As physicians, we have seen firsthand the tragic consequences of drug abuse and addiction. We have witnessed the ever-increasing number of heroin and opiate overdoses, many fatal, both across the nation and in Maine, where an average of three overdoses a week occurs.
Some of our colleagues have lost children recently to heroin overdose, and it is abundantly clear that heroin and opiate overdose in Maine is a public health nightmare.
While Maine has experienced a high rate of accidental overdose in the past decade, recently the rate has gone up even more, as a more potent form of heroin has become increasingly prevalent. The situation is not remarkably different across the rest of northern New England.
Fortunately, there is an available antidote to opiate and heroin overdoses.
Narcan can be administered through the nose to an individual who is experiencing an overdose, immediately blocking the toxic effect of heroin and other opiates. The patient can wake up, be safely treated and survive. Such a patient will then frequently get into treatment and become a productive member of society.
Significantly, Narcan (the brand name for the drug naloxone) has no potential for abuse and is safe and effective. The medication is so safe that the Food and Drug Administration is actively considering making it available over the counter.
L.D. 1686, “An Act to Address Preventable Deaths from Drug Overdose,” pending before the 126th Legislature, would make Narcan kits more available in Maine and has the potential to save hundreds of lives.
In Quincy, Mass., opiate-related overdose deaths declined by 66 percent in the first 18 months after the distribution of Narcan kits, which include doses of the antidote along with the atomizers used to administer it. In fact, since October 2010, Quincy police officers have administered the drug 221 times and reversed 211 overdoses – a remarkable statistic.
Since 2007, the Massachusetts Department of Public Health has provided overdose training and nasal naloxone to more than 15,000 individuals, yielding more than 1,500 successful overdose rescues. The outgoing national drug czar, Gil Kerlikowske, has recommended that Narcan be more widely available throughout the nation.
Opponents of L.D. 1686, including Gov. LePage, have argued that heroin and opiate abuse will increase because of the perception that the drug is safe and the risk of an overdose is decreased.
But actual experience does not support this allegation. Rather, the states that have expanded the availability of Narcan have not seen an increase in heroin use.
Furthermore, they have seen a marked decrease in death rates. Eighteen states and the District of Columbia have developed overdose prevention programs featuring naloxone, and more than 10,000 lives have been saved as a result. Urban areas have seen a 50 percent reduction in deaths, and rural areas have seen a 25 percent reduction.
The drug abuse epidemic is a public health hazard, so public health approaches should be applied to it. Seatbelt and airbag availability has lowered automotive fatalities – it hasn’t fueled higher accident rates.
The widespread availability of defibrillators used to treat potentially fatal heart rhythms in malls, airports and other public places has similarly saved lives. Bee-sting kits also save lives without encouraging risky behavior around bees. We expect that increasing the availability of Narcan will have a similar positive impact.
Evidence-based best practices need to be applied to heroin overdose deaths, and Narcan is the single most effective and lifesaving treatment that is available. Failure to expand its availability will directly contribute to the increasing number of deaths from opioids in Maine – clearly an unacceptable outcome.
Narcan kits are not expensive (about $25), and any money invested to buy such kits will be repaid many times over through the productive lives saved.
Addiction to drugs is a chronic disease. While it may be easier to look the other way rather than confront the harsh realities, there are effective treatments. Many families in Maine have been affected and suffered as a result.
On behalf of the physician members of the Maine Medical Association and the Maine Association of Psychiatric Physicians, we wholeheartedly endorse L.D. 1686 and urge our legislators to give this proposal the consideration it so richly deserves.