Vermont facing 'full-blown heroin crisis'
If asked to imagine a heroin addict, most people probably wouldn't picture someone like Raina Lowell. Bright, intelligent and good-looking, the Vermont woman had her own business when she was first prescribed the opiate, Vicodin, for back pain in 2006. She found the pills did a great job of easing her emotional pain too.
"I'm pretty convinced I became addicted to it that first time," she tells us. "I felt like I could breathe for the first time and I'd found a solution to being in this world. I felt more capable. I felt like I could be a better mother. It was much easier for me to socialise. It was easier to do everything."
We're sitting in her modest yet cosy house in Vermont's capital, Montpelier. She's open about her struggle with addiction and is eager to raise awareness about the issue.
It was Raina's first stint in rehab a few years later that introduced her to heroin users. She says her intentions were pure in the beginning.
"I thought we were all going to keep each other clean," she says, but adds: "That's how I was introduced to heroin and eventually to crack cocaine as well."
'Full-blown heroin crisis'
Last month, Governor Peter Shumlin devoted his entire State of the State speech to what he called Vermont's "full-blown heroin crisis".
He cited a 770 percent increase in those receiving treatment since 2000 and a 40 percent increase in the numbers receiving treatment for heroin in the last year.
Shumlin also referenced a new documentary about opiate addiction in Vermont called "The Hungry Heart". Raina's story is one of about a dozen featured.
The story centres on the work of a since-retired doctor, Fred Holmes, who treated many of the addicts in the film. He says that although most come through it, about one third eventually relapse.
"We had a public showing of the film about a week ago," he says. "And a kid who I thought had been doing very well came along and took part in the Q&A afterwards. He took off his hoodie and bled onto his shirt." Fred points to an area on the upper arm.
"He was a heavy duty hard core i/v heroin user and he had been one of my patients. So, for whatever reason in the time I stopped seeing him, he's gotten into difficulty and is now struggling.
"As physicians, we're programmed to be able to fix things," he says. "But if you're taking care of somebody with addiction, there are no guarantees, there's no expected defined outcome on the basis of past experience. It just gets really difficult."
Demand outstrips capabilities
Bob Bick is showing me around the methadone clinic in the state's largest city, Burlington. A 40-year veteran of treating substance abusers, he says the demand far outstrips health services' capabilities.
"We have about 175 people on the waiting list," he says. "That's been increasing at a steady rate. But we also have another 600 to 700 people who have made contact with us in the last 90 to 120 days."
So, what's to be done to solve the problem?
Governor Shumlin has been praised for his call to treat the addiction as a health crisis and not a criminal one.
And Bob believes the stigma associated with drug addiction is part of the problem.
"If we can't dispel the stigma, we are not going to make progress here. If individuals don't come in to treatment, we can't offer help and support," he says.
"When we are able to read in an obituary that someone died from a long and valiant struggle with their addiction to opiates, we will have transcended the stigma, and made it more acceptable to seek out treatment."