Gov. Paul LePage threw out a startling statistic at Tuesday’s town hall meeting in Portland — 90 percent of those addicted to heroin die as a result of their addiction. Although the governor’s number was an exaggeration, the real number — 50 percent die prematurely — is just as shocking and should galvanize support to do more to fight addiction.
This jarring number doesn’t mean, as the governor suggested, that treatment is hopeless. Instead, it’s a reminder that quality treatment must be readily and consistently available.
Researchers at the University of California, Los Angeles, followed people with heroin addictions for 33 years, from 1964 to 1997. By 1997, half the study participants — all men with criminal convictions — had died. This death rate was up to 100 percent higher than the overall death rate among men of the same age. The average age of study group survivors in 1997 was 57.4 years.
The most common cause of death (for nearly 22 percent) was a drug overdose, most often heroin. Liver disease and cancer also were common, as were homicides, suicides and accidents.
The governor used the high heroin death rate as a reason not to focus on treatment. But this attitude makes addiction hopeless, effectively a death sentence for many. It diminishes the value of people such as Nick St. Louis, who shared the story of his addiction and recovery at a forum in Bangor earlier this week.
To be sure, treatment isn’t a cure, but it can be a path back to normalcy — a job, family life, social engagement. Too often, though, there are waitlists for treatment, and lawmakers have imposed caps on the duration of common substance abuse treatments for low-income Mainers.
The UCLA study shows that treatment is a long, incremental process prone to setbacks. Of the survivors, nearly half — 47 percent — reported abstinence of five years or more in 1997. But a quarter still returned to heroin use, even after 15 years of abstinence.
In theory, stopping the flow of heroin into Maine would be the most effective way to end its use. But as the country’s decades-long war on drugs shows, there is no way to completely stop the flow of drugs, and history shows that when one drug is hard to get, addicts switch to another. Reducing the demand for heroin and other drugs by treating people who are addicted to them must be the focus of any plan.
After weeks of LePage demanding more drug enforcement agents — and threatening to call on the National Guard if he didn’t get them — legislative leaders have agreed to push for funding for 10 new agents as part of a $4.8 million plan to address Maine’s heroin crisis. LePage also issued a financial order authorizing additional funds for the Maine Drug Enforcement Agency so it can expedite the new hires. Of the four new agents funded by the state budget approved in late June, the MDEA so far has hired one.
Acquiescing to LePage’s demand for more agents gives lawmakers more leeway to delve into Maine’s heroin crisis with a focus on prevention and treatment, which State House leaders pledged to do Wednesday in announcing their $4.8 million plan. In addition to the drug agents, the plan — crafted by Republican Senate President Michael Thibodeau, Democratic House Speaker Mark Eves and Democratic Sen. Justin Alfond — calls for a new detox center in Bangor and more peer-to-peer counseling centers.
As a proactive measure, Maine policymakers need to address how the high usage of prescription painkillers in the state contributes to the heroin epidemic. There is increasing evidence that abuse of prescription opioids is a precursor to heroin use.
In 2012, Maine and New Hampshire had the highest rates per person for high-dose painkiller prescriptions. Data from Maine’s Prescription Monitoring Program show that prescription painkiller use rose from 2006 to 2010, with the largest rise among Schedule II drugs, those most likely to lead to addiction.
Prescribers are using the monitoring program to track — and, if necessary, limit or stop — overuse of controlled substances. In a recent survey, one-third of the program’s users said they had referred a patient to substance abuse treatment based on prescribing information in the database.
Sadly, we know that more people will die in the coming months because of their heroin addictions. But it’s critical that no one accepts that fact as something that can’t change.