January 19, 2020
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Lawmakers consider bill to make overdose-stopping drug widely available in Maine

Sara Gideon

AUGUSTA, Maine — Lawmakers, medical professionals, law enforcement officers and those who have lost loved ones to heroin argued passionately Wednesday for a bill that would expand access to a drug that can stop an overdose in its tracks.

LD 1686, An Act to Address Preventable Deaths from Drug Overdose, was presented by its lead sponsor, Rep. Sara Gideon, D-Freeport, to the Legislature’s Health and Human Services Committee.

Naloxone hydrochloride, also known by the brand name Narcan, blocks opioid receptors in the drug user’s brain, ending the euphoria and effects of heroin or other opiates and triggering an immediate and severe withdrawal. It can be administered in the same manner as an Epi-Pen, or as a nasal mist.

Several lawmakers appeared to be holding back tears during testimony by people who have lost family or friends to heroin overdoses, when they said easy, fast access to the drug could have saved their loved ones’ lives.

“Dead people can’t get clean,” said Neil Fishman, a Freeport resident whose father, Jack Fishman, worked on the team that created the drug in the 1960s. Fishman said his stepbrother died of a heroin overdose 10 years ago.

“There’s no question to any of us in our family that had naloxone been administered in time, it would have saved his life,” Fishman said.

In Maine, heroin use and overdoses are on the rise, a spike that law-enforcement officials link, in part, to successful efforts to prevent prescription opiates such as oxycodone from entering the black market. In 2012, fatal heroin overdoses quadrupled over the previous year, from seven deaths to 28. The attorney general’s office says that number is likely to grow again when 2013 data is compiled.

Naloxone has been used in hospitals for decades, but its use outside hospitals is limited to paramedics. Gideon’s proposal would allow all emergency medical personnel to carry and administer the drug, as well as firefighters and police officers, who often are the first to arrive at the scene of an overdose.

Currently, the drug can be prescribed to addicts, but Gideon and other proponents said addicts in the throes of an overdose are not able to administer the drug to themselves.

LD 1686 would allow an addict’s friends and family members to obtain, possess and administer the drug. The bill also would create a civil and criminal immunity for those who administer naloxone or other similar drugs to someone they believe to be suffering from an opiate overdose.

Gideon said the drug’s effects are not pleasant, but can give overdose victims a second chance at life.

“Within one to three hours of an overdose from an opioid, someone’s breathing is slowed to the point of death,” she said. “It can restore normal breathing and give someone a chance to live, but it is not a pleasant experience.”

Naloxone is used often in hospital emergency rooms across the country. Rep. Ann Dorney, D-Norridgewock, a physician, said the drug is often given to patients who are unconscious for unknown reasons. That’s because the drug has no effect on a patient who has not consumed opiates.

More than a dozen states and the District of Columbia have made naloxone widely available. As reported Tuesday by the Seattle Times, the director of the Office of National Drug Control Policy, Gil Kerlikowske, is calling on more states to adopt naloxone programs.

“By allowing first responders to administer naloxone, or Narcan, we can save lives,” said Sagadahoc County Sheriff Joel Merry, who testified in favor of Gideon’s bill.

In Quincy, Mass., police officers have begun to carry and administer naloxone. In 18 months, starting in 2010, the police department administered the drug 179 times, including 170 overdose reversals.

Gideon’s bill received national attention Wednesday morning when the Huffington Post published an article speculating that LePage would veto the bill if it passes the Democrat-controlled Legislature.

In his State of the State address last week, Gov. Paul LePage also discussed the drug epidemic in Maine, saying he would hire 14 additional Maine Drug Enforcement agents in an effort to “hunt down” drug dealers.

Last year, LePage vetoed LD 1046, a bill similar to Gideon’s, saying that providing naloxone would provide opiate abusers “a false sense of security that abusers are somehow safe from overdose if they have a prescription nearby.”

On Wednesday, representatives from the LePage administration opposed Gideon’s bill.

Jay Bradshaw, director of Maine Emergency Medical Services, said advanced EMTs, who carry naloxone, are on-hand for 99.3 percent of emergency responses.

He said expanding naloxone access to lower levels of EMTs is unnecessary, because those providers already have the training and equipment necessary to get overdose victims breathing again.

Bradshaw also cautioned that having people who are not medical professionals administer the drug could be dangerous because patients who are given naloxone “do not simply and gently awaken.”

“On the contrary, they can be angry and physically violent,” he said. “Vomiting is not unusual and in an unresponsive patient, aspiration is a real concern.”

Decisions about who should and should not receive access and training to deliver the drug should be left to the Medical Direction and Practices Board, which is made up of physicians, Bradshaw said.

Follow Mario Moretto on Twitter at @riocarmine.

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