Maine set another record for drug overdose deaths last year, a sobering sign that the state has yet to climb out of a prolonged crisis that has ravaged communities and torn apart families.
The latest data underscores the collective failure of policymakers and the shortage of political will to address with any meaningful action the worst public health crisis since the AIDS epidemic of the 1980s.
The Maine Attorney General’s Office reported Thursday that 418 people died from overdoses in 2017. That’s an 11 percent increase over the 376 overdose deaths in 2016, but the number has been climbing sharply for the past five years.
Opioids, including prescription and illicit drugs, were responsible for 354 of the deaths, although fentanyl, a powerful synthetic, has now supplanted heroin as the deadliest substance. Unlike heroin, which is manufactured from poppy plants, fentanyl can be made in a laboratory and is easier to smuggle because it’s sold in tiny doses.
“Fentanyl has invaded our state, killing 247 people last year alone,” Attorney General Janet Mills said in a prepared statement. “When people ingest this powerful powder, they often believe it is heroin, and have been told it’s heroin. But no one should take a chance with these substances. Even as dangerous as heroin is, fentanyl is hundreds (of) times more likely to kill you. The equivalent of a few grains of fentanyl can take your life.”
Last year, the Portland Press Herald/Maine Sunday Telegram published a 10-part series called “Lost” that examined the impact of the opioid crisis on the state. The series found that although many other states have been dealing with the same issue, the problem here has been made worse by a lack of resources and a lack of consensus on how best to combat the problem.
Under Republican Gov. Paul LePage, Maine has been slow to expand access to medication-assisted treatment such as suboxone, and slow to improve access to naloxone, a drug that reverses the effects of an opioid overdose.
Kenney Miller, executive director of Health Equity Alliance, said Maine still places too much emphasis on treating addiction as criminal behavior.
“After nearly 100 years of trying to address drug use by punishing people who use drugs, we must admit that tough love just doesn’t work,” he said. “Although we continue to arrest people, there continues to be no impact on rates of drug use. Study after study has shown that you can’t force people into treatment, but you can support them until they reach recovery. Today, letting people hit rock-bottom is equivalent to a death sentence.”
LEPAGE SILENT ON LATEST OVERDOSE NUMBERS
LePage, who made no mention of the opioid crisis during his State of the State speech this month, did not issue a public statement about the new data Thursday, and his office did not respond to a request for comment.
Rep. Patricia Hymanson, D-York, the Democratic chair of the Legislature’s Health and Human Services Committee, called the latest statistics “horrifying and sad.”
“We have many ways in front of us to help the state move forward,” she said. “The most important one to me is the hub-and-spoke treatment model. I’ll support that forever.”
Hymanson was referring to a bill sponsored by Rep. Karen Vachon, R-Scarborough, that would create a series of hubs around the state that exist to direct people seeking treatment into a program, or spoke, that best suits them. The state of Vermont has had success with a similar plan.
Vachon’s bill was introduced last year, but carried over to the current legislative session because of concerns over how to fund it. Estimates suggest that it could cost the state at least $6 million annually.
Vachon said Thursday that she’s hopeful her bill will pass and be funded this year. She said the numbers released Thursday should be added motivation.
“There is a lot of education that still needs to be done on this,” she said. “Addiction is still looked at as a moral failure and we need to change minds about that.”
MEDICAID EXPANSION ON HOLD
A successful citizen-led initiative to expand Medicaid in Maine last year could also provide treatment services to a number of low-income Mainers, but expansion is on hold until lawmakers can figure out a way to pay for it.
One initiative pushed by the LePage administration – and former Department of Health and Human Services commissioner Mary Mayhew, now a candidate for governor – was the creation of an Opioid Health Home program, but so far that effort has largely failed.
After pledging to spend $4.8 million to treat up to 400 Mainers affected by the crisis, a memo released this month by DHHS showed that less than $60,000 had been spent on the program in the year or so since it launched. Only five uninsured people and about 50 MaineCare recipients have received treatment.
