The most recent state data on drug overdose deaths show Penobscot County has retained its position as a Maine county with one of the highest rates of people dying from drug overdoses.
Fifty-two people statewide died from either confirmed or suspected drug overdoses in July and a quarter of those deaths were in Penobscot County, the single largest percentage for any county, according to the state’s latest monthly overdose report.
So far this year, Penobscot County has seen an average of 8.6 overdose deaths a month, up from 7.8 on average per month last year. That puts 2021 on track to be more deadly in Penobscot County and the rest of Maine than 2020, which was the deadliest year yet in the opioid epidemic.
This isn’t new for Penobscot County, and the problem has been exacerbated recently as increasingly potent fentanyl is cut into a greater variety of illegal drugs. In addition, the COVID-19 pandemic has complicated the workings of recovery programs that rely on in-person meetings and accountability measures such as medication counts and urine testing.
Penobscot County has seen a disproportionate share of Maine’s overdose deaths for years, but the more recent numbers are cause for concern, said Dr. Noah Nesin, chief medical officer for Penobscot Community Health Care in Bangor.
“These overdose rates are very concerning, even though there’s a lot of treatment available relative to a lot of the rest of the state,” he said.
Fentanyl — the most frequent substance to blame in overdose deaths — is commonly found mixed into batches of heroin. But increasingly, it’s also been found mixed in with other drugs, such as cocaine and methamphetamine, and drug users are unaware, Nesin said,
Drug treatment programs have discovered that recently in drug tests for clients they’re treating for cocaine and methamphetamine addiction, he said.
They deny having used fentanyl, he said. However, “they test positive for fentanyl because it’s in the cocaine or methamphetamine they’re using.”
In July alone, four people statewide died from a mixture of fentanyl with cocaine or methamphetamine, while two died from a mixture of fentanyl and heroin, according to the monthly overdose report.
It’s not that the combinations of fentanyl with cocaine and methamphetamine have become more common than fentanyl-heroin combinations, Nesin said. But there’s a lack of good treatment options for people with stimulant — as opposed to opioid — use disorder, he said, potentially contributing to more overdose deaths.
With recovery programs, the COVID-19 pandemic has interfered with all aspects of their programming.
“A lot of early recovery is about developing accountability, and we think that one of the most impactful ways of addressing accountability is from peers in a group setting,” Nesin said.
The pandemic has complicated recovery programs’ ability to conduct random medication counts and urine tests, he said.
To help, the state has rolled out a program that alerts health care providers when there’s been an increase in overdoses in a given community. That then allows providers to alert their patients or other folks suffering from substance use disorder, Nesin said.
The state’s new OPTIONS initiative has funded an overdose response team in Penobscot County that aims to connect people with addiction help within 72 hours after they survive an overdose.
In addition, there are efforts in place to continue distributing the overdose antidote naloxone, and to provide more testing strips so drug users can test their drugs to see if they have the especially potent fentanyl.