Gov. Paul LePage recently vetoed a bill that would have allowed pharmacists to dispense naloxone, brand name Narcan, without a prescription, stating, “Naloxone does not truly save lives. It merely extends them until the next overdose.”
This was a poor decision and a crude devaluation of the lives of the many Mainers who struggle with opioid addiction every day. Making assumptions about opioid addiction without specialized training or accurate scientific knowledge is not only bad policy, it is dangerous, jeopardizes the lives of those addicted and creates misunderstanding about addiction treatment.
The governor’s apparent logic is that someone using heroin or opioid-based painkillers would have this antidote next to them so they could use these substances without having to worry about the consequences. This position completely misrepresents the situation and misses several critical issues.
Aside from the fact that someone in the midst of an overdose on opioids likely would not be able to administer this medication themselves, naloxone causes very rapid, violent and often painful withdrawal symptoms — it is used to save lives in emergencies, not to facilitate recreational drug use. But more importantly, the governor appears to see opioid users as a narrow stereotype despite a plethora of information about the wide-ranging demographics of this disease. Roughly 80 people in this country die every day from legal and illicit opioid overdose deaths, the equivalent of a daily, midsize plane crash. Imagine the outcry if a plane crashed every day! But because these people are addicted to opioids, some people, including the governor, still believe it is their fault and that they basically deserve what they get.
As someone who has worked with people with opioid addiction for many years, I have a different perspective. I have had clients who were truck drivers, teachers, lawyers, medical professionals, fishermen, students, mothers, fathers, teens and grandparents in methadone or buprenorphine treatment programs. They were not bad or deserving of the consequences of addiction, and many became addicted by simply taking their pain medication as prescribed. These clients often struggled not only with the challenges of their opioid use disorder, an acquired disease that causes neurological changes such as making willpower an elusive and inconsistent trait, but also suffered from a great deal of shame. But they frequently can and do recover, and we must continue to offer hope and treatment.
I also have sat with parents who have lost a son or daughter to an opioid overdose. I have consoled a partner who lost a loved one to an opioid overdose. I have worked with children who lost a parent to an opioid overdose. There is no typical case, but there are typical reactions — incredible pain and loss.
One father said his daughter was using opioid pain medications without his knowledge, though he suspected she might be using drugs of some type. He told me this was a new issue for her. One morning he heard her younger sibling screaming. He ran into the bedroom and found his daughter not breathing. They called 911 and he performed CPR until the ambulance arrived, which took several long minutes. The EMTs continued CPR but his daughter could not be resuscitated. She was 14 years old. What if naloxone had been available? Would this young person have been saved? Possibly or possibly not — we’ll never know. But like all parents, this father would have done anything to save his daughter, including having naloxone available in their medicine kit if that were an option.
This is another key point LePage is missing. There is not one stereotype of an opioid overdose. Besides the case I have illustrated above, there are countless others: children accidentally taking a parent’s pain medication, uninformed prescription opioid users who mistakenly combine their medication with alcohol or benzodiazepines, and those addicted to heroin who miscalculate their dose or take heroin laced with fentanyl. All may overdose and die. Naloxone could save many of these lives.
Despite the stigma, those suffering from an addiction are people worth saving, and they deserve a chance to recover from their disorder like anyone suffering from a chronic disease. They don’t deserve to die but are simply individuals who found themselves in the throes of addiction for a wide variety of reasons and desperately want to get back in control of their lives.
Naloxone truly does save lives, because it allows a parent, partner or friend to extend a loved one’s life long enough to survive an overdose so he or she has the opportunity to find the help needed to continue on the journey to recovery.
Dan Johnson, Ph.D., is executive director of the Acadia Family Center in Southwest Harbor.