As Mainers die from opioids, Paul LePage stalls distribution of overdose reversal drug

"He says if you have to be 21 to buy cigarettes - why isn’t the Narcan age 21?"

AUGUSTA, ME - JUNE 30: During a press conference at the State House on Friday, Gov. Paul LePage said he would not sign any budget that comes out of the legislature today and he will wait the full ten days before vetoing it. If a budget is not passed by midnight, the state will enter into a partial shutdown. (Staff Photo by Gregory Rec/Portland Press Herald via Getty Images)
AUGUSTA, ME - JUNE 30: During a press conference at the State House on Friday, Gov. Paul LePage said he would not sign any budget that comes out of the legislature today and he will wait the full ten days before vetoing it. If a budget is not passed by midnight, the state will enter into a partial shutdown. (Staff Photo by Gregory Rec/Portland Press Herald via Getty Images)

For months, Maine Gov. Paul LePage (R) has been sitting on critical statewide regulations that enable pharmacists to doll out the overdose reversal drug, naloxone, without a doctor’s prescription. The need for naloxone is obvious: opioid-related overdose deaths totaled 376 in 2016, killing one Mainer a day, on average.

Despite experts’ recommendation to streamline naloxone access, as it could help curb opioid overdose deaths, LePage has let the stigma of addiction drive his policy decisions.

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On Monday, LePage told a New England Cable News reporter he couldn’t support rules that give people as young as 18 naloxone, commonly known by its brand name Narcan. “He says if you have to be 21 to buy cigarettes – why isn’t the narcan age 21?” said the local reporter who interviewed him.

The governor has been a longtime critic of widespread distribution, “saying it enables those suffering from substance use disorders to keep using drugs,” according to The Portland Press Herald.

But the only effect of naloxone is to reverse an opioid overdose, unlike cigarettes. The overdose reversal drug is intended to keep people from dying — and it does; and if a person survives an overdose, there’s a better chance for them to get long-term treatment. Medical experts often disclaim naloxone is not a cure. But discomfort with naloxone is indicative of a larger problem: viewing addiction as a moral failing rather than a disease.

In October, Baltimore City Health Commissioner Leana Wen told ThinkProgress stigma is among the biggest challenges in fighting this epidemic, which is why it’s imperative to think of addiction as a disease. The World Health Organization already recognizes opioid addiction as a complex health condition. By thinking of addiction as a disease, the public will begin to treat it as such. Wen likened naloxone to a defibrillator. “There is an acute treatment that we need to give to them right now,” she told ThinkProgress last year. Just as a defibrillator saves someone from dying of a heart attack, naloxone saves someone from dying of an overdose. Naloxone is also easier to administer — anyone can do it; Narcan, for instance, is dispensed like a nasal spray.

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Dispensing naloxone without a doctor’s note isn’t revolutionary. More than 40 states have similar naloxone rules. And more importantly the policy is evidence-based. The adoption of naloxone access laws is associated with a 9 to 11 percent decrease in opioid-related deaths, according to a national survey by the Centers for Disease Control and Prevention. And a majority of the overdose reversals were performed by other drug users, not by emergency responders.

LePage told the local NECN reporter that state pharmacists don’t need his approval to distribute naloxone without a prescription, but the Maine Board of Pharmacy maintains they are still waiting for the governor’s approval. The rules — which were part of an ominous law looking to address the opioid crisis — were sent to the governor’s office for approval in August and have been “pending” ever since.

On Monday, he invited the local reporter into his office to look for the naloxone rules.

One Maine state representative responded to the crazed event on Twitter, saying “Shame on you Governor LePage… for playing stupid games while Mainers are dying every day.”

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The pharmacy board is meeting Thursday to discuss the naloxone rules. Local Democrat lawmakers argue the pharmacy board could bypass the governor if he’s being uncooperative.