November 18, 2018
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How a new cabinet agency could help curb Maine’s opioid epidemic

Hampden Police Department | BDN
Hampden Police Department | BDN
The LePage administration has delayed two sets of rules to increase the availability of naloxone, an overdose reversing medication.

It seems counterintuitive to suggest that Maine needs another government entity to focus on the state’s substance abuse crisis. So far, the state’s government, as a whole, has done a poor job of addressing the rising toll — both human and financial — of the epidemic. Instead of helping people, the LePage administration has erected barriers and insulted overdose victims.

But this inaction and even steps backward are good reasons for a new, coordinated cabinet-level focus on substance-use disorder.

That’s the thinking of Rep. Patricia Hymanson, D-York, who has proposed the creation of the Substance Abuse Disorders Cabinet. Modeled after the Children’s Cabinet created by Gov. Angus King, the group would consist of the department heads of all the state agencies that work with Mainers with substance-use disorders. Their task would be to ensure that the state is wisely using its resources and coordinating with other entities to help reduce the number of Mainers with the disorder. Several state opioid task forces have recommended such a centralized, permanent state authority.

It is a broad charge, but current events show that without a coordinated focus on the problem — and a commitment to solve it — it only gets worse. Hymanson’s bill targets the focus and coordination problem.

Lawmakers, for example, passed a law two years ago to allow the distribution of the anti-overdose drug naloxone without a prescription. Pharmacists said the new law was confusing, so lawmakers revised it. It was then up to the Board of Pharmacy to write rules to turn the law into prescribing standards. The board finished its work and unanimously approved rules in August and sent them to the governor’s office. Gov. Paul LePage ignored the rules for more than five months and then demanded last week that they be changed to raise the minimum age to acquire naloxone to 21. The board caved to the governor’s demand, and he signed the rules last week.

The administration has also delayed — for more than two years — rules needed to allow community groups to dispense naloxone, which is also known by the brand name Narcan. The Legislature passed a bill in June 2015, which became law without LePage’s signature, that authorized organizations that work with “populations at high risk for a drug overdose” to establish overdose prevention programs through which they train drug users and others in administering naloxone and distribute it to them at no cost. The Department of Health and Human Services has yet to submit draft rules to implement the law.

The LePage administration has also cut reimbursement rates for and put time limits on medication-assisted treatment, both counterproductive to reversing Maine’s rising overdose death rates.

Meanwhile, 376 Mainers died of drug overdoses in 2016. The trend of an average of one overdose death a day continued last year.

Maine had one of the largest increases in drug overdose deaths between 2015 and 2016, according to the U.S. Centers for Disease Control and Prevention. One reason is that Maine is among the handful of states that do not allow the distribution of naloxone without a prescription.

A new cabinet group won’t change attitudes in the current administration. But it could ensure more transparency and accountability, while laying the groundwork for a more effective approach from the next administration.

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