AUGUSTA, Maine — After finding the deadly opioid fentanyl during a boat inspection, Maine’s maritime police agency was working in June 2018 on guidelines allowing officers to carry a life-saving overdose reversal drug.
Marine Patrol command staff asked the Maine State Police for a policy it implemented the previous year. Before they were done retrofitting those rules, Marine Resources Commissioner Patrick Keliher ran the idea by then-Gov. Paul LePage, who vetoed a 2016 bill expanding access to naloxone with a letter saying it “does not save lives” but “merely extends them until the next overdose.”
An adviser relayed the idea to LePage, putting a piece of paper before him with options allowing him to accept the proposal, deny it or say he wanted to talk to Keliher. He chose the second.
“If Narcan was a one and done I would likely go along,” LePage wrote by hand. “But it is fake security for drug addicts.”
That rhetoric, contained in files housed at the Maine State Archives, mirrored what he had said publicly about naloxone, marketed under the brand name Narcan. It remains a clear example of state policy on the drug turning sharply on his whims.
LePage went on to write that “fentanyl does not react with Narcan the way heroin does.” It reverses overdoses on both drugs, while someone overdosing on stronger fentanyl may need more doses, the U.S. Centers for Disease Control and Prevention says.
Marine Patrol officers did not carry Narcan until May 2019, after Gov. Janet Mills took office and police were trained, a department spokesperson said. There is no record of the agency responding to an overdose between June 2018 and when the policy was implemented. The department did not respond to a question on encounters since then.
But state-supplied Narcan has reversed nearly 4,300 overdoses from mid-2019 through May, the University of Maine’s Margaret Chase Smith Policy Center says. Roughly 93 percent of Maine’s 8,000 overdoses in 2021 were not fatal, something the center attributes largely to Narcan distribution. Law enforcement officers helped save 327 overdose victims last year.
The former governor is running against Mills, a Democrat, in a November race also featuring independent Sam Hunkler. LePage’s campaign did not answer questions about the 2018 decision, including on whether the former governor’s feelings have changed on Narcan.
Adviser John McGough instead issued a lengthy statement blaming Mills and President Joe Biden for the worsening opioid crisis and saying the governor is “floating opposition research” to the press. (The Bangor Daily News found these files during an independent review last week and was not tipped to them.)
“Janet Mills has been an absolute disaster for people suffering from substance use disorder,” he said.
LePage’s 2018 note “made my heart stop because pretty much everything that he is saying in this note is fundamentally untrue,” said Courtney Gary-Allen, the organizing director for Maine Recovery Advocacy Project, a group that works on treatment access.
“I couldn’t imagine a Maine on the front lines of the opiate crisis without the access to naloxone that we have today,” Allen said.
The crisis morphed and escalated nationally during the LePage era. When he took office in 2011, prescription drugs dominated overdose deaths, but illicit ones like heroin and fentanyl overtook them as the state saw four straight years of rising deaths through 2017.
There were dips in 2018 and 2019, but things have worsened both here and nationally toward the end of Mills’ first term. Overdose deaths topped 600 here for the first time last year and the state sat 9 percent above the 2021 total through the first half of 2022. Maine had the ninth-highest death rate of all states in 2020.
The rise is generally attributed to deadly combinations of opiates and stimulants including cocaine. Fentanyl seizures have risen this year to record levels at the southern border. McGough asked rhetorically when Mills would decry “death and destruction at our southern border” and echoed LePage’s recent criticism of her administration for scrapping a prison detox plan of his.
LePage was skeptical of Narcan going back to 2014. After raising concerns about an earlier version, he allowed a measure letting trained first responders administer it to pass. After he made headlines with his comments on the 2016 bill, the Legislature easily overrode his veto.
In 2017, he proposed a bill to require those revived by Narcan more than once to pay for it. Early the next year, pharmacy regulators approved rules raising the age limit to buy the drug from 18 to 21 after LePage said he would not sign off on them without changes. His administration slow-walked rulemaking on another Narcan bill passed in 2015.
LePage’s hostility to Narcan stands out on the national level. In 2019, the administration of former President Donald Trump, a Republican, took credit for expanding supply and noted a large bump in prescriptions after the surgeon general recommended more Americans carry it.
As attorney general in 2016, Mills started a Narcan distribution program. In the Blaine House, she hired the state’s first point person on the opioid crisis and rolled out a plan to fight it in the first two months of her tenure. The governor has not always shared advocates’ approach. In April, she threatened to veto a Good Samaritan bill before inking a compromise deal.
Allen, who was part of those negotiations, called Mills an ally despite some differences.
“I hope that Gov. LePage — if he does become governor — has grown in the ways that he says that he has grown and that we can meet him at the table and continue to save lives,” she said. “I just don’t know if that’s true yet.”