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She died young. She died from abusing prescription drugs. She's not alone.

Dan LaPrairie watched tragedy strike his cousin repeatedly until it finally took her life. In 1996, when she was 17, Jana Martineau's toddler son died from injuries inflicted by her boyfriend, Brandon Will Campbell. Two years later, Campbell was ...

Jana Martineau
Jana Martineau

Dan LaPrairie watched tragedy strike his cousin repeatedly until it finally took her life.

In 1996, when she was 17, Jana Martineau's toddler son died from injuries inflicted by her boyfriend, Brandon Will Campbell. Two years later, Campbell was convicted of second-degree manslaughter; charges of aiding and abetting first-degree murder against Martineau were thrown out.

"That started her off on her journey ... of self-medicating," LaPrairie said. "She would say: 'Maybe I should die. I don't deserve to live.' "

Martineau got hooked on painkillers, progressing from Lortab to OxyContin to methadone treatment and abuse. She lost the battle with addiction in 2006 when she died of an overdose, leaving behind three children.

Abuse of prescription drugs is a growing problem on the Fond du Lac Reservation and on reservations across the region, according to a Department of Justice National Drug Intelligence Center study released in July. According to the study, the percentage of American Indians seeking treatment for abuse of pharmaceuticals increased from 3.6 percent to 5.8 percent over a four-year period ending in 2006.

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The percentage has gone up since then, said Phil Norrgard, director of the Min No Aya Win Human Services Center on the Fond du Lac Reservation. Prescription drug abuse isn't confined to American Indian reservations -- it's sweeping the nation among poor and rich and every race -- but it has hit the small community of Fond du Lac especially hard. The result is increased violence, theft, depression ... and death.

Eight prescription drug-related deaths in Carlton County were recorded from Aug. 25, 2007, to Sept. 1, 2008, said Dr. Ricard Puumala, coroner for the county, who records deaths in homes. Five of those deaths included methadone as a contributing factor. Methadone is an opiate meant to help wean people from drug addiction, but some addicts abuse it with other opiates.

At least three of the eight county residents who died were on the reservation, said Sam Ojibway, the new director of law enforcement for the band. Some overdoses reported on the reservation are medical calls and aren't in Ojibway's records. "But there are many, many of those," he said.

LaPrairie wants the abuse to end, and hedoesn't want his cousin's death to be in vain.

"We can't allow it to continue," he said. "It's just like suicide."

A CLOSE COMMUNITY

About 2,000 of Fond du Lac's 4,000 enrolled members live on or near the reservation, said Karen Diver, chairwoman of the Fond du Lac tribal council.

Because the reservation is so small, what strikes one family strikes several, said Richard Colsen, supervisor of the Fond du Lac Meth, Stimulant and Prescription Drug Abuse program on the reservation.

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"In this program, I can draw the family lines on how everybody in that group is related," Colsen said. "Whether they lived on the same street or in the same neighborhood, the Fond du Lac community is very tight and very protective of itself."

"You can ask anyone on the reservation to name five people they knew that died before their time," LaPrairie said. "I bet you they could name 20."

In a 2007 assessment by the Min No Aya Win center at Fond du Lac, about 15 percent of respondents said they had abused prescription drugs at some time.

Some on the reservation wonder if the center gives pills too freely, or if access to generally free prescriptions at the reservation clinic leads to abuse -- notions that Norrgard disputes.

The center requires urinalysis for many seeking prescription drugs to make sure they're using and not selling them. Legal prescriptions from licensed physicians are required, and chronic users must agree to drug testing. Violations can mean refusal of future prescriptions.

And addicts are willing to pay for their drugs, Norrgard said.

"I've heard stories of people dropping stuff on their feet, trying to break a bone, pulling out their own teeth," LaPrairie said, for an excuse to get their fix of painkillers.

'ONE DOSE CAN BE FATAL'

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Medical facilities aren't the only source for addicts. They steal from relatives, barter with friends and use other people's unfinished prescriptions, said Carol Falkowski, director of the chemical health division of the Minnesota Department of Human Services.

Fond du Lac elders have told Norrgard they feel vulnerable having painkillers in their homes.

"We need to understand we now live in a country where over 5 million school-age children take a prescription drug every day for a behavior disorder," Falkowski said. "They learn from a very young age if you take a pill, you get a mood change."

Some think painkillers are safer than illegal drugs, but because those without chronic pain have no tolerance to the drugs, one dose can be fatal, Falkowski said.

Television commercials touting various drugs are partly responsible for the larger society's addiction to painkillers, Norrgard said. Methadone clinics, meant to wean people off drugs, also contribute to the problem. Users often sell their meds, he said, and the drug needs better monitoring.

Off-reservation sources

Area drug-seekers are known to travel as far as the Iron Range to get a prescription filled.

Colsen, whose year-old program has served 35 people, says off-reservation pharmacies and hospitals need to be more careful about handing out prescriptions.

"There's a 'If we don't give it to you someone else is going to give it to you' kind of mentality," he said. "But it's growing for the same reason everywhere; it's available and it's cheap."

Dr. Thomas Elliott agrees that painkillers are everywhere, but he disputes that abusers are getting them from hospital pharmacies and doctors. Elliott, medical director of the pain management program for SMDC Health System, said hospitals are controlled environments where doctors know patient histories and have them on opiate agreements if prescribed opioids, or pain relief drugs. Depending on the patient, frequent urine tests are given.

Emergency rooms also have been touted as an easy place to get painkiller prescriptions.

"The ER is confronted with a high volume of patients they don't know at all ... they come in with pain complaints and the physician is pretty much obligated to do something," Elliott said. "The default position is to believe your patient and do what is appropriate based on science to treat their pain, which may mean a small quantity of opioids."

The problem with that, he said, is a person could travel to emergency rooms across the region, stocking up. The only way to detect that is if law enforcement or family reports them, or if their medical history is within that hospital's system. If a doctor suspects the person is lying, HIPAA regulations bar them from reporting it.

The good news, Elliott said, is that a new Minnesota state registry will allow doctors to access information about anyone who has been prescribed opioids.

Dr. Darla Van Heerde is an ER doctor for both Community Memorial Hospital in Cloquet and Virginia Regional Medical Center. She's had pharmacies call and tell her a prescription she wrote was for someone who had just received pills in the last few days. In those situations, she can tell them not to fill it. If she recognizes someone as a frequent visitor, she can ask to screen them for drugs first. She said it's often difficult to tell whether someone is being truthful about their pain.

"There's no nice, neat test for pain parameters," she said. "Sometimes you're pretty darn sure someone is lying to you, but there is no way to prove it."

JANA HOLLINGSWORTH covers American Indian issues. She can be reached at (218) 279-5501 or by e-mail at jhollingsworth@duluthnews.com .

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