Maine’s failing to prevent drug deaths by limiting distribution of a medication that counteracts overdoses and punishing those who call 911 to report overdoses, according to a recent analysis. But new legislation could change the state’s approach.
The analysis, performed in October by the Trust for America’s Health, was publicized again this week in light of the death of actor Philip Seymour Hoffman by an apparent heroin overdose.
Just three weeks ago, Maine Attorney General Janet Mills sounded the alarm about a startling increase in fatal heroin overdoses in Maine, which jumped from seven in 2011 to 28 in 2012. Last Friday, an 18-year-old Bath student was hospitalized for a suspected heroin overdose.
In his State of the State address Tuesday evening, Gov. Paul LePage noted the 163 drug-induced deaths in Maine in 2012.
Many public health officials have raised concerns that efforts to curtail prescription drug abuse have led users to shift to cheaper and more readily available heroin.
In 17 states and Washington, D.C., lawmakers have expanded the availability of naloxone, a prescription medication that counteracts the life-threatening effects of opiate overdose. An overdose of heroin or other opiates such as prescription painkillers and methadone can depress breathing and the body’s nervous system, leaving users unconscious. Naloxone, known by the brand name Narcan, restores breathing, allowing users to potentially survive an otherwise fatal overdose.
Naloxone is used in Maine ambulances, but new legislation would put the medication into the hands of police, volunteer firefighters, drug users and their families. L.D. 1686, sponsored by Rep. Sara Gideon, D-Freeport, would free doctors to dispense the medication not only to a drug user at risk of overdosing, but also to anyone likely to witness the overdose, such as a relative or friend.
“Its use in Maine is not widespread,” Gordon Smith of the Maine Medical Association said of naloxone, adding that passage of the bill would ease physicians’ concerns about prescribing it.
More than 90 percent of overdose deaths involve prescription drugs, Smith explained, though not always drugs intended for the victims. Doctors prescribing painkillers know that some patients could get addicted, but many are reluctant to also prescribe naloxone for fear of a lawsuit in the event of an overdose death, he said. Providing a patient with naloxone could be interpreted as proof that a physician suspected a patient was at risk of an overdose from pills that doctor prescribed, Smith said.
The new legislation includes an immunity provision that would protect health care professionals who prescribe or dispense naloxone from civil and criminal liability and professional disciplinary action.
Then there are the drug abusers who don’t have a doctor, another reason naloxone should be made available to community addiction and recovery organizations best equipped to respond to overdoses, Smith said.
“This really would save quite a few lives…Every one of those deaths is someone’s son, daughter, brother, sister,” Smith said.
A public hearing on the bill scheduled for 9 a.m. Wednesday in Augusta was postponed due to the snowstorm.
Naloxone distributed through community overdose prevention programs has led to more than 10,000 overdose reversals, according to the U.S. Centers for Disease Control and Prevention. The medication carries risks, however, including sudden and violent withdrawal that can lead to vomiting and aspiration.
Administered through a nasal spray or injection, naloxone does not provide a high. Drug abusers who overdose still must be hospitalized after the medication is administered.
Maine is also among the majority of states lacking laws to protect those who report drug overdoses from criminal prosecution, according to the Trust for America’s Health analysis. So-called “Good Samaritan” laws provide a degree of immunity from criminal charges or sentencing leniency for people reporting their own or others’ drug overdoses. Supporters argue that fear of arrest and prosecution prevents people who overdose or witness an overdose from calling 911.
Gov. LePage last June vetoed a bill that would have protected overdose witnesses who call for help, writing that the legislation, while noble, would “create an unnecessary barrier for drug enforcement when drug use remains a significant scourge on our state.”
Maine has seen a nearly 100 percent rise in drug overdose deaths over the last decade. Nationally, rates have doubled in 29 states since 1999, quadrupling in four of those states and tripling in 10 more.