By André Beganski
The nation’s sharp increase in opioid-induced deaths since 2014 results directly from a spike in overdose rates in rural states like Maine.
In 2016, the Pine Tree state had the eighth highest opioid overdose death rate per 100,000 residents in the country, according to an analysis of Centers for Disease Control and Prevention data by the Kaiser Family Foundation. The frequency of overdoses increased 31 percent over the 2015 rate, the analysis showed.
The state recorded 418 drug-induced deaths in 2017, a 17 percent increase over the previous year, according to figures released in February by Maine Attorney General Janet Mills.
Mills attributed the surging death rates to the increased prevalence of fentanyl within the state. The synthetic opiate that can be up to 50 to 100 times more potent than heroin, accounted for 27 percent of Maine’s 2017 overdose deaths, the attorney general’s statistics said.
Nationwide, the National Center for Health Statistics recorded 42,249 opioid overdose deaths in 2016, a five-fold increase from the 8,407 opioid overdoses in 2001, with the largest increase among rural states since 2014.
Law enforcement officers and first responders on the front line of Maine’s opioid crisis said they believe the increasing rates of opioid addiction could be linked to the closure of factories, including paper mills and a decline in employment, spurred by an economic downturn that began in 2008.
As Mainers found themselves without jobs or job prospects, some gravitated toward opioids, state trooper Andrew Pierson said in an interview. “Whereas this used to be a problem that was strictly in the city, it’s not anymore,” he said, explaining that the opioid problem had spread into rural areas of Maine as well.
Josh McNally, the fire chief in Howland, a former mill town in northern Maine’s Penobscot County, said reviving drug abusers has become a regular part of his job. McNally has administered Narcan, an overdose-reversing nasal spray, hundreds of times since fentanyl began appearing in recent years. “I’ve administered Narcan more in the past two years than I have in the past 18 years,” said McNally.
The development of the drug Naloxone, now known Narcan, has been crucial in combating the opioid epidemic. Equipping emergency personnel with the nasal spray gives first responders the ability to save lives.
McNally said the people he has seen suffer multiple overdoses have mostly been unemployed men. “There’s not a lot of industry or work here so it’s easy to fall back,” he said.
The state’s opioid crisis also is affecting future generations. According to the state Department of Health and Human Services, 952 babies were born in Maine in 2017 with neonatal abstinence syndrome, local news media reported. From 2005 to 2016, one in every eight births in Maine were drug-affected babies, the news reports said.
Fentanyl has exacerbated the crisis in rural Maine, according to Steven Kenyon, police chief of Millinocket, another depressed former mill town in Penobscot County. Not only has heroin become increasingly available on the streets, the drug is often cut with fentanyl, making it more potent and potentially life-threatening, he said.
“I know there’s a lot of people in town that are hooked on drugs,” Kenyon said in an interview in early April. “You have no idea how much fentanyl is going into this drug before you get it. That’s the scary part for me.”
Kenyon said a majority of the people who get hooked on opioids became dependent on them through prescriptions. Their availability has led to the increased popularity of heroin as a cheaper alternative drug. As long as patients are saying they feel pain after they’ve been given painkillers, “the doctor will prescribe it just like that,” said Kenyon.
Until recently, many towns in Maine have had to wrestle with the opioid crisis on their own, without any state or federal funding. While most states passed legislation in response to the opioid crisis years ago, the Maine legislature enacted the “Act to Provide Access to Affordable Naloxone” only in April, after the bill was vetoed numerous times by Gov. Paul LePage for more than two years.
Bangor Councilman Ben Sprague explained how Maine’s third-largest city was dealing with the opioid crisis at a public meeting at Bangor’s Crosspoint Church on Jan. 23, according to minutes of the meeting provided by church officials.
Sprague said drug dealers, previously operating from states like Connecticut and Massachusetts, have cut out the middle man and set up shop in Bangor, according to the minutes.
In terms of policy, Sprague said he believes that Bangor’s drug problem could be solved largely through law enforcement, calling for increased collaboration between local police and the Maine Drug Enforcement Agency.
While he values deterring criminal activity, he said he also understands substance abuse as a mental health disorder. On his website, Sprague emphasized a need to “make sure that people are getting the care they need and that we are not criminalizing the disease of addiction.”
Equipping fire and police departments in Bangor with Narcan was the town’s first step towards addressing the crisis. After Bangor saw 117 overdoses in 2016, the drug’s introduction reduced local deaths down to 12 overdoses within a single year, Sprague said, according to the meeting minutes.
The town also has funded prenatal health care as well as addiction services. Prenatal programs provide medically assisted treatment to mothers and help wean them off opioids by the time their baby is born. In some cases, the town will provide housing, counseling and general assistance to families that qualify. Addiction services can transition abusers off opioids using therapy in combination with drugs that address their cravings.
While some towns have the tax revenue to successfully manage the crisis, others are doomed without federal or state funding. Millinocket does not have the budget to offer any public services in terms of addiction treatment, said Kenyon, the police chief.
“One of the walls to fixing your addiction problem is the cost to go to these rehab places.” Kenyon said. “Not everyone has the insurance that’s going to cover that, and some of the people in our town can’t afford that.”
He added that Millinocket also cannot afford to equip their police officers with Narcan.
While politicians have vocalized their concerns about the opioid problem, their policy plans are split along party lines. Congressman Bruce Poliquin, a Republican representing Maine’s 2nd Congressional District who faces re-election this year, has called for increased police funding, touting the typical Republican stance on addiction.
His Democratic opponents have expressed frustration over not addressing the epidemic in a direct manner. One candidate, Jared Golden, said at a public forum in early April: “I’m not opposed to law enforcement, but we’re not going to arrest our way out of substance abuse.” Another Democratic candidate, Lucas St. Clair, said at the same forum: “We’re not doing anything for treatment, prevention or recovery. There’s been no state or federal assistance in addressing the epidemic.”