AUGUSTA — Samuel Jonas said it is “nothing short of a miracle” that he was even able to stand before lawmakers Monday, urging them to make Maine among the first states to authorize “safe injection sites.”

Before entering drug recovery, Jonas overdosed twice on opioids and survived only because friends or loved ones quickly got him emergency help. But not all drug users are so fortunate, and Jonas was among the recovering addicts, medical professionals and social service providers who want Maine to allow individuals to use illegal drugs in safe, medically supervised “overdose prevention sites” to address the state’s ongoing opioid crisis.

“Drugs aren’t going anywhere in our lifetime,” Jonas said. “And with a place like this, maybe an active addict has a chance to go somewhere in theirs.”

Supervised injection or overdose prevention sites have been deployed in Canada, Europe and elsewhere around the world as part of the “harm reduction” strategy of drug treatment. Supporters say providing users with safe, clean and medically supervised spaces reduces drug overdose deaths and public health concerns linked to intravenous drug use and can often serve as an entry-point for treatment.

There are no such sites in the United States because federal law prohibits maintaining any places where illegal drugs are distributed or used. However, a growing number of cities and states are debating the issue at a time when heroin, fentanyl and prescription opioids are killing more than 40,000 Americans annually. Maine has averaged more than one overdose death per day in recent years, with no signs of a dramatic change for the better in that trend.

Portland Rep. Michael Sylvester, a Democrat, has proposed legislation that would direct the Maine Department of Health and Human Services to authorize two facilities where individuals could self-administer drugs they had previously obtained. The bill, L.D. 949, stipulates that facilities also must supply sterile needles, have the overdose antidote naloxone – also called Narcan – on hand and provide referrals to drug treatment or other health services.

Sylvester acknowledged the potential legal challenges, but said he believes Maine voters “have sent us up here to take risks when it’s appropriate.” Portland city officials also have discussed the issue of safe-injection sites in the past.

“It is well known …. that incarceration is not an effective path to treatment,” Sylvester told members of the Legislature’s Health and Human Services Committee. “The federal government is lagging behind us and what the people know. So the question is whether Maine can decide that saving lives is worth the risk of leading?”

Dr. Noah Nesin, chief medical officer of Penobscot Community Health Care in Bangor, said his facility provided drug treatment to nearly 600 people last year and expects to exceed 800 this year. They also make naloxone available to whoever wants it without a prescription, work in the local jail and this year will open a seven-days-a-week medication-assisted treatment program for low-income individuals.

“But people are still dying and no family has been spared impact from this crisis,” Nesin said. “We have more to do. We are compelled to do more, we are compelled to do everything we can to save the lives of people with opioid use disorder just as we would with any other disease that we treat.”

Safe-injection sites are under discussion in cities and states around the country.

In February, a state commission in Massachusetts recommended establishing at least one supervised injection site in the state. Lawmakers in New Jersey, Vermont, Delaware and other states also are debating bills to legalize safe injection sites even as some cities move aggressively to be the first to open a facility.

Federal officials, however, have taken a strong stance against such facilities.

On Feb. 6, the U.S. Department of Justice filed suit to stop a Philadelphia nonprofit, Safehouse, from opening the nation’s first legal, safe injection site. In a statement at the time, the U.S. Attorney for Pennsylvania’s eastern district, William McSwain, said “normalizing the use of deadly drugs like heroin and fentanyl and ignoring the law is not the answer to solving the opioid epidemic.”

While no one testified against Sylvester’s bill Monday, the Maine Department of Public Safety submitted a letter citing the longstanding federal opposition to such facilities. In the letter, Maine Drug Enforcement Agency Director Roy McKinney also pointed to the half-mile “tolerance zone” that would be created around the sites.

“Active drug use and drug-related crime adversely impact families, victims and the community,” McKinney wrote to committee members. “Drug use site programs convey an implicit acceptance and normalization of serious, harmful drug use and exacerbate an already alarming drug use problem. Their implementation sends a contradictory and harmful message to all citizens, especially our youth, about the sincerity and necessity of the government’s anti-drug policies and creates the appearance that the government endorses the illegal activity.”

In an statement, a spokeswoman for Gov. Janet Mills – a former state prosecutor and attorney general – called safe injection sites “potential life-saving option” but one that faces “significant legal hurdles.”

“Governor Mills will pursue every practical and legal avenue to address the opiate crisis, making treatment options available at every venue, including medication-assisted treatment and recovery coaches on call at every clinic, every law enforcement agency and every emergency room, and a true hub-and-spokes treatment model across the state,” spokeswoman Lindsay Crete said in a statement.

But bill supporters said Maine can no longer afford to wait for federal policy to catch up to the opiate crisis.

“How many lives do we have to lose before we muster the courage to be the first?” said Kenney Miller. “How many more Mainers have to lose their children, their parents, their loved ones before we are emboldened enough to consider this thoroughly studied, evidence-based strategy to prevent overdose deaths and facilitate recovery?”

The committee will hold a work session on L.D. 949 at a future date.

Kevin Miller can be contacted at 791-6312 or at:
kmiller@mainetoday.com
Twitter: KevinMillerPPH

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