Serving on the Health & Human Services committee in the Maine Legislature my eyes have been opened to some frightful conditions. Chief among them is drug addiction.
The effects of heroin on the human brain are terrifying. Drug addiction is a deadly disease gripping Maine at an epidemic rate. An average of five overdose deaths per week now exceeds traffic-accident deaths in our state. This is tragic. It is a public concern. It is why I sponsored a bill to increase public funding for increased access to syringe exchange.
Drug use destroys lives, families and communities; it compromises public health and increases health-care costs. It affects people from all walks of life. It does not discriminate across socioeconomic class. Living among us – our neighbors, friends, brothers, sisters, parents, students, lobstermen, carpenters, mechanics, roofers, healthcare professionals, community leaders – to name just a few, are addicted.
Be it boredom, life’s woes, peer pressure – it can happen without intention. An injury, illness or surgery that requires a pain medication, is one way that marks the beginning. The prescription ends, but the brain wants more. And more gets out of control. Your brain can no longer rationalize because more has taken over. You will do anything to get more. And so it goes.
Getting more, any way possible, becomes the sole focus. And when they can no longer get prescription drugs, the addicted take to the streets where lower-cost heroin can be found. But there’s a problem: The euphoric high has waned; the efficacy of a non-controlled substance is not so strong and who knows what it is mixed with. The brain craves more. The craving for the next euphoric high comes by injecting heroin straight into one’s veins. An addict is born.
Heroin use is on the rise in Maine; so, too, is the rate of incidence of Hepatitis C. In a 2015 report, the Maine CDC reported a spike in the rate of reported cases of Acute Hepatitis C to 2.3 cases per 100,000. This puts Maine at four times the U.S. rate of 0.6 cases per 100,000. Sixty-eight percent of these reported cases indicated they injected drugs in the six months prior to symptom onset.
Maine has six privately funded needle exchanges. They are hanging by a financial thread. They need more funding. Kenney Miller, executive director and founder of Maine Harm Reduction Alliance, sees more than 100 people per week pass through the exchange program.
“From the moment a new customer enters our agency, they are engaged in a process. The mere act of enrolling in a syringe exchange program is a step toward recovery, because it implies they care about their health and well-being and the safe disposal of syringes,” says Miller.
In 2014, Maine’s syringe exchange program distributed 530,000 syringes, but brought in more than 560,000 – 30,000 more than they gave out. The Portland Exchange has 900 active enrollees. Last year, more than 145,000 needles were responsibly disposed of as bio-hazardous waste, according to Dr. Caroline Teschke of the India Street Free Clinic.
“Without this service these needles might have been shared, reused or disposed of in any number of public places putting people at potential risk of serious infection and/or injury,” she said.
Teschke admits the topic of substance abuse, and particularly the injection of drugs, is a polarizing issue. However, across the country the once-controversial partisan divide has had a change of thought. States with both Democrat and Republican governors are aggressively confronting the crisis, investing state and local funds to provide more robust and sustainable programs and services. Risky behavior is reduced, and people are being linked to drug treatment.
The proposed bill will add Maine to the list of states investing state funds to help fund needle exchanges. It will cost taxpayers $75,000 per year. This funding will be in addition to the current private funding of $35,000. Maine’s six needle exchanges are co-sited with other health services. Those who work closely with the program believe this is the financial boost badly needed to provide a compassionate path to recovery. They also believe it makes good economic sense.
Once addiction has altered the brain, recovery is an upward battle. The mind needs to be able to change a thought. This happens when the person is ready. Kenney Miller believes that safe needle exchange is a way to usher people toward recovery. His conversations with clients are brief, and trust builds over time; he hears their stories, and has the opportunity to connect with them in an authentic way. According to Miller, at least 80 percent of the people who utilize safe needle exchange want to quit: “They are no longer using to get high; they’re using to ‘stay well,’ to avoid the extreme discomfort of withdrawal.”
For those uncomfortable with the idea of giving clean needles to addicts, Dr. Caroline Teschke offers a change of thought; consider the ROI (Return on Investment): “One 10-cent needle could theoretically prevent a case of HIV or Hepatitis C” she says. A lifetime treatment for HIV costs roughly $370,000 per person. A 12-week treatment program for Hepatitis C costs $84,000 per person – for those lucky to be diagnosed early; for those less fortunate, a liver transplant may cost upward of a million dollars.
Increased medical costs affect everyone in the form of health insurance premiums and taxes to pay rising public health-care costs. When you look at it this way, $75,000 more in public funding makes a whole lot of sense. Like it or not, we’re all in this together.
It is a prickly subject, indeed. What’s at risk is more than the health and safety of the drug user; it is the health, safety, quality of life and economic vitality of our community. Our communities deserve to be vibrant and whole. We cannot allow drug addiction to capture our people, inflict them with disease, and expose us to live among the epidemic debris of dirty needles and wasted people robbed of hope and purpose. We can and must do better. For those among us who suffer, this is a small price to pay.
Karen Vachon is a Republican representing District 29, part of Scarborough, in the Maine House of Representatives.
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