City leaders and substance use professionals discuss steps the city could take to combat the opioid use epidemic at a meeting last week at Casco Bay High School. Michael Kelley / The Forecaster

PORTLAND — Portland elected officials, school staff and health care experts began drafting a plan last week to prevent opioid misuse and overdose deaths in the city.

The conversation comes on the heels of a particularly notable January for Portland in terms of drug overdoses. There have been 14 drug overdoses in the city so far this year, five of which were fatal. The Maine Center for Disease Control on Feb. 1 announced a spike in overdoses in southern Maine, including at least 10 in one day, because of tainted drugs on the streets.

According to the 2018 Maine Drug Death Report, 34 of the 44 overdose deaths in Portland were from opioids. The 2019 figures are not available yet, but the number of fatalities is expected to have increased.

Portland City Councilor Nick Mavodones weighs in on what he thinks the gaps are in the city’s response to opioid misuse in Portland. Michael Kelley / The Forecaster

“Addiction and opioid use is a community problem that is going to take a community response,” said Liz Blackwell-Moore, a consultant with Birch Lane Strategies, hired by Greater Portland of Governments to facilitate the Jan. 30 discussion and help the city develop its response plan.

Attendees said the city should put more of a focus on early prevention and intervention, increase the number of recovery residences in the city and develop a policy for how naloxone, or Narcan as it is commonly known, is administered to reverse overdoses on city property.

Blackwell-Moore said a committee, made up of school and city officials, will use that feedback, see what resources are available and come up with a plan.

The major risk factors for misusing opioids, she said, are family history of addiction, mental illness, early substance use, adverse childhood experiences and access to opioids.

“We know that early experiences and early trauma can impact later health outcomes,” said Blackwell-Moore, who has 20 years of experience in substance use and chronic disease prevention.

Portland Police Chief Frank Clark said his department is trying to keep the drugs off the streets by targeting traffickers and having its substance use and mental health liaisons build connections with the community. He said this spring Portland will become a DEA360 Community, a federal program that takes the three-pronged approach of law enforcement, diversion and community outreach to respond to the opioid crisis.

Police Chief Frank Clark, center, talks about what his department is doing to respond to the opioid crisis. At left is Chris Reiger, and right, Bridget Rauscher. Michael Kelley / The Forecaster

Portland police officers are all trained in Narcan distribution and work closely with Trauma Intervention Program volunteers, who help victims deal with trauma at scenes of accidents or other emergencies, Clark said. The department has also produced a map of where the overdoses are happening to help officers figure out how to best respond to the issue.

“Putting people in jail is not the answer. We are not going to arrest our way out of this,” he said.

Janet Dosseva, a community health promotion specialist for the city, said Portland officials need to continue to support education efforts to students and parents, work to eliminate misinformation about drug use, particularly around marijuana, and offer a more restorative approach for young people caught using.

“Having a youth focus is important in the preventive efforts,” she said.

Melissa McStay, a social worker at Deering High School, said students are not getting enough substance use treatment education, especially at the middle school. Staff members need to be better trained in childhood trauma, brain development and de-escalation practices, she said.

Zoe Brokos, Portland substance use prevention and needle exchange program coordinator, said harm reduction, a philosophy that aims to reduce the negative consequences of drug use by offering education, needle exchanges, naloxone distribution, overdose prevention sites and disease testing, is a critical element in the city’s response.

“Our goal is to be that one place where they won’t feel shame, so we can build solutions,” she said.

Brokos said she would like to see the city adopt a policy as to how naloxone should be distributed at city-owned buildings and an increase in recovery residences for drug users, two things other attendees echoed.

Bridget Rauscher, manager of the city’s chronic disease prevention program, said in 2018, 190 overdoses were reversed through administration of naloxone, a drug designed to combat the effects of opioid overdoses.

The city’s Substance Use Prevention and Harm Reduction Services program will begin offering free training on overdose recognition, response and naloxone distribution at 4:30 p.m. Wednesday, Feb. 5. The weekly series, put on through help of the Maine Center for Disease Control, will be held at the India Street Public Health Center at 103 India St.