Adderall, which makes “you feel like a superhero for two hours,” explained Hellgate High School student Collin Dyer.

Academic demands and the pressures of an unknown future are a heavy burden, Missoula teens say, which is why many kids choose to find a way to relax and numb the mind. It’s not hard to do when so many people are prescribed painkillers and mood-regulating medications.

Melody Barnes, a longtime Missoula addiction counselor, has seen a dramatic rise among teenagers who use and abuse prescription drugs.

“We have a crisis,” she said of Missoula and the nation.

***

College

The good news is that addiction to narcotic prescription drugs is no higher among college students than the general public.

That’s according to Mike Frost, interim director for counseling services at the University of Montana’s Curry Health Center.

The bad? Misuse of prescription drugs is highest among young adults ages 18 to 25 – those of college age – with nearly 6 percent reporting they’ve used prescription drugs for nonmedical use, according to the National Institute on Drug Abuse.

“I’ve heard of friends using Adderall if they’ve got a big paper due,” said student Hank Stein. “They’ll get some, and it helps them concentrate. I think it’s pretty easy to find.”

A decade ago, it was a rare occurrence for a student to seek help from Curry for prescription drug addiction, Frost said. Now, Curry sees about three students a semester who are trying to recover, he said.

“We’re making more referrals like that,” Frost said. “It’s not a large number, but it’s more than what we’ve seen in the past.”

Actually, said Diane Jordan, the interim assistant coordinator for Curry’s Self Over Substance program, “it’s rare for a student to come to us saying they need help. They’re usually poking around for more drug-seeking behavior. We have to screen for that.”

***

Law enforcement

It’s been four years since the Missoula Police Department, in response to the burgeoning problem of prescription drug abuse, named Chrestenson as its first full-time prescription drug diversion detective.

What’s changed in that time?

“I’d say it’s stayed essentially steady,” Chrestenson said.

Which means very busy indeed. From people robbing pharmacies at gunpoint, to people swiping drugs from medicine cabinets when real estate agents hold open houses, from high school kids holding “Skittles parties” where they toss multicolored pills into a bowl, to dealers running some very profitable enterprises, law enforcement faces a frustratingly multifaceted problem.

It can be like a game of Whac-A-Mole. Crack down on meth, deal with a rise in prescription drug abuse. Turn your attention to prescription drugs, watch heroin regain popularity, Chrestenson said.

Still, he feels the effort is worth it.

“One attorney told me, ‘Yours is the only drug that’s killing people,’ ” he said. “That’s why we take it so seriously. ... Bottom line is, we’ll save lives. That’s the whole point of this.”

***

Drug registry

Prescription drug abuse presents almost as many problems for pharmacists as it does for the police.

People seeking drugs either to use or to sell hold up their stores, or come in with forged prescriptions – or with real ones they’ve obtained by doctor-shopping. Sometimes pharmacists themselves, or their assistants, are addicted. All of those kinds of cases show up with depressing regularity on local court dockets.

As if that weren’t enough to deal with, pharmacists have a new challenge: complying with the demands of the prescription drug registry approved by the 2011 Montana Legislature.

The registry monitors certain addicting prescription drugs such as opiates and narcotics, and requires pharmacies to report weekly on the prescriptions they fill for controlled substances.

It’s a demand some pharmacists say they welcome.

“Prescription drug abuse is a real problem in America. ... If physicians use (the registry) like it was meant to be used, it should really help the people of Montana,” said Ross Roadarmel, a pharmacist at Lolo Drug.

With just a few clicks, a pharmacist now can check whether a patient is filling prescriptions elsewhere in the region. A recent check, for instance, revealed a woman who was filling prescriptions at pharmacies from Kalispell to Hamilton.

The woman in question is now in rehab – another advantage to the registry, Roadarmel said:

“You can spot abuse and you can also spot who needs help.”

***

Worst-case scenario

Caitlin Stanich didn’t need anybody to point out that she needed help.

She knew.

