Why do Mainers keep dying from preventable opioid poisoning? In 2015, we lost 272 Mainers to fatal drug poisoning. Fast forward to last year, when 418 Mainers died. This represents a nearly 54 percent increase over two years – at this rate, we might lose more than 640 Mainers next year. Our legislators have a duty to act.
Some fantastic bills have been passed by the Legislature this year, but now they sit, waiting to be funded. It’s one thing to talk the talk. But are our legislators walking the walk? It’s easy to toss around the words “opioid epidemic” and “recovery.” Politicians know that these words will get them votes. At a time like this, though, we need more than just words – we need action. Yes, heroin kills. Yes, fentanyl kills. But what else kills is a weak and incompetent system of care for individuals with substance use disorder. This weak system of care is the result of legislators’ and government’s inaction, and this inaction signifies that those people dying aren’t important enough to save.
The state of Maine historically has not funded recovery-oriented housing, although it would quickly and efficiently get people off the streets and into recovery. The Legislature has finally passed a bill to do so, L.D. 1682, but now it must be funded. Syringe-exchange programs – which are evidence-based and have been shown to reduce the transmission of HIV and hepatitis C and the incidence of skin and soft-tissue infections – are desperately needed in Maine, and L.D. 1707 would provide public funding for these, saving Mainers money in the long run. The “hub-and-spoke” treatment model for persons with substance use disorder – which integrates medication-assisted treatment with counseling, support and general health care services – has been introduced to Maine with L.D. 1430. This would bring Maine closer to providing treatment to all people, not just those who have money and those who live in a big city. These three bills and others are a great start, but now they must be funded.
Here is a useful way to think about “stigma” and its end result: discrimination. When we talk about someone who died in the 9/11 attacks, we don’t say that they “died because their building caught fire.” We say that they died because of terrorism, because of geopolitical and ideological forces outside their control. But we have been incorrectly led to believe that when someone experiences fatal drug poisoning from heroin or fentanyl, “the drugs killed them.” No, such an explanation is an injustice to that person’s life, and it fails to capture the complexity of their condition, their life experiences that led to that condition and the awful socioeconomic, cultural and legal realities that prevented their condition from being treated effectively.
Most of these deaths, it is apparent, are caused by being subjected to a lifetime of hyper-marginalization and structural discrimination. Substance use disorder is a treatable condition, but the system of care is devoid of evidence-based and cost-effective solutions of significant scale and accessibility. That is why people continue to die.
I’m not some policy analyst. I’m not some outside observer. I’m a person in recovery, and I work daily on the front lines in treatment, peer support and recovery. In addition to working full time on an interdisciplinary substance use disorder treatment team, I lead the Portland chapter of Young People in Recovery, I serve on the board of directors of the Health Equity Alliance, and I host 19 recovery groups a month in the Portland area. I am the founder of Journey House, which will soon be opening a third recovery house, the first of its kind in Androscoggin County.
I have seen up front how public health interventions can and do save lives. Harm reduction saves lives. Treatment saves lives. Recovery saves lives. Unless we fund all three, we will continue to see friends and family die. Call your legislator today and tell them to fund L.D. 1682, L.D. 1707, L.D. 1430 and all the other bills that will provide Mainers with an opportunity to recover.
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