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February 23, 2018

Fentanyl drives 11% increase in Maine's drug overdose deaths

Courtesy / Maine Attorney General's Office Maine Attorney General Janet Mills reported Thursday that there were 418 drug-induced deaths in 2017, according to data collected and analyzed by Marcella H. Sorg of the Margaret Chase Smith Policy Center under a contract with the AG's office.

Drug overdose deaths increased by 11% in 2017, driven by a sharp increase of 27% in deaths due to illegal fentanyl and fentanyl-related substances that can be even more potent.

Maine Attorney General Janet Mills reported Thursday that there were 418 drug-induced deaths in 2017, according to data collected and analyzed by Marcella H. Sorg of the Margaret Chase Smith Policy Center under a contract with the AG’s office.

The increase in the number of deaths was down slightly from the nearly 40% increase in deaths reported in 2016 compared to the previous year. Heroin deaths decreased, as did deaths caused by benzodiazepines, but 2017 saw in increase in both cocaine and methamphetamine-related deaths, according to a news release from Mills’ office.

Most drug deaths were caused by two or more drugs, and the average cause of death involved three drugs. The vast majority of overdose deaths (85%) were caused by at least one opioid, including pharmaceutical and non-pharmaceutical (illegal) opioids. Most of the pharmaceutical opioids, or prescription drugs, were not prescribed for the person who died of an overdose. Naloxone (Narcan) was detected in 31% of the overdose victims, which indicates that someone attempted to revive the individual but did so too late.

'Fentanyl has invaded our state'

The highest number of drug overdose deaths in 2017, or 26% of them, occurred in Cumberland County, with 57 of those deaths — more than one a week — occurring in Portland. York County saw 82 deaths, or 20% of the statewide total, with 23 of these in Biddeford. Penobscot County had the third highest number of deaths, with 65, or 16% of the total.

The average age of drug overdose deaths has remained stable at 41, or close to the average age of the population of the state.

“Fentanyl has invaded our state,” Mills said, ”killing 247 people last year alone. Five of these deaths were due to the lethal drug carfentanil. When people ingest this powerful powder, they often believe it is heroin, and have been told it’s heroin. But no one should take a chance with these substances. Even as dangerous as heroin is, fentanyl is hundreds times more likely to kill you. The equivalent of a few grains of fentanyl can take your life. It is so dangerous that the federal DEA has warned police and public safety personnel to guard against exposure to fumes from fentanyl powder.”

Illicit fentanyl and its analogs are manufactured in labs in China and often shipped into the United States through other countries and into Maine through Massachusetts and other states. Traffickers often lace heroin with fentanyl and sell fentanyl as heroin because fentanyl is cheaper to make and the profit margin for dealers is so much higher, according to Mills’ office.

A call to action

Mills, who has served on the Maine Opiate Collaborative and the Legislature’s Task Force to Address the Opiate Crisis, published an op-ed in the Bangor Daily News in January outlining a 10-point plan to address the opiate epidemic. 

Among her recommendations:

  • Target areas with a high number of overdoses, hospital admissions and drug-related crimes and provide them with additional medical and economic resources, “an opioid version of Pine Tree Zones.”
  • Make naloxene, also known as Narcan, “available to every family and agency that needs it.” Mills recommends adoption of regulations drafted by the Maine Board of Pharmacy for over-the-counter naloxone.
  • Lift the state’s two-year limit on methadone treatment for Medicaid patients and raise Medicaid reimbursement rates for treatment.
  • Expand treatment and support across the state following a “hub and spokes” model, which provides a “hub” of medication treatment to reduce chemical dependency and “spokes” of primary care, intensive outpatient services and assistance with housing and employment. As reported by Mainebiz in September 2016, MaineHealth launched collaborative effort between Maine Behavioral Healthcare, Mid Coast Hospital, and Pen Bay Medical Center called the EMBARK program that treats any level of addiction.

“Public education and prevention are key,” Mills said, “along with a progressive approach to treatment, including the ‘hub-and-spokes’ model used in Vermont. In addition, we need triage teams with recovery coaches and medication assisted treatment available at every emergency room, and more drug courts to help those in trouble with the law.”

House Speaker Sara Gideon, D-Freeport, issued the following statement about the 2017 drug overdose deaths:

“This is absolutely devastating news. We can no longer ignore the impact of this epidemic, disregard the underlying causes or the lack of access to needed treatment. This data represents more than numbers — it represents our family, our friends, our neighbors. In every instance, at every age, we should be doing everything in our power to save every life possible. And the sad fact is, we are not.”

Gideon called on all branches of government to provide “leadership” in addressing the problem.

“Every aspect of Maine’s economy, community safety and family stability will continue to suffer if we do not make progress on this crisis,” she said.

Gov. LePage's response

Gov. Paul LePage issued the following statement late Friday afternoon:

“We are saddened to see an increase in overdose deaths due to opioids and we will continue to address this crisis on all fronts. The increasing availability of fentanyl is fueling an increase in overdoses. Fentanyl-related deaths surged 27 percent in 2017. When heroin users are led to believe they are taking their usual amount of heroin but it is fentanyl, they overdose. We must stop the trafficking of fentanyl into our state.

“We need more education, stronger enforcement, and more available treatment including faith-based programs. We are adding hundreds of treatment beds in Windham with a significant portion dedicated to substance-abuse intervention. We must also focus prevention efforts on our middle-school youth so that they never start using any addictive substance that can lead them down this tragic path.

"The Bureau of Insurance released data last month showing significant decreases in the prescribing of opiates covered by insurance. The Bureau’s analysis of the Maine Health Data Organization’s data for the first two quarters of 2016 and 2017 indicate that the number of members with prescriptions for opioids and opioid derivatives decreased from 51,253 in the first half of 2016 to 40,591 in the first half of 2017, a drop of over 10,000 members with these prescriptions, and that the number of prescription claims for opioids and opioid derivatives decreased 19.8%, with 27,739 fewer claims between the first half 2016 and the first half of 2017."

LePage chastises Mills

LePage also issued the following statement regarding how Mills released the 2017 figures: “As disturbing as this data is, it is even more disturbing for the Attorney General to attach to such an important and highly anticipated annual news release a PDF file of an op ed she wrote for the Bangor Daily News last month, within which she did not disclose that she is a candidate for governor. Not only is the piece ill-informed as most of her recommendations are vague, already in place or being implemented, but it is inappropriate since her office is the keeper of the State Drug Death Statistics and they should be released in the most sensitive and objective manner.”

Editor's note: This story was updated Monday morning to include the statements issued by Gov. Paul LePage late Friday afternoon.

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