She went to rehab, both inpatient and outpatient, court-ordered and on her own. In fact, she’d taken a month off work for a renewed attempt to get clean of the prescription drug addiction that had dogged her since high school when she relapsed in March, this time fatally.

Stanich grew up in Stevensville, but was living in Missoula when she died. The saddest thing is that no one in her family was surprised.

“I think maybe this is it,” her sister, Heather Montes, said she told her husband the day her father called and asked her to come home right away.

Sam Martinez knows Stanich’s fate could have been her own. Now that she’s clean, she sees the toll her addiction took on her mother, who worried daily about getting a call that her daughter was dead.

“My mom is so different with me now. She sleeps at night. She’s happy,” said Martinez.

But at the age of 26, Martinez has already seen prescription drug addiction claim the lives of five of her friends, all about her own age. Another friend sold drugs to someone who overdosed, and now faces a homicide charge, she said.

“It’s horrible, but at the same time it gives me motivation to want to be better and help people,” said Martinez, who’s majoring in addiction treatment at the University of Montana.

***

Treatment

Through an initiative that focused on pain management, Montana and the Missoula community put the spotlight on prescription drug abuse a few years ago and ushered in revisions to various pain policies and practices at health care facilities.

Now, patients, families and even doctors are more educated, according to clinicians working in the field of addictions. And just last month, Recovery Center Missoula opened its doors to treat adults with chemical dependency and mental health illnesses.

Until it opened, people in western Montana had to travel to Billings or Warm Springs for treatment. Now, they can seek help closer to home.

But gaps in treatment remain. For one thing, the recovery center was slated to be full the first month it opened, according to Tammera Nauts, executive director.

It has 16 inpatient beds, the phones are ringing with people calling for admissions, and Nauts said one great need is simply for more beds.

“It is just really kind of jaw-dropping,” said Nauts.

So far, education about the issue has focused largely on the professionals who deal with it, not the general public whose members might become addicted.

That needs to be expanded, and fast, said Sam Martinez, the recovering addict.

“I don’t think people understand how bad opiates can be.”

Missoulian reporters Betsy Cohen, Keila Szpaller and Martin Kidston contributed to this story.

Missoulian reporter Gwen Florio can be reached at 523-5268, gwen.florio@missoulian.com, or @CopsAndCourts.

Copyright 2015 missoulian.com. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

