AUGUSTA — Illicit drugs and people who are using alone are the primary driving forces behind the record number of Mainers who died from a drug overdose last year, the state’s director of opioid response told lawmakers Wednesday.

Preliminary data from the University of Maine show that 2022 is already a record-breaking year for overdose deaths in Maine: 649 people died from a fatal overdose during the first 11 months of the year. There were 631 fatal overdoses in 2021.

Nonpharmaceutical fentanyl, alone or in combination with other drugs, accounts for 78% of all fatal overdoses between January and November 2022.

“It’s deadly and it acts so quickly. It’s very difficult to get people to help in time,” Gordon Smith, the opioid response director told the legislature’s Health and Human Services Committee.

“And secondly, too many people use alone in circumstances where we lose valuable time because they’re in an upstairs bedroom or in a bathroom and there’s nobody with them,” he said.

Maine has tried to push messaging that encourages people that if they are going to use drugs, they shouldn’t be alone but “we’ve not been successful in saturating the community with that message, or they’re ignoring the message,” Smith said.


Smith, public health experts and recovery advocates have spoken numerous times before about how the pandemic has increased isolation and taken people away from supports such as a recovery community, which not only affects their well-being but also means that people are alone and do not have anyone there to call for emergency services or administer naloxone, the overdose-reversing drug.

Smith said he feels “frustrated that we lost so much time during the pandemic.”

“I feel like I’ve had two positions: I was director of opioid response before the pandemic … and then since,” he said. “And now it’s kind of, not back to the beginning, but it’s really been a difficult experience to be managing a very serious epidemic in the middle of a global pandemic when in fact many of the things you might do to respond to the global pandemic adversely affected the epidemic.”

Also significantly impacting fatal overdoses is the introduction of xylazine and nonpharmaceutical tramadol. Both drugs showed up on toxicology reports for the first time in 2021, almost always in combination with fentanyl. According to preliminary data for 2022, xylazine was identified as a contributing cause of death in 34 out of 434 deaths related to nonpharmaceutical fentanyl; tramadol, a type of opioid, was listed in eight deaths.

Xylazine is an animal tranquilizer that lowers people’s heart rate and can also cause necrotic wounds. Since naloxone only reverses the effects of opioids, the more xylazine in a person’s system, the less effective naloxone is in reversing an overdose, Smith said.

Smith said the preliminary data of fatal and nonfatal overdoses for 2022 is “pretty grim, but there are some hopeful signs as well.”

While fatal overdoses increased from 2021 to 2022, preliminary data indicates that the increase will be significantly lower compared to the previous year’s increase. Once the numbers are finalized, total fatal overdoses in 2022 compared to 2021 will likely only be about half of the 25% increase Maine saw in 2021 compared to 2020’s numbers.

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