U.S. Senate candidates from left, Lisa Savage, Max Linn, Maine House Speaker Sara Gideon, and Sen. Susan Collins moments before beginning their debate at the Holiday Inn By The Bay, Friday, Sept. 11, 2020 in Portland, Maine. Credit: Brianna Soukup / Portland Press Herald via AP

Maine has been among the states hit hardest by the opioid epidemic, ranking ninth among states in per-capita deaths in 2018. The problem has worsened during the coronavirus pandemic, with the state’s death rate increasing during the first half of 2020.

Policymakers at both the state and federal levels have proposed a range of solutions to address the opioid crisis, including improving access to short-term and long-term treatment options, providing funding to law enforcement to help with response and holding opioid manufacturers legally or financially responsible for the consequences of the epidemic.

The issue has also come up in Maine’s nationally targeted U.S. Senate race, in which Sen. Susan Collins, R-Maine, faces challenges from House Speaker Sara Gideon, a Democrat, and independents Lisa Savage and Max Linn. The four candidates have framed the epidemic in different terms when considering the public health and law enforcement responses, though they support some similar policies. Here is more on where they stand.

Susan Collins

Collins, who sits on the Senate committees addressing health and appropriations, has called for a “multipronged” approach to addressing the crisis, calling for resources to address prevention, treatment, and recovery.

The Maine Republican was a cosponsor on a bipartisan 2016 bill which was considered the first major piece of federal opioid legislation. The bill created grant programs for overdose training for first responders, awareness campaigns and other measures aiming to fight the epidemic.

Collins also sponsored two provisions that were passed as part of a bipartisan 2018 bill to address the epidemic, allocating funding for peer support networks and allowing hospice staff to dispose of unused opioid medications after a patient dies. Collins’ opponents have criticized her for opposing an amendment to that bill, sponsored by Sen. Bernie Sanders, I-Vermont, that would have imposed retroactive fines on some drug companies and executives. Collins said the amendment was too broad, and notes that several Democrats also opposed it.

More recently, the Maine Republican supported provisions passed as part of an appropriations bill last year with funding for drug treatment courts and prescription drug monitoring programs, as well as increased funding for law enforcement programs targeting heroin. She also co-sponsored legislation to require medical professionals who prescribe opioids to undergo training in addiction prevention.

Sara Gideon

Gideon has called for viewing the opioid crisis as a public health issue, rather than a criminal one. On the campaign trail, she frequently talks about a bill she sponsored in the state Legislature to expand access to naloxone, the opioid-overdose reversal medication, which passed after lawmakers overrode a veto from then-Gov. Paul LePage. She co-sponsored bipartisan legislation signed by LePage in 2016 that expanded addiction and treatment options and increased the number of agents with the state’s drug enforcement agency.

At the federal level, she has called for funding to expand access to affordable addiction treatment and for education and prevention efforts as well as public health research. She has also called for a public option to broadly expand access to health care.

The Democrat has also called for large pharmaceutical companies to be held “accountable” for their role in the epidemic. She supported legislation that passed last year to add licensing and registration fees for opioid distributors in Maine and use the money to fund treatment and recovery programs.

Lisa Savage

Savage, a former Green Party member, calls for the end of incarceration for possession and personal use of drugs, saying substance abuse is a public health problem, not a criminal one. She calls for on-demand health counseling and treatment to be available for any individual who needs it, and supports expanding health care coverage through Medicare for All.

She has also called for expanded access to opioid overdose reversal medications, such as naloxone, and increased use of needle exchanges and supervised consumption sites.

Savage has also been critical of pharmaceutical companies, saying they sometimes push drug use beyond what is medically necessary, and calls for executives to be held accountable for illegal advertising, marketing or distribution of opioids.

Max Linn

Linn’s approach to addressing the opioid crisis highlights the role of law enforcement, with the Bar Harbor businessman supporting increasing funding for border agencies while blaming China for the influx of fentanyl.

Linn said he supports decriminalizing the use of marijuana and using funds from legal sales of the drug to fund treatment for individuals seeking treatment for opioids and other drugs, but he does not support safe injection sites or “abundant” use of naloxone.