On the first anniversary of Marissa's death, very little has changed. Her boyfriend Marlon Gidluck went to the correctional for a stupid crime he committed while under the influence of methadone. Marlon had not seen Marissa for several days before her death. Ed Khayfets who was charged in connection with giving her the drugs which killed her is free on bail as far as we know.
Mention the phrase "injection drug abuse" and most people conjure up images of strung-out junkies living on dingy Vancouver streets, their arms ravaged with needle tracks, their blood infected by disease.
These are the hardened and the desperate - people who poke holes in their arms to escape a life of neglect or abuse. That's what we tell ourselves. They are not our children, who go to school and come home at night, watch TV and refuse to clean their rooms.
They are not supposed to be people like Marissa Guttormson, who lived with her mother and brother in a tidy bungalow in Saskatoon, and who loved attending Nutana Collegiate, spending time with countless friends, singing and collecting stray cats.
She was far from neglected, far from desperate, always smiling and helping anyone who needed it. She once dreamed of becoming a conservation officer.
Then one day her mother, Maxine, found a syringe. Marissa was only 15 or 16.
"You just don't know. You don't know if it's your kid. And hopefully you have a good enough relationship with your kid that it's not going to come as a shock if you do find them, because heaven forbid," Maxine recalls.
In the ensuing years, there were confrontations. Marissa insisted her drug use was recreational, a weekend thing she did with some of her friends. She was adamant that there was no danger.
"She specifically told me that she would not die from it. You couldn't overdose from morphine," Maxine remembers.
Maxine was terrified. She tried everything, even taking her daughter's syringes, spoons and the names and phone numbers of drug dealers to the police.
She got nowhere, she says. The police needed more proof, and the agencies she contacted told her she could not force her daughter into rehab.
All she could do was take counselling herself, they told her, "so I could learn how to deal with my frustration at not being able to do anything at all. If your child is not willing, or doesn't recognize that he has a problem and is willing to go to one of these facilities, there is nobody that will touch him."
Maxine found her daughter at home in bed on Jan. 15, dead of an overdose. She was 18.
Devastation does not begin to describe her state of mind these days. She is incensed - at the person who gave her daughter the drugs and the system that left Marissa's loved ones alone in their struggle to save her.
Although she agreed to talk about her tragedy in the hope that just one teenager would get the message, Maxine does not really believe there is any way to stop the spread of IV drug use - because it is so hard to detect before it is too late, and because no one wants to let go of the delusion that it's something that happens to other people's children.
Don Meilke shares her frustration. The EGADZ street outreach worker says he sees far more kids with drug problems than alcohol problems, because drugs are easier to obtain than alcohol.
"I've seen kids that swore they'd never touch that stuff, they'd never stick a needle in their arm. And they're doing it now. It's just too easy to get," he said.
Even the children of "very influential people" have come to him and admitted they use hard drugs. "These parents had not a clue," he said.
Teens who try injection drugs do so because of peer pressure and convenience - and because they do not know how addictive it is until it's too late, he said.
"It's so frustrating. It's a problem that's really reached epidemic proportions, and what do we do about it? Do we sweep it under the rug?"
Users getting younger
Concern is spreading, but attempts to define the problem are full of pitfalls. It seems teenage girls are more likely to take a chance on IV drugs than boys, and they are getting younger, according to Saskatoon police Sgt. Jerome Engele.
"Those young kids now? They will try anything," he said.
A survey done by students at Marion Graham Collegiate last December showed about 18 per cent of Grade 9 students had tried drugs.
The list of substances some teens reported trying is staggering: Ritalin, cocaine, heroin, ecstasy, diet pills, mushrooms, hashish, marijuana. The majority said their parents did not know about it.
"Grade 9 students! That's what they're abusing," Engele said. "It sort of floors me."
Police, parents and students later concluded the anonymous survey was not accurate, that some of the respondents had falsified their answers. When they learned The StarPhoenix had been told about the survey, school officials sprang to keep Marion Graham from getting a reputation as a school with a drug problem.
But the results did not surprise Meilke - simply because he knows the problem has reached every school, not just one or two. As many as 80 per cent of the teens he sees have tried or regularly use IV drugs.
"Come on, wake up," he said in an interview. "People need to wake up. It's in your homes, it's in your schools, it's everywhere. And we need to quit hiding and saying it doesn't happen to us. Because it does."
He places a phone call to the father of a 16-year-old girl who has been trying for a couple of years to straighten herself out - and failing. He and the girl's mother have been chasing her for years. The father's voice, filled with frustration and dashed hopes, crackles over the phone line. He does not want his name used.
"As far as I remember she was 12 or 13 when I found out," the father says. "She keeps shooting up and doing other drugs that don't mix."
