Gov. Paul LePage hit many familiar notes during his State of the State speech Tuesday, but he surprised some listeners by devoting a significant portion of it to Maine’s growing heroin problem and calling for an escalation of the state’s “war on drugs.”
The governor’s emphasis on arresting and prosecuting drug offenders sets him apart from mainstream trends in public policy, which have begun to tilt toward addiction intervention and treatment as a more effective response.
LePage framed his call for a more aggressive war on drugs with statistics, noting that heroin overdoses in Maine quadrupled from 2011 to 2012, and that 927 drug-addicted babies were born in Maine last year at an average extra cost of $53,000 per birth – paid for largely by publicly funded programs.
During his three years as governor, LePage has proposed or made significant cuts in the funding that supports drug intervention and treatment programs, especially for opiate addiction treatment under MaineCare, the state’s Medicaid program.
In the budget that he submitted to the Legislature in 2011, LePage sought to cut $4.4 million from the program that funds substance abuse treatment. In subsequent negotiations, he offered to cut the reduction in half, but the Legislature finally refused to eliminate any of the funding.
Last month, the state imposed a two-year limit on MaineCare payments to people who are being treated for opiate addiction with suboxone and methadone, with certain exceptions. About 12,000 Mainers had suboxone prescriptions in 2010, according to the state Department of Health and Human Services, and many of them were MaineCare recipients.
Earlier this year, 19,000 Medicaid recipients classified as “childless adults” were removed from the program, including hundreds of beneficiaries who used the health care for methadone to treat heroin addiction. The cut was proposed by LePage, who has often said that able-bodied adults should go without state assistance.
The DHHS estimated that the state would save $22 million by cutting the coverage, but the estimate has been disputed by drug treatment and poverty advocates.
LePage said he wants to fully fund the Maine Drug Enforcement Agency, adding 14 positions. Based on the most recent salary data for the agency, hiring another 14 agents would cost about $1 million. That’s in addition to LePage’s plan to provide an additional $700,000 in funding for the agency, and to hire four new prosecutors and four new judges for enhanced drug courts.
All told, the governor’s plan could cost close to $3 million, according to estimates provided by the staff for House Speaker Mark Eves, D-North Berwick.
Democrats were glad that the governor raised the issue in his State of the State address, but several were concerned that he was pushing an enforcement-specific approach.
Sen. Anne Haskell, D-Portland, who served on the Legislature’s Criminal Justice and Public Safety Committee and is now the assistant Senate majority leader, quickly noted that she didn’t hear a lot about treatment and prevention in LePage’s speech.
“We can’t arrest our way out of Maine’s drug problem,” she said. “Law enforcement cannot do this alone; we need to address addiction by treating it as the disease it is or Maine will continue to lose.”
LePage’s approach contrasts with that of Vermont’s Democratic Gov. Peter Shumlin. Shumlin – who also is chairman of the Democratic Governors Association, which has criticized LePage regularly – used his entire State of the State Message to address that state’s heroin epidemic.
During his 34-minute speech, Shumlin urged lawmakers to devote more money to treatment and programs. According to a copy of his speech, Shumlin said it costs Vermont more than $1,100 a week to imprison drug offenders, while weekly treatment costs $123.
“The time has come for us to stop quietly averting our eyes from the growing heroin addiction in our front yards, while we fear and fight treatment facilities in our backyards,” Shumlin said.
A 2010 report by the Maine Office of Substance Abuse, released in April 2013, estimated that the total cost of substance abuse in Maine was $1.4 billion. That represented a 56 percent increase from 2005.
Of that 2010 total, only $47 million, 3.4 percent, was spent on substance abuse treatment. About 80 percent of the funds spent on treatment were public, mostly from MaineCare.
In 2010, 14,996 people were admitted for some type of drug treatment. The average cost to treat each patient was $3,134, the report said.
Last year, LePage vetoed a bill to expand the use of Narcan, a drug that is administered when someone is in the often-fatal respiratory distress that happens during an overdose. Rep. Sara Gideon, D-Freeport, has submitted a similar bill this year.
Democratic U.S. Rep. Mike Michaud, who is challenging LePage in this year’s election, noted in a prepared statement Wednesday that the governor vetoed the Narcan bill last year while cutting Medicaid enrollment.
“Maine has a significant problem with drug addiction,” Michaud said. “We see the consequences in every community in our state. But if we want to improve lives, we have to take a balanced approach that pairs tough anti-drug laws with treatment, mental health care, job training and other support services. In this regard, the governor falls far short.”
Eliot Cutler, an independent who also hopes to unseat LePage, said the governor was right to raise the issue of drug abuse but he worried that LePage’s approach was too heavy on enforcement.
Staff Writer Eric Russell contributed to this report.
Steve Mistler can be contacted at 791-6345 or at:firstname.lastname@example.orgTwitter: @stevemistler