With so much attention focused on COVID-19 and the disagreements over restrictions put in place to slow the spread of the illness, the distressing news that drug overdose deaths rose last year in Maine was easy to miss.
Last year, 380 Mainers died from drug overdoses, according to a new report the Maine attorney general’s office released Friday morning. That’s a 7 percent increase from 354 fatal overdoses in 2018. There were 417 drug overdose deaths in 2017, a record high.
The release of these new numbers is a stark reminder of the hard work that remains to be done to reduce the prevalence of substance use disorder and its worst outcome, overdose deaths.
That work, of course, is complicated by the coronavirus pandemic and the restrictions that have been in place since March to limit in-person contact. However, there are innovations — such as virtual support meetings and take-home doses of medications used to treat substance use disorder — that have extended treatment and support to those who may not have accessed it in the past.
“Way, way too many many people are dying of drug overdoses in Maine,” Gordon Smith, the state’s director of opioid response, told the Bangor Daily News. “That’s a reflection of how dangerous these drugs are, particularly fentanyl.”
Fentanyl, which is often mixed with illicit drugs such as heroin and cocaine to increase the euphoric effects, was involved in 259 overdose deaths last year, a 19 percent increase from 2018. Fentanyl is often mixed with other drugs without the user’s knowledge, making it more dangerous.
Although most fatal overdoses involved two or more drugs, there were startling increases in the number of deaths attributed to cocaine and to methamphetamine. Narcan, a drug used to revive those who have overdosed on opioids, does not work for cocaine and methamphetamine overdoses. Cocaine-related deaths rose by 22 percent and methamphetamine-related deaths rose by 81 percent from 2018 to 2019.
One positive in the new numbers from the attorney general’s office is that overdoses due to prescription opioids have decreased. This may be evidence that state efforts to restrict opioid prescriptions are working to decrease the availability and misuse of these drugs.
While the coronavirus pandemic has certainly complicated work to reduce substance use in Maine, there are reasons for hope, Smith says.
For one, the Mills administration is projecting a message of hope after eight years of a negative response to addiction from the previous administration, which increased stigma, he said. Former Gov. Paul LePage often framed addiction as a personal failing and stalled rules to make Narcan more widely available.
“The message now is that recovery is possible,” Smith said, adding that the state now has many tools — such as Narcan, needle exchanges and recovery homes and coaches — that can put Mainers on the path to recovery. Beyond the message, the expansion of Medicaid has made substance use treatment available to nearly 10,000 Mainers who weren’t covered before. Access to behavioral health services has also grown with Medicaid expansion.
It is important to know that, despite the pandemic, many services remain available to those seeking substance use disorder treatment. Methadone clinics, for example, remain open and a larger number of clients can receive take-home doses, which limits in-person contact and the need to make a daily trip to a clinic. Everyone who gets a take-home dose also received Narcan.
Hundreds of recovery coaches continue working across the state, reaching out via phone or video to connect with those working to recover from substance use disorder. Peer support groups, such as Alcoholics Anonymous and Narcotics Anonymous, continue to meet, often virtually. One benefit of virtual meetings is that they are happening around the world and country so people can join at whatever time is convenient for them. In addition, such meetings, along with telehealth consultations, can be more accessible to people who lack transportation or child care. Virtual events can also enhance anonymity.
After the pandemic abates, an assessment should be done to see what beneficial “emergency” steps — such as telehealth consultations and virtual meetings, along with increased access to methadone and needle exchanges — should remain in place.
We are under no illusions that substance abuse disorder, which is rooted in childhood trauma, abuse and poverty, will be quickly minimized. But, the continued focus on treatment and support for Mainers in recovery, even in the face of a pandemic and troubling new numbers, gives us hope.