Rural Maine. A quiet house by a snow covered lake. An older woman in a bathrobe and slippers walks into the laundry room to take out the last load of the night. There, sprawled out on the floor, is her daughter. Keeled over. Unresponsive and turning blue. The mom screams and rushes to the kitchen to call an ambulance. The daughter’s boyfriend hears the scream and comes stumbling downstairs with an intramuscular dose of Naloxone in hand. He rips off the cap. A recorded voice in the device instructs him how to inject the shot. He jabs it into the young woman’s leg. Within a few seconds, she revives. By the time the paramedics arrive, she’s still a bit woozy, but she refuses to go with them to the hospital. It’d only bring more trouble. And it’d take her away from her newborn baby, who by now has begun wailing from his cradle in the other room.
Just another Saturday night in Maine.
Last year, fatal opiate overdoses took more than one life a day in Maine. Here in town alone, they took the life of more than one Portlander a week. This crisis is easily one of the most devastating epidemics this state has ever seen, but it’s hard to know what to do about it.
If you watch TV shows like “Celebrity Rehab” or “Intervention,” it’s easy to think that the best approach to treating Substance Use Disorder (the clinical term for “addiction”) is to ship people off to high end residential treatment programs, preferably for at least a few months. But such interventions are often beyond the reach of most families. We desperately need solutions that are in reach, practical and effective.
Here are five that come to mind:
1.Harm Reduction Now!
Every family in Maine, regardless of where they live, should have an easy way to get their hands on Naloxone, clean needles and public health information about how to respond to overdoses effectively. Take those injectors away, and trust me on this, people like the woman in the story won’t magically stop using dangerous drugs. Those drugs will just be a lot more likely to kill them.
2. More detox beds!
At present, there are very few publicly funded detox facilities in Maine where anybody can simply go, stay for a whole week, and circulate all the drugs and alcohol out of their bodies. The ones that do exist, like the Milestone detox in Portland, are almost always full, and there’s no waiting list, it’s just first come, first served. Even if the woman in the story were to get desperate and call to be admitted, odds are, she’d be told to call back later, and by that point, there’s a good chance she’d be high again.
3. More public oversight of drug counseling programs!
If the woman in the story were to enter professional counseling, the quality of care she might receive could vary wildly. Drug treatment is a highly lucrative business, and especially as more and more Mainers gain access to MaineCare and use it to enter treatment, we’ve got to make sure that every program adheres to the same high set of standards.
4. More programs for parents with children!
For young parents with substance use disorders, like the one in the story, the best treatment option can often be one where they can bring their children to and have the kids taken care of while they undergo counseling. Few such places exist, and there are almost none for men.
5. More support for the families of people struggling with drugs!
Had the woman in the story not had her overdose reversed, the grief and ensuing chaos that her family would have experienced would likely have been overwhelming. If a trained grief counselor could connect with every family in the early stages of mourning a tragic overdose, hopefully we could minimize that damage.