As overdose deaths rise, Gov. Janet Mills’ broken promises on opioid crisis come into focus

Governor Janet Mills signs legislation before a group of lawmakers in 2019.

AUGUSTA – As Governor Janet Mills entered office in 2019, deaths due to the use of drugs in Maine had declined from the previous year. Now, one year into the Mills administration, the Maine’s Attorney General says drug deaths are on pace to rise again, this time by more than 4%. At the same time, a review of Governor Mills’ first full year in office shows many of her promises on battling the opioid crisis have not been fulfilled.

On the campaign trail, Governor Mills focused on the opioid crisis, promising a ten-point plan and effort to combat the problem, which has claimed thousands of Maine lives.

During the campaign, Attorney General Janet Mills told Maine voters, “History will note that we have lost an entire generation of people to the opioid epidemic and that we have simply failed to address this preventable disease.”

While the claim that Maine had “lost an entire generation of people” was obviously hyperbolic, it seemed to speak to a sense of urgency Janet Mills felt on the issue. That sense of urgency seems to have given way to a more measured tone this week, when Governor Mills spoke about the opioid crisis in the face of numbers showing it is getting worse on her watch.

“Fighting the opioid epidemic will be a long, difficult battle with ups and downs, but when it comes to the lives of our neighbors, friends, and loved ones, it is a fight that my administration will never shy away from,” said Mills in a statement.

But Governor Mills’ claim that her administration will “never shy away from” fighting the opioid epidemic doesn’t hold up when looking at the lack of progress, or in many cases, attempts at progress, to keep her campaign promises on the issue.

An analysis of Governor Mills’ plan shows that she has failed to carry out most of her own recommendations.

In one case, a policy to create a drug education program in Maine schools, the policy has been pushed out so far that Maine can expect to see another 800 overdose deaths before the Maine Department of Education even begins drafting the curriculum.

Maine’s state budget currently allocates about $5.5 million to combat the crisis, but Gordon Smith, Governor Mills’ Director of Opioid Response, says that about one-third of that money is being spent on needle exchange programs for drug users. More than $700,000 more is dedicated to the development of the school curriculum that won’t begin until 2021.

The amount of funding and effort Governor Mills has brought to bear in directly dealing with the crisis pales in comparison to the money and effort Mills has put into other parts of her agenda. In areas such as expanding Maine’s Medicaid program, fulfilling promises to environmental groups, growing welfare spending, expanding abortions or even providing emergency funding for non-citizen welfare, Mills has arguably spent more money and political capital moving her agenda forward.

Following is a breakdown of the promises Janet Mills made on the campaign trail followed by an update on the progress of lack thereof:

Target the 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.

No proposed legislation. Not addressed in Governor Mills’ state budget.

Rein in prescribing practices that encourage addiction and put opioids in the hands of people who misuse and divert them. A new law to monitor and limit opioid prescriptions, proposed by the governor and enacted in 2016, is a good beginning, but analyzing prescribing trends and providing better training for prescribers will further reduce overprescribing and diversion.

No proposed legislation. Not addressed in Governor Mills’ state budget. Because the rise in overdose deaths is not due to opioid prescriptions, this has only a tangential connection to the issue.

Make naloxone, also known as Narcan, available to every family and agency that needs it. The Maine Board of Pharmacy drafted regulations for over-the-counter naloxone; these rules should be promulgated and adopted.

A bill to require recovery residences to have Narcan on hand, L.D. 303, was signed into law in June of 2019. Nobody from the Mills administration testified in favor of the bill. The primary sponsor of the bill was a Republican. Mills has taken other steps to make naloxone available in public buildings and schools.

Establish an opioid emergency line — a 2-1-1 line on steroids — to provide accurate information and emergency referrals 24 hours a day.

No proposed legislation. Not addressed in Governor Mills’ state budget.

Lift the state’s two-year limit on methadone treatment for Medicaid patients and raise Medicaid reimbursement rates for treatment.

A bill, L.D. 266 that proposed to do this was sponsored by Senator Linda Sanborn. It was then withdrawn before having a committee hearing.

Expand drug courts and provide medication-assisted treatment and supportive services to participants.

Drug courts are not addressed in any proposed legislation or in Governor Mills’ proposed budget.

Gordon Smith claims that Medicaid expansion gave access to medication-assisted treatment to 5,000 people. Only 43,000 people have enrolled under Medicaid expansion, which, if true, means that almost 12% of Medicaid expansion enrollees are receiving medication assisted treatment.

Provide treatment slots and supportive therapy across the state, along the lines of Vermont’s “hub and spokes” model, providing a “hub” of medication treatment to reduce chemical dependency and “spokes” of primary care, intensive outpatient services, and assistance with housing, employment, and so on.

No proposed legislation. Not addressed in Governor Mills’ state budget.

Make recovery coaches available on call at every emergency room and clinic, and medication-assisted treatment available for every person with substance-use disorder.

No proposed legislation. Not addressed in Governor Mills’ state budget. Gordon Smith claims the state trained 250 coaches in 2019.

Expand the number of detox slots, recovery residence beds and peer recovery centers.

No proposed legislation. Not addressed in Governor Mills’ state budget.

Provide prevention programs in our schools and communities.

As discussed above, this program has had more than $700,000 allocated to it under L.D. 29, but the Department of Education will not begin drafting the curriculum until 2021.

Other issues

-In July of 2019, Governor Mills organized an opioid summit in Augusta. More than 1,000 people attended. Advocates for recovery spoke out, expressing their disappointment that Governor Mills ‘missed the mark’ according to the liberal Maine Beacon website.

-A bill introduced in early 2019, L.D. 578, directed Maine’s DHHS Commissioner to develop a pilot program to help people suffering from opioid use disorder to transition to recovery. The Mills Administration did not testify in support of this legislation, despite the support of the National Alliance on Mental Illness.

Following are links relevant to this article.

Latest Drug Deaths Report from Maine Attorney General:

http://www.maine.gov/tools/whatsnew/attach.php?id=2025575&an=1

Janet Mills’ ten-point plan to tackle the drug crisis:

https://www.janetmills.com/issues/opioids

L.D. 303 Requiring Narcan in recovery residences:

http://mainelegislature.org/bills/display_ps.asp?snum=129&paper=HP0227&PID=1456

L.D. 266 to life the two-year limit methadone treatments:

http://mainelegislature.org/bills/display_ps.asp?snum=129&paper=SP0078PID=1456

L.D. 29 to begin developing a drug prevention curriculum in schools, cost work won’t begin until 2021.

http://www.mainelegislature.org/legis/bills/display_ps.asp?PID=1456&snum=129&paper=&paperld=l&ld=29

L.D. 578 pilot program to assist transition to recovery of people with opioid use disorder:

http://mainelegislature.org/bills/display_ps.asp?snum=129&paper=HP0422&PID=1456

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