Adam Perkins has spent the past four-plus months trying to reach people in the Bangor area who have just survived a drug overdose or are at risk of overdosing.
He might talk to them about pursuing treatment if they’re ready for it or connecting them with a community of people in recovery. He might offer overdose-reversing naloxone and test strips so they can see if there’s potent fentanyl in the drugs they’re buying. He might direct them to a certified needle exchange where drug users can find clean syringes. He might refer them to other services they might need.
Since May, he estimates he’s connected with about 150 people — including people who have survived overdoses along with people who are close to them, such as family members. Perkins also estimates he’s distributed about 200 boxes of naloxone, which contain two doses each. At least 20 overdoses have been reversed as a result of that effort, he said.
“It’s absolutely saving lives,” Perkins said.
Perkins is the Penobscot County liaison for a statewide initiative that aims to reach people who have survived overdoses or are at risk of overdosing. The initiative, called OPTIONS (Overdose Prevention Through Intensive Outreach Naloxone and Safety), has assigned liaisons to all but one Maine county to put people on the ground so they can reach out directly to people struggling with addiction. It’s also funded an overdose response team that specifically aims to connect with people within 72 hours after they’ve overdosed.
The $2.5 million initiative, which Gov. Janet Mills announced last fall, is paid for mostly with federal funds. Every county but Knox County now has an OPTIONS liaison.
The initiative is getting underway as 2021 shapes up to be the deadliest year yet in Maine’s opioid epidemic, following a 2020 that saw overdose deaths rise. Maine has averaged about 50 overdose deaths in the first eight months of this year, up from an average of 42 last year and 32 in 2019. Penobscot County has seen a disproportionate share of those deaths — 64 so far this year. Cumberland County has almost twice the population of Penobscot, but saw only four more overdose deaths through the end of August, according to monthly reports published by the attorney general’s office.
The OPTIONS initiative started operating in Penobscot County in May, and Perkins, an employee of Community Health and Counseling Services, has been working on community outreach and building relationships ever since. He meets with Bangor police weekly, for example, as police are the source of about half of Perkins’ referrals.
He’s also part of the Penobscot County Overdose Response Team, which is run out of Bangor’s public health department and involves a number of community groups focused on addiction recovery as they work to connect people with help at a time when they might be more likely to seek it — shortly after they’ve overdosed. The team also includes the Piscataquis County OPTIONS liaison, Ashley Robertson.
Gordon Smith, Maine’s director of opioid response, said the liaison program was the state’s most important strategy for addressing overdoses, “because that’s something that happens on the ground in the community.”
Liaisons are showing people “a clear pathway to treatment,” he said. Giving drug users naloxone keeps them alive “so that the promise of recovery and treatment really becomes available to them.”
Data about the OPTIONS program’s effectiveness are not yet available, but the state’s overdose review panel will convene in the next 30 days to discuss early results, Smith said.
It’s hard to quantify the success of outreach efforts like the OPTIONS program because it’s “such relational work,” said Whitney Parrish, the director of policy and advocacy for the Health Equity Alliance, which provides Narcan and operates a syringe program in Bangor.
While she’s “cautiously optimistic” about the program’s future, “for as much as the state has invested into the program, I was hopeful that there will be more of an impact by now,” Parrish said.
One thing the overdose response team has focused on is building up a stable of peer recovery coaches, people who have been through addiction recovery themselves and work with those going through the same experience, said team coordinator Sara Yasner, who works closely with Perkins.
Having that stable of coaches has helped the team reach people in Penobscot County beyond service hubs like Bangor, Yasner said.
“It’s helped spread this resource out a little bit more,” Yasner said. “We’re hopeful that it will kind of fit that niche of how we connect with someone who overdosed, or is at risk of overdosing when they’re not really connected to any other program or support.”