ST. ALBANS, Vt. — Every day, Samantha Emerson fights the craving that led her here, to a seat on the porch of a tattered home, under a leaking roof beside a trash-strewn yard.
The 26-year-old single mother of two has no job, cannot afford to fix her car, and faces eviction from a household where chaos is commonplace and opiates, which Emerson has worked hard to beat, remain a temptation.
The view from her kitchen window suggests another life entirely, a postcard world she is in but barely part of. A few miles east of St. Albans in far northern Vermont, snow-topped mountains rise majestically from the thick forest. It is a jarring contrast — the serenity, the desperation — that has come to characterize a corner of New England many Americans associate with covered bridges and dairy farms.
Here in Franklin County, hard by the Canadian border, cheap heroin and stolen prescription drugs have ravaged many of Emerson’s generation and the teenagers coming up behind them. Although Emerson says she is sober now, the battle against addiction still boils inside her and in the state she calls home. Vermont, according to its governor, Peter Shumlin, is confronting a “full-blown heroin crisis.”
Treatment for opiate abuse has skyrocketed almost eightfold statewide since 2000. Despite its sparse populace, Vermont has become an inviting market for drug dealers. A bag of heroin, which can be bought in large cities for as little as $4, can be sold for $30 — or more — a few hours up the interstate from Boston, Springfield, and New York.
Here, the remoteness that makes the state attractive to many Northeast city dwellers has a perverse effect on the price of drugs. It’s a place where dealers from out of state can make much bigger profits than in urban markets where the supply is greater.
“Every week, our Drug Task Force estimates more than $2 million of heroin and other opiates are being trafficked into Vermont,” Shumlin told lawmakers Jan. 8 in a State of the State address that focused almost exclusively on drugs. “In every corner of our state, heroin and opiate drug addiction threatens us.”
The number of people receiving heroin treatment in Vermont has risen by nearly 40 percent in the past year alone. And through Nov. 15, 2013, Vermont recorded 17 deaths from heroin, nearly twice as many as in 2012. When prescription drugs are included, the state by that date had recorded 56 opiate-related deaths last year, an increase of two from 2012.
“We all have friends whose car has been broken into, whose houses were broken into, and we didn’t used to see that,” Shumlin said in an interview in his office. “I’ve just heard of too many Vermonters who are concerned that their safety and security, which we all consider sacred, are being threatened.”
Pinpointing the reason that heroin and other opiates have hit the state hard is difficult, Vermonters say. The state exudes a low-stress, outdoors-friendly quality of life, but teenagers and young adults ranked No. 1 in the nation in the use of illicit drugs in a federal survey from 2011 and 2012.
“Being in the middle of nowhere with nothing in your community — no community center, no theater — makes it hard,” said Bess O’Brien, a filmmaker from Peacham whose new documentary, “The Hungry Heart,” chronicles the struggle with drug addiction in the St. Albans area.
The scourge here began about a decade ago with drugs such as OxyContin and Percocet, opiates that physicians prescribe as painkillers — often in large amounts to minimize the need for a quick, repeat visit, given that many live a great distance from their doctors, health officials said.
The pills would often be stored at home in accessible places like medicine cabinets, where teenagers could easily gain access. As the high became more seductive, authorities said, so did robbery and home invasions to support a habit for drugs such as “Perc 80s,” popular pills that cost about $100 each and pack 80 milligrams of the painkiller Percocet.
“I was literally in love with OxyContin. At first it was fun to get messed up, and then I had to,” said Emerson, who lives off a muddy dirt road. “I didn’t have any sober friends. You surround yourself with users. You don’t want to feel out of place, I guess.”
But at that price, a habit that cost hundreds of dollars a day became difficult to sustain. And then pharmaceutical manufacturers repackaged drugs such as OxyContin, which users previously had crushed into powder and snorted, to make them harder to abuse.
Enter heroin, an opiate with a vastly cheaper price.
“The illicit drug business is thriving,” said St. Albans Police Chief Gary Taylor. “Heroin is a dirtier drug. They’re [injecting] it, there are discarded syringes, and we’re finding younger and younger addicts,” some in their early teens.
Few corners of Vermont have suffered as much as St. Albans, a small city of 6,894 people that the State Police in 2009 called the burgeoning “drug capital” of the state. “We all feel the impact of substance abuse, either directly or indirectly,” Mayor Liz Gamache said.
Katie Tanner, a 27-year-old from St. Albans who began abusing prescription drugs when she was 16, became addicted to morphine.
“Morphidic euphoria, I used to call it,” Tanner said. “I used it as a way to escape everyday life.”
On a drive through St. Albans, Tanner pointed toward an elegant home that has been converted into an inn. “That’s where I OD’d,” she said casually.
After the overdose, a local doctor recalled, Tanner lay clinically dead in a hospital before being resuscitated.
