Battle Over Heroin Overdose Antidote Hits Maine

Skip Gates waited in the lobby of the Maine State House in late March, clutching a list of Republican legislators. Any day now, the House could vote on a bill that would distribute naloxone, the antidote to a heroin overdose, to Maine residents, and Skip’s son Will died five years ago after snorting heroin at college. So he came to help persuade.

“My suggestion is, if we don’t pass this, it’s coming to a family near you, and sooner rather than later,” Skip, a retired math teacher, told VICE News. “If it’s your son, if it’s your daughter, if it’s your grandchild who is in overdose, can you live with yourself forever, knowing that you did not support the thing that could have saved them?”

A naloxone bill passed in 2013, but Maine’s current governor, Paul LePage, vetoed it. That bill split along party lines, with the Democrats voting for it and the Republicans against. In January 2014, Democrats proposed a new bill, and this year Gates and company are going for a veto-proof majority. LePage says in early March that he plans to veto again, calling naloxone an “escape,” the Portland Press Herald reported.

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“It’s an excuse to stay addicted,” he tells reporters, and proposes a law enforcement-driven crackdown instead.

Twenty-two other states already have naloxone laws. Maine’s overdose rate falls about in the middle nationally — 10.4 per 100,000. New Mexico is 23.8 and West Virginia is 28.9. Heroin deaths are on the rise in Maine, but in 2012, the most recent year for which data is available, 140 of the 163 overdose deaths were related to pharmaceutical drugs. The prescription drug oxycodone was the leading factor, according to the state Department of Health.

Will Gates was a junior at the University of Vermont when he died. He was studying molecular genetics and worked as a substitute teacher.

“It may be that the people who are super-bright, my son was incredibly bright, they may need to seek these heavy drugs out to stop all the flow of information, just to get a little respite,” Skip Gates told the legislators.

Opioids, including heroin and oxycodone, operate like endorphins, the body’s painkiller and the happiness chemical. They block pain messages to the brain. A load of endorphins makes an aching marathon runner feel like Hermes. A load of heroin makes an aching Lou Reed “feel just like Jesus’ son.”

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Naloxone is an opioid antagonist, meaning it reverses the effects of an opioid overdose. It sticks to opioid receptors in the brain better than heroin or oxycodone, kicking them off the receptors for a little while. But unlike opioids, naloxone does not depress the respiratory system, which is what causes overdose victims to stop breathing and die.

Naloxone has been standard in emergency rooms since the 1970s. Distribution among drug users began underground, and the first official take-home program started in Chicago in 1996. The American Medical Association endorsed widespread access in 2012, a few years after overdoses surpassed car accidents as the number one cause of accidental death in America.

The CDC classified prescription drug use as an “epidemic” in 2011. States responded with strict prescription monitoring programs, going after “doctor shoppers,” users shuttling between prescribers, and “pill mills,” doctors prescribing loads of painkillers. Where crackdowns were successful, the new “heroin crisis” took hold. And another term caught on — the crisis’ “changing face” — meaning the people dying were white and middle class.

The alarm bells sounded for the home invasion. Drugs have to be the stranger in town. If we keep naloxone in the drawer, we admit that we know the guy, and expect that he might come knocking.

Zoe Odlin-Platz knows the guy. She comes from a fishing family, and they are her people. Drug users are also her people. In her office at Portland’s India Street Clinic, a breast pump rests on a box of syringes.

“We all say it, these are your friends, these are your family,” says Odlin-Platz. “But they really are. They really are just trying to get by just like we are. We can go home and drink three glasses of wine, and nobody’s going to point the finger at us.”

She’s hesitant to talk about drug use among fishermen because she’s worried people will misjudge them. It’s a secret. The captains say, “No junkies on my boat.” But Odlin-Platz says naloxone is especially important for fishermen, because they spend weeks on the water, beyond the reach of any ambulance.

“One guy recently died on the boat out at sea,” she says. “They stayed out there. I mean he’s dead, there isn’t anything they could do, so they stayed fishing.”

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Odlin-Platz tries to get her clients to come in before their long trips, telling them, “Please don’t dump your needles over the edge of the boat just because the captain’s coming. Your tolerance is down, and I know you’re tough and I know you can handle so much, and I’m not trying to tell you, you can’t handle your shit, but just be careful.”

Drug users who have detoxed are at high risk of overdose because their bodies are unused to their regular amount of drugs.

“There’s a lot of pride here,” says Zoe. “A lot of people come in for the first time and they’re embarrassed, and say, 'you probably just think I’m a scumbag.' And I say, 'no, I really don’t. I’d rather hang out with you than with a lot of people.'”

Governor Paul LePage would rather not hang out with drug users. His dad was a mean drunk. The Portland Press Herald reported that Gerard would light fires in the house in alcoholic rages and assault the 17 LePage children. They were poor, without hot running water or an indoor toilet, and often wanting for food.

Paul left home at age eleven, after his father, Gerard, beat him and broke his nose, sending him to the hospital.

“He gave me a fifty-cent piece, and that’s where my life began. I just walked,” LePage told DownEast Magazine.

At eleven, Paul was homeless, and began working odd jobs, landing at a paper company for most of his career. Before becoming governor, he was the general manager of a chain of discount stores, Marsden’s Surplus and Salvage.

On April 9, LePage tells a press conference he still opposes open access to naloxone.

“I just don’t think it’s appropriate, with liability issues, to just open it up and say, be a drug addict and we will allow you, we’ll have everybody on the street have a little pen so if you croak, we’ll inject you,” he tells a press conference. “That’s what they were asking. Basically, an open. I’m saying no.”

LePage has tried to cut millions from treatment while advocating for more drug arrests. In 2012, he capped funding for methadone and suboxone, the medical treatments for addiction, meaning people relying on them for two or more years were no longer covered. Public funds have been slashed since Shelby Briggs, Portland’s overdose prevention coordinator, went to publicly funded rehab herself in the ‘90s.

“There are 13 or 14 public beds for women in Maine for rehab,” says Briggs. “Nobody can afford it. It’s thousands of dollars a week. And people generally don’t get better in a week.”

Approaching the April 14 vote, the Republicans, aligned with LePage, won’t budge on open distribution of naloxone. A week before it, House leadership cuts a deal, the Bangor Daily News reported. Families can obtain naloxone if they register the name of the drug user and other limitations, but the advocates still can’t give it out. The governor refrained from vetoing the legislation.

Briggs says that since the law passed, she’s had two clients die. She was driving recently when she saw a client fallen out by the side of the road, a local kid. Without naloxone, she couldn’t bring him back to consciousness. She rubbed his chest, holding him, and waited.

Image via Wikimedia Commons by Intropin