Maine has been hit hard by the opioid overdose epidemic, which has claimed almost 1,500 lives in the past five years.
Our response has at times been chaotic, fragmented and often in conflict with the best thinking of experts in the field. We can’t keep wasting time.
Gov. Janet Mills’ promise to put the state’s response to the crisis under the supervision of one person is the right approach and long overdue.
Opioid use spreads like a virus, and it does not respect the boundaries of state agencies. It’s not just a problem for police departments, or doctors, or pharmacists, or first responders, or schools, or jails, or homeless shelters, or treatment providers — it’s a problem that needs attention from them all.
We don’t yet know exactly what the governor has in mind, but opioid responses in other states offer an idea of how a coordinated approach could work here.
It starts with reducing people’s exposure to drugs, through law enforcement’s disruption of drug networks and imposing the kind of limits that Maine has set on prescribers. It also includes expansion of access to the lifesaving overdose antidote naloxone. And it ensures that there is medication-assisted treatment for everyone who needs it, whether they come into the system through an arrest, an emergency room visit, a needle exchange clinic or their doctor’s office.
And that access should continue even if they are incarcerated. A successful response also should include supports such as housing assistance and job training for people who are trying to rebuild their lives in recovery.
More doctors need to be educated about providing treatment through their practices. Currently only 742 are certified; to reduce people’s exposure to the drugs. by the federal government to treat patients with Suboxone, making outpatient drug treatment unavailable to too many Mainers.
Whoever becomes Maine’s opioid coordinator will have some assets that the state has not had in the recent past. By implementing the Medicaid eligibility expansion that was approved by the voters in 2016, there will be money to provide treatment for as many as 25,000 people with drug use disorder who did not have health insurance. And the state has failed to apply for federal grants that would have helped pay to fight the epidemic as it was growing. To fund the comprehensive approach, a coordinator could be in charge of making sure that the state is drawing down all the federal money it is entitled to.
This problem is too complex to be the responsibility of one government agency. A single coordinator can make sure that the half-dozen agencies that have responsibility for some aspect of the drug crisis are moving in the same direction.
Let’s not wait for 1,500 more deaths before we make an effective response.
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