Tanner, who said she has been off drugs for eight years, suffered brain damage from a lack of oxygen related to the overdose. She speaks with difficulty because she bit off part of her tongue during the frantic efforts to save her.
Years later, Tanner said, she sees a hometown still badly scarred.
“It happens like that,” she said, snapping her fingers. Tanner estimated that more than half of the students at Bellows Free Academy, the local high school, were using opiates when she attended.
Overall, crime here spiked by more than 40 percent in just a few years after 2004, when abuse of prescription opiates began to surface, according to police data. Violence was an attention-grabbing part of that increase, Taylor said, as was a rise in break-ins and burglaries.
“We are seeing more of the types of crime in our communities that we once thought of as being urban,” Taylor said.
As a result, community leaders and activists said, families have been torn apart and hundreds of teenagers and young adults are jeopardizing their chance for stable lives.
“First, it was thought it was derelicts who had problems. Now it’s the doctor’s son, the lawyer’s kid,” said Karen Grenier, director of The Turning Point, a state-funded recovery center in St. Albans where the addicted and the struggling can ask for help or simply relax without being judged.
“You just take a look at people walking down the streets. You can pick them out,” Grenier said of drug victims. “I think some people have been hurt physically. Some people disappeared from here who were never heard from again.”
A hairdresser by training, Grenier got a jolting introduction to drug addiction when a teen in her family became dependent on pills and heroin. She and others in the community — “parents in hell,” she called them — pushed for resources to help the vulnerable.
Those parents eventually got a recovery center, next to a former drug house, but four of the children of the parents have died from overdoses. The most recent succumbed to heroin shortly after the governor’s State of the State address.
“That’s why I do what I do,” Grenier said. “I don’t know if you can ever arrest it, but people are trying.”
The Turning Point has tapped into plenty of demand in Franklin County. The small storefront space, where recovering addict Melinda Lussier recently provided background music on a keyboard, attracts as many as 1,350 visits a month, Grenier said.
Shumlin urged legislators to approve money for more treatment in a state with 640 people lingering on a waiting list for help. He also pushed for a fundamental shift in the perception of drug use — from a criminal problem to a public health issue — in which some suspects would be directed to immediate treatment instead of languishing for months, and continuing to abuse drugs, while their cases wind through the courts.
“In many ways, the judicial system is an addict’s worst nightmare,” said Shumlin, a second-term Democrat.
Here on the front lines of battle, activists such as Dr. Fred Holmes, a longtime local pediatrician, know firsthand the dangers of delay. For years, Holmes admitted, he was “clueless” about the opiate addictions of his patients, many of them teenagers whom he had treated since birth.
They looked the same, they acted much the same, and they seemed like average St. Albans adolescents who did not divulge their secrets and, like teenagers everywhere, considered themselves bulletproof.
“I was embarrassed for my own lack of knowledge,” said Holmes, a slight, gray-haired man with a gentle smile. “It was very sad. We’re supposed to fix things, and this wasn’t fixable.”
Holmes received thousands of phone calls from people asking about addiction treatment for themselves or others. He began treating 134 patients with Suboxone, a drug used to curb opiate addiction, and met with many of them weekly.
In the final year of his four-decade practice, from which he retired in 2013, the 71-year-old physician chose to deal exclusively with patients struggling with drug use.
“It’s part of their culture,” Holmes said. “When you hear kids talk about it, it might as well be a cheeseburger.”
Talking forthrightly about opiate abuse has become central to the counterattack against drugs. Frank discussion was slow to begin in Vermont, but the floodgates have opened in a state where Yankee reticence is strong.
“There has definitely been a different focus on drugs. You hear about it all the time,” said O’Brien, the filmmaker whose documentary has been shown in schools, community centers, and theaters around the state.
“It didn’t matter where we were,” O’Brien said. “There were these parents who walked into the screenings bleary-eyed and shell-shocked because their kids are dealing with these issues.”
The film, which focuses on Holmes’s work in St. Albans, will receive a state grant to bring its message to every high school in the state. On Tuesday, the documentary is scheduled to be shown to the Legislature in Montpelier, the capital.
Activists and elected officials, however, said they are hopeful that the dark legacy of addiction — overdose deaths, crime, and broken homes — can be blunted and perhaps reversed.
“I’m optimistic we can make a difference, but I’m also realistic that addiction has been around ever since people have been around,” said Dr. Harry Chen, state health commissioner.
In a short walk along Main Street in St. Albans, Mayor Gamache gestured toward new sidewalks, coffee and boutique shops, and a construction project near City Hall that is expected to bring 150 jobs.
“If you were here a year ago, you would have seen a downtown in decline. It looked that way, and it was getting worse,” Gamache said. “Now we’re feeling good about ourselves. That doesn’t mean we’re a community without problems, but we haven’t been afraid to talk about it.”
MacQuarrie can be reached at firstname.lastname@example.org.