(26) Comments

  1. GaryTinkSanders
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    GaryTinkSanders - May 07, 2013 7:11 pm
    Case #1 One of my good friends tried to get on food stamps after he had worked for 2 different employers that did not pay him, he was broke, destitute and out of food, he went and applied for emergency food stamps for him, his wife and two children, he was turned down for all assistance. The only help he received was from my family, not the government. All he needed was a temporary helping hand.
    Case #2 I know a lady that never had a job in her life, has 3 kids, gets food stamps, energy assistance, section 8 housing, is drunk at least 2or 3 days a week, been arrested for drinking and driving with kids in the vehicle, drugs and paraphernalia too, kids taken away twice and given back, OD on prescription drugs and now is receiving social security disability.
    Unless your glasses are rosier than mine someone is blowing smoke up your skirt because this woman hasn't earned anything and taxpayers are supporting her.
  2. GaryTinkSanders
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    GaryTinkSanders - May 07, 2013 4:49 pm
    Congratulations and continued success. You obviously made the choice to get the healing started and stuck with it, it is refreshing to hear a testament like yours. :)
  3. startingover
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    startingover - May 07, 2013 12:48 am
    All drugs. Went to prison, went to treatment, got out, stayed clean the last 5 years, working, going to school, and getting close to a bachelors and an associates degree.
  4. startingover
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    startingover - May 07, 2013 12:45 am
    have you been on food stamps lately Gary? Do you hand them out? Yes you have to work to get them. You can only draw for a month or two before you must be employed. If you are not employed when you recieve them, you must take classes on getting a job. You must register with Job Service, and be actively seeking employment. No job means eventually no food stamps.
  5. sofaking tired of the GOP
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    sofaking tired of the GOP - May 07, 2013 12:33 am
    Yeah use Lindsay Lohan and Charlie Sheen as examples nice, rich people get whatever they want. That doesn't change the fact that jail has a worse record of rehabilitating addicts than treatment sorry.
  6. GaryTinkSanders
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    GaryTinkSanders - May 06, 2013 5:05 pm
    Illegal drugs?
  7. GaryTinkSanders
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    GaryTinkSanders - May 06, 2013 5:04 pm
    I have yet to see any person getting food stamps or other government benefits have work for them. They should have to work for them and they should be drug tested.
  8. startingover
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    startingover - May 06, 2013 10:56 am
    I find it interesting you automatically equate poverty to drug use. Florida requires drug testing at the time you apply for food stamps, and randoms after that. Out of slightly more than 3 million people receiving food stamps, 2.7% have had a hot UA. They spend $30-40.00 per test. That comes out to $105,000,000 in drug tests alone. I wonder how many families that money could help?
    Welfare is not an occupation. You are required to work to continue receiving food stamps, the assistance is meant to help subsidize low incomes, not replace them.
    Americans used to care about their poor, or the people that couldn't work for some reason. It is sad the mentality has shifted to anybody who can't help themselves on their own, isn't worth helping.
  9. Sukey
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    Sukey - May 06, 2013 6:45 am
    I agree Walter. Its disgusting. The parasites are over running the people who believe welfare is not an occupation.
  10. GaryTinkSanders
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    GaryTinkSanders - May 05, 2013 8:58 pm
    sofaking tired It is also a proven fact that people ask for treatment to receive reduced jail or prison terms (Lindsay Lohan, Charlie Sheen for example) and then return back to their old ways.
    http://gossiponthis.com/2013/03/19/lindsay-lohan-is-going-to-rehab-instead-of-jail-again/
  11. sofaking tired of the GOP
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    sofaking tired of the GOP - May 05, 2013 8:21 pm
    It's proven fact that jail does barely anything to prevent drug abusers from returning to drugs while in jail and after they are released. Recidivism rates are lower for drug offenders sentenced to treatment instead of jail. Get some facts before blaming people.
  12. wildmtn
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    wildmtn - May 05, 2013 6:53 pm
    "the prescription drugs whose use rose sharply a decade ago as physicians with the best of intentions tried to better deal with patients’ pain" I am not so sure of the "best intentions". I think this falls squarely in the lap of the medical profession and their close partners, the drug companies with their "pill for everything" mentality. Together, they made this mess and they need to be held accountable to clean it up. It should be their money going into the treatment. I know 22 year olds with valid opiate prescriptions for "back pain" with no documented injury or cause. The doctors and drug companies are the most dangerous dealers out there because they're legal.
  13. startingover
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    startingover - May 05, 2013 6:05 pm
    9 months clean, WELL DONE!
  14. startingover
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    startingover - May 05, 2013 6:03 pm
    I used drugs for 30 years, and worked my butt off the entire time. I paid my way and supported a family. I never got anything for free.
  15. startingover
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    startingover - May 05, 2013 6:01 pm