Malory Shaughnessy, executive director of the Alliance for Addiction and Mental Health Services of Maine, said the LePage administration has been weighed down by bureaucracy and is not willing or able to work with the providers who are experts in delivering care to those needing substance abuse treatment.
None of the two dozen candidates vying to be Maine’s next governor issued public statements Thursday about the overdose numbers. Mills, a Democratic candidate, did include her 10-point plan for addressing the crisis as part of the statement she released as attorney general.
BILLS FILED, BUT FUNDING UNCERTAIN
Reaction to the report among state political figures was confined to Democrats.
Maine Democratic Party Chairman Phil Bartlett called the 2017 numbers “sad and tragic,” and placed blame on the LePage administration.
“Not only has the governor failed to act in any meaningful way to address the opioid crisis, but he’s exacerbated it by actively working to restrict access to lifesaving treatment and anti-overdose medication,” Bartlett said. “Abating this crisis needs to be one of the first priorities for Maine’s next governor.”
Democratic House Speaker Sara Gideon called the latest report “devastating.”
“We can no longer ignore the impact of this epidemic, disregard the underlying causes or the lack of access to needed treatment,” she said in a prepared statement. “This data represents more than numbers – it represents our family, our friends, our neighbors. In every instance, at every age, we should be doing everything in our power to save every life possible. And the sad fact is, we are not.”
The latest statistics were released on a day when the Legislature’s Health and Human Services Committee was discussing a trio of bills that would provide additional housing resources both for Mainers in addiction recovery and for those living with mental illness. The fate of each likely hinges on whether lawmakers can find funding.
PORTLAND ALONE SAW 57 DEATHS
Data released last fall for the first six months of 2017 suggested that the number of deaths in Maine might be plateauing. From January through June, there were 185 deaths, slightly below the pace of 2016.
But the death count escalated in the second half of 2017.
During that same time period, LePage stalled a measure that would have allowed people to purchase naloxone over the counter without a prescription. Although the Maine Board of Pharmacy voted to approve the rules, they sat on the governor’s desk for five months.
The pharmacy board finally approved the rules this month, but only after raising the minimum age to purchase naloxone from 18 to 21 at the governor’s insistence.
The new overdose report, prepared for the AG’s Office by Marcella Sorg, a forensic anthropologist at the University of Maine, shows that the problem has hit urban areas hardest. One in four deaths last year occurred in Cumberland County, and 57 were in Portland alone. York County saw 82 deaths, or 20 percent of the statewide total, with 23 in Biddeford.
The average age of those who died from a drug overdose was 42, which is close to the average age of the population of the state.
The state also saw increases in the number of deaths attributed to cocaine and methamphetamine.
DEATHS DECLINE IN 14 OTHER STATES
The continued increase in Maine overdose deaths comes at a time when several other states are reporting decreases.
Data released this month by the U.S. Centers for Disease Control and Prevention showed that deaths had declined in 14 states, including Massachusetts and Rhode Island, during the 12-month period that ended in July 2017.
Even with those declines, though, overdose deaths have reached a peak in the United States. Comprehensive numbers have not been released for 2017, but in 2016 there were 63,632 overdose deaths. The number has been steadily increasing for the past two decades, but the 20 percent increase from 2015 to 2016 was the largest on record.
Drug overdose deaths in Maine used to be exceedingly rare. In 1997, there were just 34 – less than the monthly average for 2017.
The spike in drug deaths started in 2000, with 60 deaths. The next year, it was 90. The year after that, 165 people died. A majority of those deaths were linked to prescription opiates such as OxyContin, which was increasingly being diverted and abused.
From 2002 through 2011, the number of overdose deaths was more or less steady – never eclipsing 179 or dropping below 153.
Since 2011, though, deaths have increased every year. In 2014, a then-record 208 people died. Just three years later, that number had doubled.
Eric Russell can be contacted at 791-6344 or at:
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