Need further proof that Gov. Paul LePage has no empathy for Maine people struggling with substance abuse disorder? He wants to force towns and emergency personnel to collect money from anyone who needs a lifesaving dose of an anti-overdose medication more than once.
Under a ridiculous bill introduced on the governor’s behalf, if a town or county employee or agent administers naloxone hydrochloride, sold under the brand name Narcan, to someone who has overdosed on an opiate, the town or county must determine if the person has overdosed before. If they have, the town or county must collect a payment to cover the cost of the drug, which reverses the effects of an overdose. If towns and counties fail to do this, they can be fined $1,000 per incident.
First, this bill is simply cruel. Punishing those struggling with substance use disorder because they need life-saving treatment is counterproductive. Dr. Noah Nesin, vice president of clinical affairs at Penobscot Community Health Care, perfectly summed up this double-standard. He wondered whether the state would make “the same requirement of people with other chronic diseases.”
“If the answer is no, then the bill is simply an attempt to codify our society’s bias about addiction into law,” he said in an interview with the BDN.
“If a person suffers more than one cardiac arrest will they have to pay for the second use of a defibrillator?”
Or, closer to home for the governor, if a person has failed to lose weight after trying several different methods, should taxpayers pay for his stomach-reduction surgery?
Second, this legislation would create bureaucratic nightmares. How would towns and counties find out who has previously received naloxone? No such list currently exists. Would the state maintain a registry? Who would collect the information? How much would this cost? Of course, money that goes to record keeping is money that could be directed to addiction treatment.
LePage also betrays a fundamental misunderstanding of addiction. Last year, he had to apologize for repeatedly erroneously insisting that a student at Deering High School had overdosed and been revived with naloxone three times in one week and after one incident had simply returned to class.
In his a veto letter last year, LePage said naloxone does not prevent deaths; it just delays them because people with addictions will overdose again. “Creating a situation where a heroin addict has a needle in one hand and a shot of naloxone in the other produces a sense of normalcy and security around heroin use that serves only to perpetuate the cycle of addiction,” the governor wrote. Someone who is in the midst of an overdose cannot administer naloxone to themselves, so this make-believe anecdote can’t even happen.
Researchers affiliated with The Miriam Hospital at Brown University addressed this thinking in a 2010 study, which cited a growing body of research that found that drug use did not increase with naloxone availability.
“It is unethical to allow a narrow focus on the harms of drug use to overshadow an opportunity to save human lives,” they wrote. At worst, opposition to expanded use of naloxone “represents a denial of drug users’ basic human dignity by devaluing their lives.”
Naloxone does save lives. If someone has overdosed on heroin or prescription opioid medication and is quickly given naloxone, he or she can be revived. This gives someone a second — and, yes, sometimes, a third or fourth — chance. Some will use that chance to end their drug use.
Administering naloxone, of course, shouldn’t happen in isolation. Treatment, preferably medication-assisted treatment with comprehensive counseling, is needed next. But in Maine, as in many other states, access to treatment is hampered by a lack of funding and by residents’ lack of health insurance.
A bill to further punish people with substance abuse disorder will do nothing to stop Maine’s deadly opioid epidemic and should be rejected by lawmakers.