AUGUSTA, Maine — Demand for action in response to Maine’s deadly opiate abuse epidemic has spread from rural Maine towns all the way to the halls of Congress.
This week on Capitol Hill, fighting addiction takes priority as the House of Representatives considers new measures to combat the problem. Many of those measures are contained in a sweeping piece of legislation called the Comprehensive Addiction and Recovery Act, which has passed in the Senate and is working its way through the House. But that bipartisan effort has stumbled over funding.
Meanwhile, President Barack Obama has called the opioid crisis a threat to the United States that is as serious as terrorism. He supports the bill.
Here’s a look at at the situation.
What is the Comprehensive Addiction Recovery Act?
After years of posturing and negotiations, the Comprehensive Addiction Recovery Act was introduced in the Senate in February. Within weeks, the Senate voted 94 to 1 for passage. The Senate version would provide a slew of new grant funding across the spectrum of the fight against drugs, from education to law enforcement to treatment and recovery.
It also would:
— Give police and firefighters more authority to use naloxone, a drug that reverses the effects of heroin overdoses.
— Set up more disposal sites for unused prescription medications.
— Provide grants through the Justice Department for treatment courts, including for veterans and students.
A Democratic amendment to the bill would have provided $600 million in funding, but it failed in the Senate. This week, the House is considering a package of several bills with the intention of either passing them individually or merging them with the Comprehensive Addiction Recovery Act, which currently provides about $85 million in funding but is in flux.
The House of Representatives has devoted most of this week to considering measures that fight opioid addiction.
One bill, co-sponsored by U.S. Rep. Bruce Poliquin, a Republican who represents Maine’s 2nd District, would launch a study by the Government Accountability Office to report on how to better treat newborns suffering from fetal opioid exposure. The House passed the bill Thursday.
It “makes sure that we get the information we need as to how hospitals and other medical facilities are currently treating these addicted babies such that we can fill in the gap with Medicaid funding,” said Poliquin Wednesday on the House floor.
Poliquin, who has lost a family member after a decades-long fight with addiction, also is a member of a congressional task force aimed at combating the heroin epidemic. That bipartisan group introduced more than a dozen bills, many of which are under consideration this week. They include proposals for competitive grant programs, new tools and restrictions for doctors who prescribe potentially addictive drugs, new treatment options and a bill that would alter sentences for some federal drug charges.
U.S. Rep. Chellie Pingree, a Democrat who represents Maine’s 1st District, said she supports many of the bills in question but criticized Republicans who have blocked efforts to attach more funding to the bills. Pingree is a co-sponsor of a bid to authorize $600 million in emergency spending for prevention, treatment and criminal justice programs contained within the Comprehensive Addiction Recovery Act legislation.
“I can’t understand how it is possible that my colleagues fail to recognize the critical importance of investing in the lives of people suffering from addiction,” said Pingree during a floor speech on Tuesday.
Efforts back home
Earlier this month, the Maine Opiate Collaborative, which was launched last year by Gov. Paul LePage in partnership with Attorney General Janet Mills and U.S. Attorney Thomas Delahanty, released its findings after a months-long process that involved more than 20 public forums across Maine. The process resulted in a list of broad recommendations that are contained in a 60-page report.
“This is only the first step,” reads the introduction to the report. “We must work to establish a working plan and then execute that plan.”
Sagadahoc County Sheriff Joel Merry, who co-chaired the law enforcement arm of the task force, said that while the recommendations are broad — such as establishing more drug courts and treatment options within the county jail system — the group’s prolonged work has already yielded progress, including better information sharing between law enforcement agencies in rural Maine and agencies in areas where many drug dealers serving Maine come from, such as Massachusetts and Connecticut.
“It helped us kind of get out of the silo effect and realizing that law enforcement is just going to be banging our knuckles on the ground without help from the treatment and recovery folks,” said Merry. “I’ve seen a paradigm shift among law enforcement toward moving folks into treatment programs. They’ve been very successful, but somehow we need to continue to fund those programs and make sure they’re well resourced.”
Among the progress made this year by LePage and the Legislature was the approval of a $150 million facilities bond to renovate the Windham Correctional Facility, including 200 new beds for substance abuse services. While LePage has touted that project as a major achievement — and most people agree with him on that point — Merry said it will likely serve only major offenders who are sentenced to more than nine months in the state prison system and leave out scores of lower-level convicts in the county jail system.
“One of the things that concerns me about that program is that it’s back-end treatment,” said Merry. “In order for a person to get treatment at the correctional center in Windham, they’re going to have to be convicted of a serious crime. … We need a therapeutic community at the county jail level because if we don’t have it, we’re missing a great opportunity to make a difference.”
The Legislature and LePage also agreed on the enactment of a bill that will set lower limits on how much opioid medication a person can be prescribed and requires doctors to check patients against the Controlled Substances Prescription Monitoring Program. Some say that while the bill has its merits, it could create secondary problems.
Dr. Mark Publicker, a Portland-based addiction specialist, said he worries that it will increase the underground market for prescription drugs. Of more concern to Publicker is that doctors and other medical professionals who write prescriptions — who in the past were under pressure to prescribe opioid-based drugs that were billed as harmless and nonaddictive — are not trained to wean patients off their medications. The new limits on prescriptions, which take effect later this summer, will results in some patients having their prescriptions cut in half.
There are an estimated 80,000 Mainers taking prescription opioids.
“There’s no attention being paid to how clinicians are supposed to help these patients withdraw,” said Publicker. “Extremely few clinicians have any skill or knowledge about how to do that. … What I’m anticipating when this law takes effect is a mess.”
Publicker said there’s a reason that debates in Congress and among the Maine Opiate Collaborative have produced scant results.
“You already know what the [Maine Opiate Collaborative’s] findings are without even looking. We need more education and more focus on community programs,” he said. “There was no implementation plan, no request for funding. … It’s a document that will have no effect. That’s a lack of leadership talking.”
Independent U.S. Sen. Angus King, who has participated in anti-drug summits across Maine, hosted four round-table summits and introduced a number of bills in Congress, said the key is ensuring that entities from local police and doctors to federal prosecutors are all pulling in the same direction.
“We all recognize the urgency of addressing the opioid crisis here in Maine, and to do that, we have to employ an all-hands-on-deck strategy that brings together medical professionals, law enforcement, and families fighting this epidemic to harness their collective expertise and experience to make Maine stronger,” he said.
Maine broke its record for drug overdose deaths in 2015 with 272 fatalities — about five per week — which was fueled by a drastic increase in heroin use. No data are available yet for 2016, according to the attorney general’s office. But that does not mean the problem has gone away, as recent obituaries so sadly attest.