Seventy-eight people die every day in the United States from an opioid overdose, and, on average, one of these people dying each day is from Maine. It is nothing less than shocking that a public health menace is killing a person every day in our state.
In November, Maine Attorney General Janet Mills announced that, despite numerous efforts to address the problem, deaths from drug overdoses so far this year are outpacing the record number of deaths we saw last year. Three days later, the U.S. surgeon general released the first report from his office on substance use disorders. The report takes a comprehensive look at the problem of the misuse of alcohol, prescription drugs and other substances and brings together the best available science on the adverse health consequences of substance misuse. The report summarizes what is known about what works in prevention, treatment and recovery.
These two announcements demonstrate the severity of the epidemic of drug abuse in Maine and the nation. But where is the sense of urgency and the outrage from the public and from our state leaders?
As an emergency physician and president of the Maine Medical Association, not a day goes by when I do not witness the tragic consequences of opioid abuse. While I applaud the Legislature and Gov. Paul LePage passing legislation to limit the prescribing of opioid medication, I lament the lack of resources going into prevention, treatment and harm reduction. That legislation will save thousands of Mainers from going down the road from opioids to heroin, but it will do little — if anything — to assist those individuals who are suffering from substance use disorders now.
Maine is in desperate need of detox beds and providers of medication-assisted therapy, such as with buprenorphine and methadone. While Congress enacted legislation months ago allowing nurse practitioners and physician assistants to prescribe buprenorphine, the required courses are just being developed so prescribing won’t start until well into 2017. In the meantime, another 11 Mainers will die from drug overdoses this year, with incalculable loss to society and their loved ones. While the Legislature approved the creation of a 10- bed detox facility in January and the contract has been awarded to a nonprofit in Greater Bangor, the contract has not yet been signed, meaning the beds will not be available until well into 2017.
The framework already has been laid for effective action. What our public officials need to do is implement without delay the recommendations of the Maine Opiate Collaborative, released in May. Its full report can be read on the Maine Medical Association website at mainemed.com/advocacy/opioid-crisis.
I know from my involvement that good progress has been made on prescribing guidelines by the Bangor Area Controlled Substances Work Group and that development of the social detox program in Bangor is moving forward, but we must break down barriers to providing naloxone rescue kits, and we must waste no more time getting more prescribers qualified to prescribe buprenorphine to more people, including in primary care practices and residency programs.
The association will be advocating for the implementation of these recommendations during the first regular session of the 128th Legislature, and I encourage all Mainers to talk to their elected leaders about it now. There is no issue more deserving of the Legislature’s attention.
Dr. Charles F. Pattavina, M.D., is chief of emergency medicine at St. Joseph Hospital in Bangor.