Addiction is not a homelessness issue. It is a disease that can happen to anyone. But being homeless makes it nearly impossible to break free from addiction: No one is going to get well without housing. We need to ensure there is an unobstructed path to recovery that includes housing for people who are homeless and suffering from addiction. Otherwise, people are living a death sentence.

The opioid epidemic is not caused by homelessness, but it has added to homelessness. Yet there is no way that the groups that are working to end homelessness will solve the opioid epidemic. We simply lack the resources, and it is far too big a problem. We will need everyone working together to solve this.

According to the federal Substance Abuse and Mental Health Services Administration, 75 percent of people who are battling heroin addiction arrived at that drug by using oxycodone and other opioid medications. Portland’s Milestone Foundation suggests that figure is 80 percent.

Until recently, the medical community was judged based on how well each patient felt their pain was being controlled. It is no surprise that giving people opioids controlled their pain – at least initially. And doctors did just that. But for many people, that opioid prescription became a necessity just to feel normal, and not feel deathly sick. And then it ran out.

Heroin is virtually identical to OxyContin, less expensive and easily accessible in every Maine community. Once a person’s physiology is dependent on opioids, using them becomes the person’s only priority. It is a disease that is powerful, and a disease that is deadly.

Overdoses are about someone trapped in a cycle of doing exactly what they have learned they need to do to feel normal, with nearly instantaneous and lethal results – someone, for example, taking the exact dosage of something that looked like heroin but was Fentanyl, a synthetic opioid analgesic 50 to 100 times more potent.

In Maine, 376 people died from overdoses in 2016. The year before, 272 people died. That’s 648 people gone in the past two years alone. That is 648 families suffering a devastating blow, 648 communities losing one of their own.

For people under age 45, opioids have replaced alcohol as the primary substance of addiction in both of Maine’s emergency shelters for people using substances. Alcohol is the prevalent substance for people over age 45.

A lack of MaineCare (Medicaid) health care coverage exacerbates the problem: Maine has cut access to MaineCare for single adults in the last six years. A recent analysis by the Region III Homeless Council determined that 60.5 percent of people addicted to substances and homeless in Penobscot County had no insurance.

So instead of having access to treatment and finding a road to recovery, people are becoming stuck in addiction with no way out. An untreated cycle of addiction and homelessness is a very complex problem that affects every single one of our most expensive emergency systems in Maine. Leaving this unsolved is costly.

An unobstructed path to recovery does not currently exist in Maine. We need to have creative treatment and housing options for people to get well and remain well. This begins with having opioid detoxification facilities available: Maine currently has just one, with only 16 beds.

With opioids, the system needs a quick and open door to detox, with another door immediately opening to stable housing to build on that early, fragile recovery. For people with insurance, this looks like a treatment facility. For people without insurance, particularly if they’re homeless, this looks like a pathway to death.

We can correct this. We know how to build an adequate system of care, from detox to stability in housing. When we do, we will see people productively working and participating in our society. When we don’t, we see an expensive death spiral.

We have a long way to go to have enough detox facilities, sufficient access to treatment, insurance and funding for housing and recovery. Let’s put our resources into action to efficiently solve the problem – by creating a pathway to recovery for everyone who needs it. All of us will benefit from doing that.


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