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Maine House OKs greater access to overdose antidote; LePage vows veto


Overview

Originally Published: 04/14/2014

Post Date: 04/14/2014

by Steve Mistler


Summary/Abstract

The journey of a thousand miles begins with a single step. Maine's House of Representatives passed the Naloxone Bill 147 - 0 today and it now moves on to the Senate. Although, hampered with restrictions not found in other states that have passed Naloxone bills, it is a first step.

Content

The governor says the Legislature is playing politics by poisoning a deal he made with the bill’s sponsor.

 

AUGUSTA –– The House of Representatives on Monday gave preliminary and unanimous approval to a bill that would give some family members of opiate addicts greater access to naloxone, a drug that reverses the effects of an overdose.

Gv. Paul LePage said he planned to veto the bill because it included a provision that allowed trained law enforcement officers to administer naloxone. The governor said in a statement that the provision was not part of an agreement he struck last week with the bill’s sponsor, Rep. Sara Gideon, D-Freeport, and Rep. Barry Hobbins, D-Saco, who met with LePage last week to urge him to support the bill.

The Senate has not yet taken up the bill, but given the unanimous vote in the House, lawmakers appear likely to override LePage’s veto.

The bill is far more restrictive than recent laws enacted in other states, which have granted broader access to naloxone, also known as Narcan, to combat increased deaths from overdoses of heroin and other opiates.

The amended bill had been an attempt to strike a compromise between Gideon and the LePage administration. Shortly after the House voted 147-0 to approve the bill, Gideon said she believed the amended proposal didn’t go far enough, but would still help prevent deaths by overdose by allowing first-responders such as police officers, firefighters and basic emergency medical technicians to carry and dispense the overdose antidote naloxone. Currently, only paramedics may administer naloxone. Advanced emergency medical technicians can, but only with approval from a hospital.

While Gideon’s original proposal would have greatly expanded and decriminalized the possession and administering of naloxone by family members and homeless shelters, she said Gov. Paul LePage preferred a narrow proposal.

The governor’s willingness to compromise on the proposal followed the recent airing of a report on “NBC Nightly News” that documented the national heroin epidemic and the expanded use of naloxone. During that report, LePage explained his opposition to broadening the use of naloxone, saying during a news conference held last month, “It’s an escape. It’s an excuse to stay addicted.”

The governor’s position had softened during the negotiations, especially after his meeting with Hobbins. However, on Monday, he said the Legislature “decided to play political games with people’s lives” by further amending the bill.

“Our compromise bill allows family members to carry naloxone, but not police, which was acceptable to Rep. Hobbins and Rep. Sara Gideon, the bill’s Democratic sponsor,” LePage said in a statement. “Despite their agreement with me, the Legislature has put up a version of the bill they know full well will be shot down. We are trying to provide this life-saving measure to families, but lawmakers are trying to score political points.”

Adrienne Bennett, the governor’s spokeswoman, said that some law enforcement officials had expressed liability concerns about using naloxone to the governor, which was the reason for his objection.

Gideon said Monday that the governor and his administration “never fully articulated” their objection to police administering naloxone.

Many Maine law enforcement officials supported the original proposal, including the Maine Sheriffs Association. The Department of Public Safety, which falls under the control of the LePage administration, testified against it.

Monday’s unanimous vote would appear to bode well for an override of the governor’s veto, assuming Republicans maintain their current support. The law enforcement provision was also backed by the Republican members of the Legislature’s Criminal Justice and Public Safety Committee.

Bennett acknowledged the Republican support for the law enforcement provision, but that didn’t change the governor’s position.

“There are issues that the governor and Republicans agree upon, but he (LePage) has made his position on this clear,” Bennett said.

Gideon said Monday that the compromise proposal would make a difference in reducing deaths from overdoses. There were 163 Maine overdose deaths in 2013.

During her floor speech Monday, Gideon said opioid addiction and overdose knew neither class, nor occupation.

“These people are dying and we can help them,” she said.

The drug is given as a nasal spray that goes directly to the brain, where it binds to opioid receptors to stop the effects of an opiate, such as heroin. Overdose victims have between one and three hours to receive naloxone to reverse the effects of the opiate. Given that window, supporters for expanded use of naloxone argued that first responders and family members are in the best position to save lives.

According to the U.S. Centers for Disease Control and Prevention, 105 people die as a result of drug overdose, and another 6,748 are treated in emergency departments for the misuse or abuse of drugs every day.

The amended proposal approved Monday would allow licensed health care providers to prescribe naloxone to family members of opiate addicts under specific conditions. A key provision requires the addict to have an established patient relationship with a health care provider.

Gideon acknowledged that the provision assumes that addicts have been upfront with their doctor about their drug use and that they’re seeing a doctor at all. However, she said the proposal would still “help people” and was probably the best outcome given the governor’s philosophical opposition to naloxone.

LePage last year vetoed a similar bill. In his veto message, he said the anti-overdose drug would “make it easier for those with substance abuse problems to push themselves to the edge, or beyond. It provides a false sense of security that abusers are somehow safe from overdose if they have a prescription nearby.”

If the measure becomes law, Maine will join 21 other states and the District of Columbia in legislating access to naloxone. Seventeen of those states and the District of Columbia allow the drug to be distributed to the public. The expanded use of naloxone has resulted in more than 10,000 overdose reversals since 2001, according to the U.S. Department of Justice.

The expanded use of naloxone comes amid a sharp increase in heroin overdoses in Maine and nationally. According to the Office of the Attorney General, heroin deaths in Maine quadrupled between 2011 and 2012, from seven deaths to 28. The trend is mirrored nationally. There was a 45 percent increase in heroin overdose deaths between 2006 and 2010, according to the U.S. Department of Justice.

The increase in heroin overdoses follows increased heroin use nationally.

Attorney General Eric Holder last month urged first responders to carry naloxone to combat the increase in heroin overdoses. He said that expanded naloxone use, as well as “Good Samaritan” laws that grant immunity from criminal prosecution to those seeking medical help for someone experiencing an overdose, can save lives.

Steve Mistler can be contacted at 791-6345 or at:[email protected]Twitter: @stevemistler

 

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