Maine has a heroin problem, according to every available measure. Usage is up, arrests are up and deaths by overdose quadrupled between 2011 and 2012, with even more last year.
As serious as the heroin problem is, however, it’s not Maine’s only drug problem. The abuse of prescription painkillers is still the most common way Maine people illegally access opiates. They are the means by which young people are introduced to hard drugs and the means by which they get addicted to them, and they are by far the most common cause of fatal overdoses. In 2012, 28 people died of heroin overdoses; there were 101 deaths from prescription drug abuse.
It’s right for the public to be concerned about the growth of heroin abuse in Maine. It is a dangerous drug that is distributed by criminal organizations that stretch from Massachusetts to Mexico. Once gangs get a toehold in a community, they are hard to dislodge.
But it’s important not to lose sight of the prescription drug abuse problem that feeds the demand for heroin and puts the state at risk. It’s also important to view this as a complex public health problem that should be fought with treatment as well as law enforcement.
The heroin and prescription opiate problems are closely linked. Painkilling drugs like OxyContin and Dilaudid are vitally important to the treatment of people in severe pain, often at the end of their lives.
In the wrong hands, however, these medications provide new users an introduction to opiates that can be taken without needles and doesn’t carry the stigma that comes along with heroin use. These pills may be more socially acceptable, but they are just as addictive.
Over the last decade, the state has made progress in preventing the diversion of prescription drugs onto the black market, making these drugs more scarce and more expensive.
This scarcity fuels the demand for heroin, as addicts migrate to a drug that’s cheaper to buy and easier to find.
Gov. Paul LePage has proposed adding more police and prosecutors to address the problem, and while enforcement is important, it’s not enough.
In the face of this epidemic, the state has been cutting back on drug treatment. Maine has created a two-year cap for people who receive methadone treatment under the MaineCare program. Some drug-dependent MaineCare recipients lost their coverage and their access to treatment. Cutting treatment funding not only prevents severely damaged people from trying to turn their lives around, but also means there will be more addicts on the street.
The math is inexorable. More addicts in the state means more drugs around — and that means more people are likely to start using. Trying to save money by policies that increase the number of addicts is hopelessly shortsighted.
Maine needs to address its drug problems from every angle. That means viewing the heroin epidemic in context with abuse of other opiates, and recognizing that law enforcement and treatment are both essential to the state’s response.