AUGUSTA — Brianna Nielsen doesn’t regret calling for help when a fellow drug user overdosed in front of her last year, knowing now that her quick action saved his life.
But the decision also landed her in jail and further complicated an already difficult climb back to sobriety and regaining custody of her young son.
“I know that I did the right thing by calling 9-1-1, saving my neighbor’s life. I worry, though,” Nielsen, a Portland resident clean for a little more than a year, told lawmakers on Friday in support of offering “medical amnesty” to people who report drug overdoses. “Because of the consequences that can happen to the person calling 9-1-1, they’re scared. And I fear there a lot of people not calling 9-1-1 when someone has overdosed in front of them.”
Nielsen was among dozens of people who testified Friday on a slew of bills aimed at addressing an opioid crisis that shows few signs of abating after killing about one Mainer a day last year. Many of the proposals sought to expand opioid treatment across Maine, whether by providing an additional $6.7 million a year for comprehensive medication-assisted treatment, or by increasing the MaineCare reimbursement rates paid to methadone clinics.
Other proposals, however, were a direct response to perceived foot-dragging at Maine’s Department of Health and Human Services and the Board of Pharmacy in crafting rules aimed at expanding access to the lifesaving drugs that reverse overdoses.
“We would like to do our part and are frustrated that we are not able to do so,” said Douglas Carr, a lobbyist for Rite-Aid, said of the delays in rules allowing pharmacies to make naloxone or Narcan available without a prescription.
A record 376 people died of drug overdoses in Maine last year, the vast majority of them from heroin or prescription opioids. While opioid addiction is a problem across the U.S., Maine recorded the nation’s third-highest increase in overdose deaths – a surge of 27 percent – between 2013 and 2014 and the fourth-highest increase in 2015. Overwhelmed treatment and social services providers now routinely use the word “epidemic” to describe opioid problem in Maine, the challenges of treating the disease and the resulting calamity of addiction.
“We are already in the midst of a second epidemic – a second epidemic of Hepatitis C,” said Kenney Miller, executive director of the Health Equity Alliance, which administers four of the state’s six needle-exchange programs.
Policymakers in Maine have been debating how to best respond to the heroin crisis for years and have directed additional money toward treatment and law enforcement. But the state also has been accused of being slow to respond.
One of the more sweeping bills considered Friday by the Legislature’s Health and Human Services Committee – L.D. 1326 sponsored by Republican Rep. Karen Vachon of Scarborough – would provide $75,000 in state funds for needle-exchange programs. It also would eliminate the criminal penalties for possessing a hypodermic needle for drug use. Needle-exchange programs have been proven to reduce the transmission of infectious disease and often are used as a way to connect drug users with treatment programs.
DHHS said the department partners with needle-exchange programs, but that the prevention programs do not allow direct funding of syringe exchange programs. The department opposed the proposal to decriminalize needle possession.
“While we understand the rationale, we do not believe that decriminalizing drug paraphernalia in the midst of an addiction epidemic is the right direction and that it sends a message of passive consent for dangerous and destructive activities,” Sheldon Wheeler, director of the DHHS Office of Substance Abuse and Mental Health Services, said in testimony to the committee.
The bill sponsored by Vachon also aims to make naloxone or Narcan more accessible by allowing overdose prevention programs to disperse it and providing $50,000 in state funds. That was the goal of a bill that passed the Legislature two years ago, however it was never funded and DHHS has yet to complete the rulemaking part of the initiative. Vachon’s bill would essentially sidestep the rulemaking.
Ross Hicks, harm reduction coordinator at the Health Equity Alliance, said his organization has been forced to operate in a legal gray area when distributing overdose prevention kits because DHHS “continues to sit on its hands” rather than craft the rules. His organization recorded 60 overdose reversals from kits distributed during the six-month period in which it was fully funded.
“Each time I handed a kit out, I am potentially breaking the law,” Hicks said. “As much as I enjoy the Robin Hood-esque idea of me breaking the law to do good, I wouldn’t have to if DHHS produced the rules required by law.”
Vachon’s bill also would create an “exemption from criminal liability” for anyone who overdoses on an illegal drug or who may have been using drugs themselves when they called for help for an overdose victim.
Nielsen, the recovering addict arrested by Westbrook police after calling 9-1-1 for her neighbor, said she would still make that call today. But she said the looming charges affected her ability to get a job and have complicated her efforts to get her life back on track.
Others told similar stories.
Shaun Le, a Portland resident who is in recovery, said his friend was declared brain dead because he was deprived of oxygen for seven minutes between the 9-1-1 call and the paramedics’ arrival. Another drug user fled the scene after making the 9-1-1 call..
“I believe that in that situation if the bill went through and these things were in place, that person would have stayed with him,” Le said. “They would have given him CPR and, if that oxygen had been given to him, he’d still be here today.”
A DHHS representative said the exemption could help increase the number of lives saved from overdoses. But the Maine State Police and Department of Public Safety opposed the creation of a “blanket exemption from arrest or prosecution.”
“We are concerned that this could have unintended consequences resulting in taking away a tool for law enforcement and prosecutors in our fight against illegal drugs,” said Major Brian Scott with the state police. “To insulate a person from being held accountable for their criminal wrongdoing may serve to exacerbate the drug problem we are facing. It would also likely be a considerable hindrance or make it impossible in obtaining search warrants in a case where a person dies as a result of that overdose.”
The various proposals heard Friday to increase funding for treatment likely will face tough scrutiny from lawmakers as they craft a two-year budget. Earlier this year, the Legislature approved a plan to funnel $4.8 million in state and federal money toward comprehensive, medication-assisted treatment for opioid addiction, providing services to an estimated 400 additional people. Testifying against Vachon’s proposal for an additional $6.7 million per year, a DHHS representative said the Legislature should “give this model a chance” before allocating additional money to the program.
Kevin Miller can be contacted at 791-6312 or at:
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