Dr. Ann Marie Lemire, medical director of the Cumberland County Jail, could have given lawmakers a raft of statistics. Instead, she told them a story.
About five weeks ago, a man near the end of his sentence was desperately afraid of what his release would mean. He was homeless and was worried that once he was back on the street, he would resume using opioids. He connected with Portland Public Health and made an appointment to speak with a community educator after he got out. But before that meeting could occur, he overdosed and died, less than 24 hours after his release.
It’s a tragic story, but not that unusual. Maine was unprepared for the opioid overdose epidemic, which has taken lives of people from every economic stratum. But as the state steps up its response to the crisis, special attention needs to be paid to the most vulnerable – people who are homeless and can’t access treatment as easily as someone with a more stable life. A bill to address that special circumstance, L.D. 1337, is before the Legislature and should be passed.
The Homeless Opioid User Service Engagement or HOUSE program would provide detox, medication-assisted treatment, supportive housing and case management for people like the patient Lemire described. The bill, sponsored by state Rep. Drew Gattine, D-Westbrook, calls for the state to create two facilities, one urban and one rural, that could treat up to 50 people as part of a pilot program. It is based on models that have proven successful in other states.
If this bill sounds familiar, there’s a reason. It was a recommendation of the bipartisan Opioid Task Force that operated during the last Legislature. A bill just like it passed both the House and Senate last year, but there were not enough votes to override a veto from then-Gov. Paul LePage. In his veto message, he said that the state was already doing enough to combat the epidemic.
That wasn’t true then, and it’s not true now, despite the significant commitments the state has made to make treatment more available since Gov. Mills has taken office. Her decision to implement the voter-approved expansion of Medicaid eligibility will result in more people seeking and receiving drug treatment in Maine, if the experience of other states holds true here.
But coverage alone is not always enough. Homelessness is often more than a lack of housing. Mental illness and addiction also play a role in a life on the street, and it’s unrealistic to expect people to work on each of their issues in isolation.
Certainly, no one should be afraid to get out of jail. The fact that the worst fears of Lemire’s patient came true so quickly speaks to how the problems of homelessness, mental illness and substance use are tightly woven and need to be addressed holistically.
In her prepared remarks, Lemire encouraged lawmakers to “look at the person beyond homelessness, opioid use or their mental illness. They are someone’s son or sister or father.”
That’s good advice. Lawmakers should heed it and pass the HOUSE program.
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