    Ah yes, the old, and outdated, Moral model for examining the personality disorder known as substance abuse. Wen following the Moral model alone you fail to take into consideration the fact that substance abuse is generally co-morbid with other forms of mental illness. Thus there are numerous theoretical perspectives that attempt to address the problem. The sociocultural model, biopsychosocial model, and the medical model all approach the problem of substance abuse from different perspectives. They also usually seek to determine the underlying causes, and co-morbid conditions. It has been my experience that there is no single model that adequately addresses or explains the underlying forces behind substance abuse, but it is rather a combination of them all. Biological, psychologocal, and social forces have as much to do with it as a conscious decision to use. I think for many the moral model plays into it only at the onset. The decision to use drugs to cope. However that decision is influenced by all the other factors as well.
  16. Re-Made in Montana
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    Re-Made in Montana - May 05, 2013 5:49 pm
    I wish there was a "Like" button here.
  17. GaryTinkSanders
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    GaryTinkSanders - May 05, 2013 4:43 pm
    To answer both of you, the resources this program receives needs to go to people who are serious about making the break from drug dependency, not people wanting a lessor jail sentence. It is not up to me to decide who gets to go thru the program but I don't want to see their resources squandered either.
  18. sep924
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    sep924 - May 05, 2013 4:01 pm
    Walter12 clearly has not tried to get a prescription lately for any of these so-called regulated medications (which include even sleep meds). The crackdown on addicts, although well-warranted, has made life exceedingly difficult -- and in some instances, dangerous -- for patients who do need these medications for legitimate reasons and now can't get them. There has to be a balance. Prescribing physicians need to learn how to recognize an addict from a patient truly in need, and stop treating everyone like they're a pill popper or doctor-shopper.
  19. LilyVonShtupp
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    LilyVonShtupp - May 05, 2013 12:48 pm
    Walter, my man, you really need to get some "mood pills".
  20. LilyVonShtupp
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    LilyVonShtupp - May 05, 2013 12:47 pm
    What's the criteria for who needs the resources? Who decides? You, Gary? I'm assuming you have some special qualifications?
  21. Gomez
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    Gomez - May 05, 2013 12:36 pm
    Thank you for running this article. It is timely & important. We recently lost a family member about the same age as Mrs. Martinez to prescription drug abuse & I can only say to her that she needs to stay strong & continue to fight this battle. The heartache to those left behind by the loss in our family was, and is devastating. I say this to her as someone who has been there, had my own battles w/alcohol (sober 17 years now) and lost a family member, I know how difficult this problem is but you need to do the right thing & keep yourself clean. You owe it to yourself, your child & those that love you. It won't be easy but it can be done. I know you can do it.
  22. Re-Made in Montana
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    Re-Made in Montana - May 05, 2013 9:38 am
    Who actually needs the resources Gary?
  23. GaryTinkSanders
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    GaryTinkSanders - May 05, 2013 9:06 am
    Stories like this will help increase criminals with drug problems receiving a lessor sentence because they are just smart enough to ask for help they don't really want, they will eat up resources that would otherwise go to somebody that needs them. The first thing addicts need to do is realize that their poor decision making and desire for euphoria is to blame not the pills, not the meth and not the pain. Accept personal responsibility.
  24. Thinkin Conservative
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    Thinkin Conservative - May 05, 2013 8:31 am
    ALCOHOL is the number 1 drug that kills! ALCOHOL detox is also the most deadly! ALCOHOL costs society millions in health and collateral damages! Any addiction is hard to deal with (I know). The only way out is to STOP! I am sick and tired of hearing about the terrible withdrawal symptoms of meth and prescription drugs. It won't kill a person, it just feels that way. If an individual plays with fire, they will get burned!!!!!!!!!!!!!!
  25. Tronski
    Report Abuse
    Tronski - May 05, 2013 8:15 am
    Perhaps Ms.Martinez has some problem, but she is clearly addressing them, and is open about her mistakes. I wish her good luck, addiction is a disease and Sukeys comments clearly fail to recognize that. Since this forum prohibits "defamatory and abusive language", I hope Sukeys comment will be removed. I believe calling her an "simply unfit to even care for herself" qualifies as defamatory and abusive.

  26. walter12
    Report Abuse
    walter12 - May 05, 2013 7:35 am
    Finally, an article that is so true. This town of Missoula is full of people that are on (something). The clinics in town give these pills to anyone who wants them. Uppers, downers, pain killers, mood pills, happy pills, and on and on. You go into WalMart and half the customers are on something. Many times, they do not even have to pay for these pills. Some fed program that these people are living off, even pays for their mood pills. One day soon, all of our society will just collapse under the weight of (everyone getting things for free) even drugs. Dopers are takers, and when the takers outnumber the producers, the game is over.
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