A drug abuse problem in the Upper Peninsula is on the rise, fueled in part by poverty conditions and in part by a cutback in rural law enforcement, drug enforcement officers say. At the western end of the peninsula, Marquette County is becoming a major hub for drug trafficking throughout the U.P. and is seeing an influx of drug dealers moving in from cities, according to the U.P. Substance Enforcement Team in Marquette. Here on the eastern end of the peninsula, much of the drug trade is coming from smaller, local dealers and local people selling their prescription pain pills out of economic need.

In Mackinac County, the biggest drug problem by far is the abuse of prescription pain medication, reported Lieutenant Ken Mills with Straits Area Narcotics Enforcement (SANE). His program covers Mackinac, Chippewa, and Luce counties in the U.P., and four counties in the northern lower peninsula.

A successful investigation that took several cocaine dealers out of play over the past year in the Eastern U.P. has cut down on the ready availability of cocaine and crack here, but has created a greater street demand for the four most sought after prescription pain pills: oxycodone/ oxycontin, methadone, morphine, and vicodin.

Poverty is helping to fuel the rise in the local drug trade, Lt. Mills said, with one 80 milligram oxycontin pain pill worth up to $75 on the street. Vicodin pills are routinely sold for $5 to $7 apiece, and methadone for $10 per dose.

"There's a lot of money involved," Lt. Mills said. "People who have a legitimate prescription can pay a small copay to get the drug, and then resell it. With difficult economic times, people often turn to this to supplement their income. You have someone who legitimately needs the medication but also needs money right now for house payments, gas, or to pay their bills, and they will sell part or all of their prescription. There's public knowledge that there's money to be made. We've had cases of older folks asking their son or daughter, 'Do you know anyone who would want to buy some vicodin?' They are being forced by economics into making a bad decision. Then there are cases of young adults stealing medications from their parents or grandparents, and the patient may not even realize there is some medicine missing."

Visiting more than one physician to collect multiple prescriptions, or faking pain to obtain painkillers are other ways people can get access to the drugs, which they then sell. This is prescription fraud, a four-year felony.

To cut off the supply at its source, the SANE team has turned to physicians and pharmacists, urging them to take extra care in not providing a large supply at one time, and has arranged informational speakers to address doctors and nurses at local hospitals. In a oneyear old program, the narcotics team now sends a monthly list to all area pharmacists, naming patients who have been caught selling their prescription drugs. The pharmacist can then choose to not serve that patient or to dispense the medication differently.

It's been a helpful measure, Lt. Mills said, and pharmacies outside the area have even asked to be added to the fax list.

"These measures don't always result in a criminal charge or an arrest, but maybe they will get the person some needed help," he said.

Years ago, he said, hospital emergency rooms could help prevent the problem by keeping and sharing lists of people who were "shopping around" for prescriptions from different doctors, but today, privacy laws prevent health care providers from supplying each other, or the narcotics team, with such information. The privacy law, the Health Insurance Portability and Accountability Act of 1996, is known as HIPAA.

Another way pharmacists and police work together is through a program called MAPS, the Michigan Automated Prescription System, which tracks all locations where a patient's prescriptions have been filled. Duplicate prescriptions will show up here. Pharmacies are mandated by law to participate.

At the tribal health clinic in St. Ignace, which provides a large share of the doctor visits in the area and fills about 3,000 prescriptions a month, participating in MAPS is not mandatory, but the pharmacy does so because "it's in the best interests of the community," said pharmacist Phil Siebigteroth.

The pharmacy will only dispense a maximum of 30 days worth of medicine at a time in most cases, Mr. Siebigteroth said, while the law actually allows for filling up to a six-month supply of a prescription - something he suggests many pharmacists or physicians wouldn't do, anyway. He points out, however, that "a 'big jar' of 100 vicodin, for example, is not really a lot of vicodin." At a maximum allowable dose of eight tablets a day, a month's worth of the drug is 240 tablets.

At this and other pharmacies, patients are not allowed to refill prescriptions if they claim to run out early, and if they claim prescriptions were stolen, they must file a police report. Damaged medication must be returned to the pharmacy, where it is chemically analyzed to be sure it is actually the drug it is claimed to be.

"We hold a hard line" on managing prescriptions, Mr. Siebigteroth said.

While cutting down the local supply of cocaine and working with people in the medical field are positive steps, they won't solve the drug problem, Lt. Mills said, because, "If you arrest people who are selling in the community, you still have a market there of addicted people" who may turn to other drugs. The painkillers, which are opiates, are highly addictive.

The high street price of the pharmacy

made painkillers has led to a growing market for heroin, a cheaper

opiate, in the Eastern U.P. and northern lower Michigan, he said.

Most of the heroin that comes in is not produced here, but is brought in by local people in small shipments from the Detroit and Grand Rapids areas.

This is in contrast with parts of the Western U.P., where they "actually now have people moving to the U.P. from Detroit, Milwaukee, and Chicago just to sell dope," said Detective Lieutenant Jeff Racine of Marquette.

"I never dreamed it would get this bad here," he said. "We're seeing a nationwide upswing in drugs in rural areas, as opposed to cities, and in my opinion, it's because law enforcement is lower in rural areas and the bad guys know it. They know the uniforms are spread thin, and they are targeting these areas. In Michigan, we're down between 1,600 and 2,000 police officers since before 9/11."

In Mackinac County, drug cases are handled by Prosecuting Attorney Fred Feleppa.

"There is an upswing in drugs here, especially prescription abuse or prescription diversion," he said. "If you have a prescription bottle of 100 Vicodin and you use 10 tablets, you can sell the rest for some fairly easy money. I think there is an entire subculture out there in Mackinac County where people are buying and selling." And while most participating in this form of drug abuse tend to be young or middle aged adults, "it does trickle down to the kids," Mr. Feleppa said.

A SANE detective stationed on Mackinac Island in recent summers has been successful in generating some arrests there, Mr. Feleppa said, and probably "is just scratching the surface." The poor economy is definitely a trigger for other crimes seen recently in the county, as well as drugs, said Sheriff Scott Strait.

"When the economy goes south, the crime rate goes up," he said. "People get stressed out and start looking to defraud somebody of something. Our business picks up. Generally we're seeing more bad checks, more credit card and Internet fraud complaints.

"Prescription drug abuse is by far the worst it's ever been," he said. "It's growing tremendously."

Embezzlement cases in the county have also been higher than usual, with five in the last year, Mr. Feleppa said, but that crime is underreported, as "most people are just quietly fired."

Larceny of gas, reported in the area last summer, has gone down since the price has gone down, and a rash of break-ins in the Les Cheneaux area reported over the past two years has also seemed to subside, the sheriff said.

In that area, a Neighborhood Watch volunteer group has formed and is active in Clark Township, something Sheriff Strait would like to see expanded into other areas in the county.

Meanwhile, the SANE team continues using undercover buyers to infiltrate the drug network, and is encouraged by the good results that came from the local cocaine investigation over the past couple of years.

"One good thing is we don't see a lot of methamphetamine labs up here, and in cocaine, we've taken down some big targets over the past year or two, some in Mackinac County," Lt. Mills said. "We've had some good dealer knock-offs in the past three years in St. Ignace, the Mackinaw City area, and Cheboygan area. We don't see heroin dealers on the street corners here, as you do in the cities. As for the work we've done so far this year, I think we're having an impact, but it will take awhile to see the effects."

More information about forming a Neighborhood Watch group is available from the Mackinac County Sherrif's Office.

To report suspected drug activity to SANE, call (800) 621-8651. Callers may remain anonymous.