Pubdate: Mon, 07 Jul 2014
Source: Boston Globe (MA)
Copyright: 2014 Globe Newspaper Company
Contact: http://services.bostonglobe.com/news/opeds/letter.aspx?id=6340
Website: http://bostonglobe.com/
Details: http://www.mapinc.org/media/52
Author: Brian MacQuarrie

PAUL LEPAGE TOES HARD LINE ON DRUG CRISIS

Supports Enforcing Laws Over Treatment Options

LEWISTON, Maine - When Massachusetts' governor invited his New 
England counterparts to a meeting last month on the surge in opioid 
overdoses, the only no-show was Governor Paul LePage of Maine.

Governor Deval Patrick urged reporters after the meeting not to read 
anything into LePage's absence. It's just a scheduling problem, he said.

But LePage's press secretary, Adrienne Bennett, had a different take: 
The governor felt staying in Maine to talk with veterans and release 
crime statistics was "a higher priority than a photo-op with other 
New England governors," Bennett said.

To his critics, LePage's decision to bypass the Waltham, Mass., 
meeting struck them as combative business as usual for a governor 
who, alone in New England, is emphasizing law enforcement over 
treatment as a response to the drug crisis.

While other governors have called for hefty increases in funding for 
treatment, LePage called for $2 million to hire 14 drug agents, four 
judges, and four prosecutors to target a drug trade he said is 
ravaging the state.

"We must hunt down the dealers and get them off the streets," LePage 
said in March when he proposed beefed-up enforcement.

The proposal foundered when LePage, at the 11th hour, would not agree 
with Maine's House of Representatives to scale back the package to 10 
agents, eliminate the judges and prosecutors, and keep $750,000 for 
treatment that had been added in earlier negotiations, said Kathleen 
Newman, the governor's deputy chief of staff.

"They didn't want to give the governor a win," Newman said.

But to many Democrats, the Republican governor's stance proved he is 
a my-way-or-nothing politician, a throwback in the decades-old war on drugs.

It is a persona that might have roots in LePage's own story, Maine 
lawmakers said. One of 18 children from an impoverished home in 
Lewiston, he fled an abusive father at age 11, lived on the streets 
for two years, but eventually attended college and forged a 
successful business career before becoming mayor of Waterville.

That Horatio Alger tale is laudable, some critics say, but they 
suspect it has made it hard for him to see nuances in crime and 
punishment, hard work and hard luck, and the morality and biology of 
drug addiction.

"Overemphasis on enforcement without an equal commitment to treatment 
is just spinning the merry-go-round faster and faster," said state 
Representative Mark Dion, a Democrat who is cochairman of the 
Criminal Justice Committee and a former Cumberland County sheriff.

"Jail doesn't work, I can tell you that, and it's because addiction 
is compulsive," said Dion, who served as deputy police chief in 
Portland for 21 years.

Essdras M Suarez/Globe staff

A session was held in June at Grace Street Services, a 
substance-abuse treatment center in Maine.

LePage's staff said the governor sees treatment as important, but 
that he wants to ensure that funding for these services is spent wisely.

The governor, who declined to be interviewed for this article, 
rejected federal funds to expand Medicaid. The money would have 
extended coverage for substance-abuse services and other health needs 
to an additional 70,000 residents, according to Maine Equal Justice 
Partners, a nonprofit legal-aid provider.

LePage vetoed a good Samaritan bill in 2013 to give legal protection 
to people who call 911 to help overdose victims. And this year he 
refused to sign a bill, which became law anyway, allowing first 
responders and family members to carry Narcan, a drug that reverses 
the effects of opioid overdoses.

"It's an escape," LePage has said of Narcan. "It's an excuse to stay addicted."

According to health workers in Maine, the number of addicts and other 
people who need substance-abuse help is rising sharply. But LePage 
has "a level of unwillingness to help those people for whatever 
reasons," said state Representative Sara Gideon of Freeport, a 
Democrat who sponsored the Narcan bill.

Marty O'Brien, who founded the Grace Street Services recovery center 
in Lewiston, said he is turning away more and more uninsured addicts 
in the city, where 22.8 percent of the population lives below the 
poverty level, compared with 13.3 percent statewide, according to a 
US Census Bureau estimate for 2008-2012. On a recent weekend, O'Brien 
said, seven people he knew had overdosed.

Dr. Michael Kelley, a Lewiston psychiatrist who is chief of 
behavioral health for St. Mary's Health System, said more than 80 
percent of patients in the hospital's detox unit have an opioid 
addiction. When he started work at St. Mary's about 15 years ago, 
Kelley said, the figure was 10 percent.

And in Bangor, Pat Kimball, executive director of Wellspring 
substance-abuse services, said she has a waiting list of 80 people, 
many of them uninsured, for 28 beds.

"I've never had to fight so hard for people to get well, and I've 
also never had to fight so hard for the money to support it," Kimball 
said. "You have an administration that wants to go back to the old 
war on drugs."

Essdras M Suarez/Globe staff

Marty O'Brien, who founded the Grace Street Services recovery center 
in Lewiston.

 From 1986 to 2010, drug arrests increased 238 percent in Maine and 
accounted for 10.9 percent of all arrests in 2010, according to a 
study issued last year by the Muskie School of Public Service at the 
University of Southern Maine. Only Connecticut, at 13.3 percent, had 
a higher proportion of drug arrests in New England that year.

After LePage took office in 2011, total spending in Maine on 
substance abuse treatment, excluding federal funds for Medicaid, fell 
to $19.95 million in fiscal 2013 from $20.16 million the previous 
year, according to state data. In that time, health care admissions 
for opioid abuse rose to 8,783, from 8,591.

"Our resources don't match the level of the problem," acknowledged 
Guy Cousins, director of the state Office of Substance Abuse and 
Mental Health Services.

Cousins said all parts of the response - law enforcement, treatment, 
the courts, and others - need to be connected and coordinated to make 
headway against opioid abuse.

LePage's staff said he is not opposed to investing in treatment. 
State officials have met with treatment providers "to talk about 
success rates and how the state can support programs which are proven 
to provide successful outcomes and opportunities for Mainers with 
addiction," said Bennett, LePage's press secretary.

"It is simply not enough to throw money at drug addiction without 
examining if the programs are effective," she said.

The state also has shown significant progress in reducing the 
prescription of opioids, Bennett said. In 2013, the 76.9 million 
pills prescribed in Maine in 2013 were 4.8 million fewer than in the 
previous year, she said.

Even LePage's critics agree that enforcement must be part of the 
plan. But symbolism is also important, they said, which is why they 
wish he had traveled to Brandeis University to meet his fellow governors.

"We have this opportunity for a fresh look, a new approach, and our 
governor refuses to participate," said Alison Beyea, executive 
director of the American Civil Liberties Union of Maine.

"He's up here railing in the newspaper that he's trying to get 
something done and that no one will cooperate with him," said state 
Representative Drew Gattine, a Westbrook Democrat who sits on the 
Health and Human Services Committee. "So, not only does he not go, 
but he sort of talks about it in a negative way, and unfortunately 
that's kind of our governor's style."

To LePage's staff, however, that is so much empty bluster.

The suggestions that emerged from the Massachusetts meeting "about 
sharing data and working together could have been accomplished in a 
15-minute conference call," Bennett said. "The governor chose to stay 
in Maine and work on the issues."
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MAP posted-by: Jay Bergstrom