Everywhere we turn, there is talk of the opioid epidemic that is killing hundreds of Mainers and tens of thousands of Americans each year. We want to propose an idea that might seem wild to some: Drugs are not what’s killing our people – the real killer is stigma.
Stigma pushes people to use in secrecy and alone, where they are more likely to die from an overdose. Stigma infiltrates our medical system, legislative bodies and even some recovery institutions, creating barriers where there should be avenues for support, increased safety and empowerment. This stigma is rooted in classism, rigid investment in a “bootstraps” notion of self-reliance, confusion and judgment about mental illness and racist notions of whose drug use constitutes a so-called “problem” that requires punitive measures.
If we want to stop drug-related deaths and despair, we must banish stigma and embrace harm-reduction practices. We must fully honor the dignity of every person who uses drugs, and provide the information, tools and supports for people to be as safe as they can be. Right now, the Maine Legislature has an opportunity to lead the nation in harm-reduction practice by passing L.D. 949, An Act to Prevent Overdose Deaths, sponsored by Rep. Mike Sylvester of Portland.
This bill would establish two overdose-prevention sites. These are clean, supervised facilities where someone can safely inject drugs they have acquired elsewhere, with access to clean syringes, fentanyl testing strips and people trained to administer naloxone and perform CPR in the event of an overdose. Overdose-prevention sites are one of many evidence-based public health interventions that keep people who use drugs alive and offer pathways to recovery if and when someone is ready.
Unfortunately, some legislators, including Patty Hymanson, House chair of the Legislature’s Health and Human Services Committee, continue to approach overdose-prevention sites with skepticism, and may vote against L.D. 949 for the second year in a row.
An “ought not to pass” vote would follow a public hearing where dozens of Mainers – many of whom with lived experience of drug use and overdose – spoke vulnerably about what an overdose-prevention site might have meant for themselves and the many loved ones they’ve lost. While Hymanson repeatedly asked whether those who testified had ever been in an overdose-prevention site, multiple people testified to being found, or finding their loved ones, unconscious in parked cars and gas station bathrooms, near death or dead. We have seen and felt that sort of despair, which is why we are calling on legislators to end this indignity.
Still, lawmakers ask: How do we know overdose-prevention sites will work? To which we respond: We are willing to try anything to save our communities. Because we believe in everyone’s value, because we are heartbroken and rageful at the indifference and political timidity of those with something left to lose.
When it comes to safe injection, up seems to be down, right becomes wrong, stigma is science and what is humane is illegal. The only explanation is that the stigma is so deeply embedded it can eclipse even the foremost principle of a provider’s code of ethics: Do no harm. If Rep. Hymanson – a physician – and fellow members of the Health and Human Services Committee vote “nay,” not only will the bill die, but so will several dozen or hundred Mainers who could have accessed overdose-prevention site services.
Refusing to do everything in our power to end the suffering of people who use drugs is doing active harm to our entire state. Decades from now – much like inaction around the AIDS crisis – it will be noted with whom decision-makers cast their lot. We hope Rep. Hymanson and her colleagues cast their lot with the several hundred Mainers we lost last year to this epidemic, the thousands of loved ones who mourn them, and the living Mainer right now injecting in a dirty gas station bathroom who deserves so much more.
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