No child is safe
Dr. Lowell Loewen, who oversees Saskatoon's methadone program for the Saskatchewan College of Physicians and Surgeons, agrees that IV drug use is hitting younger and younger kids. Once they start, "they'll use what's available," he said, adding no income bracket or social niche is safe.
"Addiction doesn't worry about where you come from," he said. "The perception that a person has to be from the gutter to be an addict is false."
Adding to the frustration is the speed with which needle drugs can take over a life, progressing from occasional weekend adventures to a life-changing - or life-ending - problem with blinding speed, catching teens unaware and leaving people like Meilke struggling to fight the problem with resources that do not match its magnitude.
Marissa's boyfriend, Marlon Gidluck, remembers the way she lit up a room.
"She was nice to everybody," he said. "You know the kids in school that everybody shoots spitballs at and picks on, those were all the kids that were crying the hardest (when she died)."
On the last day he spent with her, they bought matching shirts and ball caps, and he begged her to stop taking needle drugs. Struggling with addiction himself, he offered to spend every dollar in his pocket buying anything she wanted - except IV drugs.
They had a loud fight about it. Marlon stormed out of her house and never saw her alive again. The argument was still unresolved eight days later when he got a phone call and learned Marissa was dead.
"Most people when they heard that she OD'd were blaming me," he said. "If I had been the one . . . I would want to be locked up, I couldn't live with myself. I'd either have to be locked up or dead."
Though he was already cleaning up when it happened, Marissa's death has shocked him and all of her friends, Marlon says.
"I'm never going to push a needle through my skin again. And I hope this can be like a positive thing in the sense that a lot of my friends (will quit). It seems like a lot of people, it had a stronger effect on. How close does it have to get to you before you wake up?
"It would be really, really good if this story scared the shit out of a lot of kids."
According to police records, 14 people died of drug overdose in Saskatoon last year. A police spokesperson was unable to provide a breakdown of their ages.
Three more died last month. All three had methadone in their system at the time, though only one obtained it legally.
Prescribed to about 250 local addicts to replace IV drugs and steer them away from crime and disease while they stabilize their lives, methadone is the subject of much debate - and much anger. It has been a way to control disease and addiction-driven crime, and a source of hope for addicts who see no other way to lead a normal life.
But it has also been stolen, sold or given away with disastrous results, and some people are raising questions about the doctors deciding who should take it, and who can be trusted to carry it around.
Maxine Guttormson's questions began the day she came home to find her pretty 18-year-old daughter Marissa dead of a drug overdose before the teen was old enough to legally drink.
She wants answers about a drug called methadone - from the addict who gave it to Marissa, the doctor who prescribed it to him, and the system that contributed to her daughter's death while it blindly strove to improve someone else's life.
Maxine found her daughter in her room with two bottles of methadone. They belonged to an addict whose doctor prescribed it to him through Saskatoon's methadone program for people fighting addiction to drugs like morphine and heroin. One of the bottles was half empty.
Apparently, despite his history of drug trafficking, a doctor trusted the addict enough to give him "carries" - pre-measured doses of the drug that he could take home rather than making a daily trip to the pharmacy where he'd drink it under supervision. That trust cost Marissa her life.
According to her friends, the addict gave or sold some of his methadone to Marissa on the night she died, along with cocaine and Ritalin. She was not on the methadone program, so she had not built up a tolerance to the medication. "The cops knew (the addict) by name the minute they showed up at my house when I called them, when I first found her. How on earth could he ever have gotten a freakin' prescription to walk around with it?" Maxine wonders.
"The doctor is very much at fault . . . and there should be some consequences to kids like (him), who feel they're helping somebody like Marissa (by giving them drugs). What gives him the right to know how much she should be taking?"
Police are investigating Marissa's death, and charges may be pending. Meanwhile, Maxine's questions are hard to answer.
Dr. Brian Fern, one of three doctors prescribing methadone to addicts in Saskatoon, has the most experience in the area. His involvement with methadone began in the 1970s, and he was a key player in creating the current program in 1997.
But when contacted for information about the program's origins and rules, he responded angrily, refusing to answer any questions. "We're running a therapeutic program here. This isn't an Arizona chain gang," Fern snapped before hanging up the phone.
Dr. Lowell Loewen, who is contracted by the College of Physicians and Surgeons of Saskatchewan to oversee the methadone program, was more forthcoming. But his answers raise more questions.
Loewen is about to begin a series of audits at the offices of all Saskatchewan doctors licensed to prescribe the drug for addiction. For the first time since it all began in 1997, he will look at their charts and records to see if they are following provincial guidelines.
But the guidelines have only just been developed, and are guidelines only. Doctors will not be punished for failure to comply with them. The audits are "educational."
