A cloud of death and loss hung over Gov. Janet Mills’ fourth annual opioid response summit, held last week in Bangor.

The meeting came as Maine suffers yet another year of record fatal overdoses, as does the country as a whole.

People are dying because there is far too little treatment available for drug addiction, and because the stigma surrounding drug use keeps them from seeking help. They’re dying because our communities are underfunded, addiction is criminalized, and mental health ignored.

But they’re dying mostly because the supply of illicit drugs has become remarkably dangerous.

It was only two decades ago that fewer than 20,000 Americans a year died from overdoses. Then there came the flood of new opioid medications marketed to doctors as relief for every-day pain.

These medications were no different chemically than the heroin that could be bought on the black market. But unlike heroin, pain medications such as Oxycontin were legitimized by doctors and pharmaceutical companies, and soon millions upon millions of doses were being pumped into our communities.

Soon after, deaths by overdose began to rise. The sheer amount of opioid pain medication available made sure of it.

But the deaths didn’t really begin to take off until later, when governments began cracking down on the overprescription of opioid medications. People who were using the medications regularly, whether recreationally or to treat chronic pain, needed a replacement. The heroin they found was not as safe as medications made in a lab.

Then came fentanyl, and other synthetic opioids. Far more powerful than heroin or prescription meds, synthetic opioids are sold illicitly on their own, mixed with various fillers. Often, they are used to give heroin or cocaine a bigger kick, or pressed into pills and passed off as diverted prescription medication – people never know what they are getting.

Synthetic opioids have driven deaths by overdose to new heights, more than five times what the U.S. experienced in the early 2000s. Experts say the overdose epidemic will not let up, and could kill more than 1 million Americans this decade.

Far more than ever before, the illicit drugs circulating in our communities are poison. If that fact is not addressed, people will continue to die at this unforgivable pace.

That’s not all that should be done. There is a shortfall of treatment options everywhere, particularly in rural areas, which pushes those who would otherwise seek help back toward the black market. (Gov. Mills at her summit announced $4.5 million going to community providers for residential treatment.)

More Narcan will help, too, as will needle exchanges, fentanyl test strips, and other strategies that reduce the harm of illicit drug use. Possession of small amounts of drugs should be decriminalized.

But any progress will be limited as long as the drug supply remains so deadly.

Fentanyl is produced in China and Mexico and smuggled over the border, where only a small percentage of trucks are ever checked for contraband. Border officials hope to one day check all trucks.

But the U.S. has never been successful in stemming the flow of illegal drugs. There is just too much money in it. Smugglers have always found another way, and likely will again given the profit available from American customers.

We may not be able to get rid of fentanyl, but we can replace it with a safer, regulated supply. It may sound radical, but that’s only because it goes against years of wrong-headed rhetoric on addiction.

As the deaths mount with no relief in sight, we can’t reject ideas that could save lives.

We simply can’t sit back and accept the loss of so many Americans.

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