Prescription Narcan? Maine bill would make it available to drug addicts
Naloxone is effective at reviving heroine overdose victims, but widespread distribution could make it easier for users to push themselves to the edge
Portland Press Herald
AUGUSTA, Maine — Is a life worth $22?
Henry "Skip" Gates thinks it is.
He said he would give anything to go back to that morning in 2009 when his son died of a heroin overdose at the age of 21.
He would love to have been able to give his son a dose of naloxone, which could have stopped the overdose and saved his life.
Gates told lawmakers Wednesday that the state should make the drug -- which costs an average of $22 a dose -- more widely available because he doesn't want anyone else to suffer "the unthinkable."
Gates, who lives in Skowhegan, was among more than a dozen people who testified before the Legislature's Health and Human Services Committee in support of a bill that would expand access to naloxone, also known by its brand name, Narcan.
L.D. 1686, sponsored by Rep. Sara Gideon, D-Freeport, would make the drug available by prescription to family members or caretakers of drug addicts. It also would allow emergency medical technicians, and perhaps even police officers and firefighters, to carry and administer the drug. Currently, only licensed paramedics can administer Narcan.
The drug is given as a nasal spray that goes directly to the brain, where it binds to opioid receptors to stop the effects of an opiate, such as heroin.
A similar bill was passed in last year's legislative session but vetoed by Gov. Paul LePage, who said in his veto letter that it would "make it easier for those with substance abuse problems to push themselves to the edge, or beyond. It provides a false sense of security that abusers are somehow safe from overdose if they have a prescription nearby."
LePage is likely to veto the latest bill, if it passes. In his State of the State address last week, the governor talked about Maine's growing drug problem and proposed increasing enforcement resources to fight drug dealers, but spoke little about more resources for drug treatment.
By contrast, Vermont Gov. Peter Shumlin devoted his entire annual address to his state's growing drug crisis, focusing on treating addiction as a disease.
LePage's stance has been noticed nationally, with The New York Times contrasting his approach to combating the state's drug problem with Shumlin's. The liberal website Huffington Post was deeply critical of Le- Page, running a story Wednesday under the headline, "GOP Gov. to addicts: Drop dead," criticizing LePage's stance on drug abuse and his opposition to expanding access to Narcan.
New Jersey Gov. Chris Christie opposed increasing access to Narcan but changed his mind last year after hearing about its benefits from people who had been affected, including the singer Jon Bon Jovi, whose daughter overdosed on heroin and survived.
SUPPORTERS FOCUS ON SAVING LIVES
While introducing her bill to the committee Wednesday, Gideon acknowledged that more must be done to reduce the amount of drugs available and get more people into treatment, but said Narcan saves lives.
Sagadahoc County Sheriff Joel Merry, who spoke in favor of the bill, said good public policy should always lean toward saving lives, "regardless of the circumstances."
Cumberland County Sheriff Kevin Joyce testified that he generally supports making Narcan more available but shares the governor's concern about creating a "false sense of security" for users.
Although most who spoke favored the bill, there was opposition, including from two members of the LePage administration -- Nick Adolphson, representing the Department of Health and Human Services, and Jay Bradshaw, representing the Department of Public Safety.
Adolphson said the administration is concerned about the bill's provision that would require Medicaid reimbursement, which would add costs to a program that already is stretched.
Bradshaw said it's important for people to recognize that Narcan is "not a benign medication." He spoke about patients getting angry and violent when they regain consciousness, and said vomiting and aspiration is a major concern.
The bill has overwhelming support from health care organizations, ranging from the Maine Hospital and Maine Medical associations to the Maine chapter of the National Association of Social Workers to the Drug Policy Alliance, a national group that advocates for treating addiction and substance abuse as a health crisis.
Many who testified Wednesday referred to the success of a recent expansion of Narcan access in Quincy, Mass., where the police department made the drug available to all officers in 2010.
Within 18 months, the number of overdose deaths from opiates decreased by 66 percent. During that time, police administered 225 doses of nasal Narcan, which reversed the overdose effects in 214 of those cases.
Overdose deaths from all drugs have been relatively stable in Maine over the last decade -- there were 163 in 2012 -- but there has been a sharp increase in the number of deaths attributed to heroin. From 2011 to 2012, the number jumped from seven to 28. Officials expect that even more occurred in 2013, for which statistics are not yet available.
ACTOR'S DEATH RAISES AWARENESS
Public safety officials and substance abuse experts say heroin has become more prevalent, in part because it is cheaper and easier to get than prescription opiates such as OxyContin.
The death of actor Philip Seymour Hoffman from a heroin overdose this month has re-initiated a national discussion about the increasing use of the drug.
Gates, who lost his son Will to heroin 4 1/2 years ago, said people must understand that "the typical overdose victim is never typical."
"Not even Academy Award winner actors at the pinnacle of their careers are immune," he said.
Gates and others noted that people cannot get treatment or rebuild their lives if they are dead.
Rep. Paul McGowan, D-York, told a story about his nephew who was found in the middle of a road recently, unconscious from a heroin overdose.
"He's alive today because the first responders did the appropriate thing and were able to bring him back from that overdose," McGowan said. "He's now in a rehab program in Minnesota, but he's alive. He gets another chance."
After Wednesday's 90-minute public hearing, Gideon said she was encouraged by the broad support, although she knows that it will be difficult to convince some Republicans to support the bill, and that the Republican governor is likely to veto it.
"I think everyone agrees on saving lives and I think we can find a way to put this drug responsibly into the right hands," she said.
The Health and Human Services Committee will consider the bill at a meeting in the coming weeks before voting on its recommendation to the full Legislature.