Meanwhile, Maxine is not the first mother to go through this nightmare. Encouraged by Maxine's decision to speak about her tragedy, Carol came forward to talk about her 17-year-old son Chad. Their names have been changed at her request.
Last June, Chad - who sometimes smoked pot but was not a heavy drug user - bought a bottle of methadone from a man he knew who was on the program. The man's doctor thought he was trustworthy enough to carry it.
The doctor was wrong. Chad died after drinking the methadone. Carol says Chad's friends gave police the man's name, but she never heard back from them. She wrote a letter to the college of physicians and surgeons, wanting to know why the man was allowed to carry methadone.
She received a letter this week in which Loewen called overdoses "part of the disease process." He also said the addict who sold Chad the methadone had his carry privileges suspended for one month as a result of Chad's death.
Certain her son's death was preventable, she wonders aloud whether it's going to take a wrongful death lawsuit to make doctors take the issue more seriously.
When contacted by The StarPhoenix regarding Chad's death, Saskatoon police Staff Sgt. Al Sather said investigators have decided to take a second look at the case.
So many questions: why are addicts trusted to walk around with a lethal supply of a drug? At least two teens are dead because of it - and what's being done? How do doctors decide who to trust? Who pays when they make a mistake?
Loewen is quick to point out the difficulties and complexities faced by doctors caring for addicts.
"Certainly, these are people that are not trustworthy; they are con artists," he said. "This is not new to physicians. They do it every day, it's tough. It's taken me four years to get three doctors and we now have a fourth one coming on stream to work with these people. Any physician who wants to do this should get a bouquet."
Saskatchewan doctors who wish to prescribe methadone need experience and training in addictions medicine and must apply to Health Canada for a licence to prescribe it, with approval from the college of physicians and surgeons.
Until now, the only guidelines telling doctors when they should allow carries and how to deal with patients who continue to use street drugs came from Health Canada - but they were written in 1992 and are now considered outdated. Methadone programs across the country have become less restrictive of patients' freedoms since then.
With the help of about half the methadone-prescribing doctors in the province (there are about 20), Loewen recently completed new guidelines for Saskatchewan, which are expected to be passed by the college's governing council this weekend. They say doctors should not allow patients to carry methadone during their first three months on the program, and recommend they consider altering carry arrangements if patients are caught selling methadone.
But because of the nature of addiction, patients are expected to have "slips and relapses," so doctors will continue working with them as long as they are making some progress, he said.
Though patients sign a contract promising to abstain from street drugs and not sell their methadone, breaking these promises - even if it's done repeatedly - is rarely grounds for removing them from the program.
In fact, under the new guidelines, when a patient continues to use street drugs her doctor should take that as a sign that she needs more methadone. If she sells her dose, the guidelines suggest that her carry privileges be taken away, but not permanently.
"You don't throw them out. If you did that you'd have nobody on the program because these people all foul up for the first two or three months," Loewen said.
Doctors who violate the guidelines do not face punishment for doing so. "That's not a law, that's a guideline and people may deviate from the guidelines if they have a good reason to."
Even if the doctor's reason for doing it is not satisfactory, Loewen said he would sit down with him, review the guidelines and advise him not to do it again. This is known as "progressive discipline," which Loewen says is preferable to punishment because punishment would scare other doctors away from taking part in the methadone program.
Doctors' decisions are only as good as the information they have about their patient, he added.
"And when you don't have that information, you may not do as good a job." Following the lead of B.C. and Ontario, Saskatchewan has shifted from a tightly controlled system to a more flexible one in an effort to improve its success rate and keep addicts from dropping out or relapsing.
Forcing all 250 Saskatoon patients to head to a pharmacy every day would keep them from endangering others by peddling their methadone. But that would inconvenience the addicts and doctors, not to mention pharmacists at the five drug stores dispensing the drug. Some patients would miss their dose, setting them up for a fall.
None of the people openly criticizing Saskatoon's methadone program are advocating its closure. All of them say they recognize the benefits of steering addicts away from the crime, disease and family breakdown associated with an illegal drug addiction. They all know it can work miracles in people who seemed beyond hope.
But they also feel that doctors, in their efforts to make methadone easier for patients, pay too little heed to the risk it poses for others.
Saskatoon police Sgt. Jerome Engele, a board member of the local methadone program, called it "a great drug, if it's used responsibly."
"Once it is abused, it's a very dangerous drug, as is morphine, heroin, Ritalin, all of them. They're dangerous drugs when they're abused, and people are willing to take that chance. And they know the repercussion, and that is death."
Everyone is abusing the system, but doctors are learning and getting better, he said.
That's cold consolation to Maxine.
"At what cost are they getting better?" she asks bitterly. "How long is it going to take - until one of their kids dies?"