Opioid Crisis: Understanding the problem and creating solutions

The panelist of experts on the opioid crisis. Pictured From left to right: Penobscot County Sheriff Troy Morton; Sen. Andre Cushing, (R) Newport; Patty Hamilton, Bangor Public Health Director; Sen. Geoff Gratwick (D) Bangor; Tripp Gardner, MD, PCHC

BANGOR (February 28, 2018) State Senator Andre Cushing (R) Newport spoke into a microphone and asked the question, “How many of you have a family member or a friend who has been affected by opioids?” Several hands went up. Cushing was one of five panelists discussing the opioid epidemic at the Bangor Region Chamber of Commerce Early Bird Breakfast at Season’s Restaurant. The tables were filled, and there were even some people standing in the back.

Cushing was joined by one of his colleagues in the legislature, Senator Geoff Gratwick (D) Bangor, who is also a retired physician. Both men served on the states opioid task force which, in December, released a comprehensive report to tackle the opioid epidemic with a three-pronged approach that includes enforcement, treatment, and prevention. Gratwick, however, expressed his concerns that the legislature and the governor won’t implement the task force recommendations. He shared a handout showing 19 legislative bills, most of which, he said were still in some state of legislative limbo. “Is this another document that gathers dust?” Gratwick asked, “One person dies from a drug overdose every 21 hours in the state.”

Gratwick was followed in the panel discussion by Tripp Gardner, MD, a psychiatrist, and medical director at Penobscot Community Health Care (PCHC). He discussed the biology of addiction, explaining how opioids release dopamine in our brain, which is a chemical that stimulates our pleasure centers. He said that opioids release five times more dopamine than when we eat food and three to four times more dopamine than is released during sex. He stressed that opioid use disorder is a medical condition that people need to be treated for like any other medical condition. “The car is driving, the accelerator is down, the brakes aren’t working, and you can’t turn off the road, that’s why you need help. That’s why we need to help you,” he said.

Penobscot County Sheriff Troy Morton understands all too well how serious this epidemic has become. As one of the panelists, he discussed the impact of the opioid epidemic from a law enforcement perspective. “As a sheriff, I run the largest mental health facility and the largest detox facility, and now I run the third largest hospital in the county,” he said, referring to the increased amount of time his officers spend dealing with drug overdoses. He says his officers are trained to use the lifesaving medicine Narcan and Naloxone. Just last week, he said one of his deputies administered Narcan to a person who had overdosed in the town of Eddington. The sheriff said people need to understand that putting people in jail will not help them stay sober. “The idea that if we lock them up long enough they’ll stop doing it, that’s not going to stop it,” he said.

Patty Hamilton, Public Health Director for the city of Bangor, agreed with the sheriff and the other panel members that there needs to be a multi-faceted approach to address the epidemic. She wrapped up the panel discussion by listing out all the work that the Community Health Leadership Board (CHLB) has done in the past three years to address the issue. CHLB is a partnership of area hospitals, health-care providers and the city of Bangor that seeks to reduce stigma and increase understanding of substance use prevention, treatment, and recovery. “Healthcare organizations that have normally competed with each other have come together and put a plan in place,” she said.

CHLB has worked to help secure grants to fund a substance abuse caseworker at the Bangor Police Department, open up the Wellspring Social Detox facility, reinstate the drug court, and open up a rapid access clinic. It has also launched the Circle of Caring campaign to raise awareness and provide free overdose reversal medication to those in need. Other new programs include Health Equity Alliance’s LEAD (Law enforcement assisted diversion) program and the Bangor Area Recovery Network (BARN) peer recovery coaching program.

Hamilton closed by reminding audience members that this is a community responsibility and that more can be done. She urged business members in the audience to look at their own health insurance plans to see if they offer behavioral health and employee assistance programs and to educate their employees about those programs. “We also need to erase the stigma and reinforce that this is a medical condition and not a moral failing,” she said.

If you or someone you know is dealing with substance use disorder, call 2-1-1 to get connected to resources or visit 2-1-1Maine.org