Gina Morin sits in her room in Lewiston on Thursday. Morin spoke at the Board of Pharmacy hearing Thursday, urging the board to make the opioid overdose drug naloxone available to Mainers of all ages without a prescription. As a grandmother of a 10-year-old, she said she worries about his generation. “They are putting barrier after barrier up for these young people,” Morin said. “I think our children are worth more than politics.” Staff photo by Brianna Soukup
GARDINER – Health professionals and drug treatment advocates urged regulators Thursday to make naloxone available to Mainers under age 21 without a prescription, rejecting a political compromise backed by the LePage administration.
The Maine Board of Pharmacy heard the comments on the same day that the U.S. Surgeon General issued a public health advisory calling on more Americans to carry – and learn how to administer – naloxone so they can quickly respond to a life-threatening overdose.
“It is time to make sure more people have access to this lifesaving medication, because 77 percent of opioid overdose deaths occur outside of a medical setting and more than half occur at home,” U.S. Surgeon General Jerome Adams said in a statement.
Adams’ call for increased access to naloxone – also known as Narcan – stands in stark contrast to Gov. Paul LePage’s steadfast resistance to policies that have been adopted by nearly every other state nationwide. As recently as last week, LePage wrote while vetoing a Narcan-related bill that “making it possible for anyone and everyone to obtain naloxone extends the misuse of opioids and is simply bad public policy.”
On Thursday, Maine’s Board of Pharmacy heard roughly an hour of public comments on proposed rules that would allow pharmacists to dispense naloxone without a prescription to Mainers who use opiates or who come in contact with individuals at risk of overdoses. But in a compromise meant to win LePage’s support, the board proposed limiting prescription-free access to Mainers age 21 and over.
Speakers said that decision was based on politics, not medicine or the on-the-ground reality of Maine’s worsening opioid crisis.
“Drug addiction doesn’t discriminate against age, so why should our overdose prevention policies?” said Gina Morin, 48, a Lewiston mother and grandmother. “Denying a lifesaving overdose antidote to anyone under the age of 21, while our communities are dealing with overdoses at the rate of nearly one a day, is unacceptable.”
Morin’s partner battled opioid addiction about three years ago, and her daughter’s friend died of an overdose five years ago, she said. Now Morin is worried about the next generation – including her 10-year-old grandson – and believes having naloxone readily available means “you can save someone long enough to get them to the hospital.”
“There’s a lot of peer pressure out there,” she said in a subsequent interview. “You know someone is going to say, ‘Just try it, take a bump.’ Kids are starting earlier on this stuff because it’s more accessible now.”
“There is no evidence to support a restriction based on age,” said Kenney Miller, executive director of the Health Equity Alliance, a group that distributes naloxone kits as well as clean syringes to at-risk individuals. “There is no evidence that naloxone dispensation increases the amount of people using drugs.”
Lawmakers, meanwhile, are considering a separate bill that also would lift any age restrictions on pharmacists dispensing naloxone without a prescription.
Thursday’s hearing follows years of inaction on the issue at a time when Maine averaged more than one drug overdose death per day – including 418 deaths last year – largely from opiates.
The majority of overdose deaths occur among people older than 24, according to the Kaiser Family Foundation. In 2016, there were 25 overdose deaths among Mainers 24 or younger, out of a total of 301 overdose deaths that year.
Naloxone quickly reverses the deadly effects of an opiate overdose and has been administered thousands of times in Maine in recent years, largely by emergency responders. Yet Maine is one of the few states in the nation not to allow pharmacists to dispense naloxone without a prescription, although pharmacies and health clinics can obtain a “standing order” from a physician to distribute the antidote.
LePage has been the primary opponent of the practice, arguing in a 2016 veto letter that “naloxone does not truly save lives; it merely extends them until the next overdose.”
It’s been two years since the Legislature passed that bill directing the board to allow pharmacists to dispense naloxone without a prescription and then overrode LePage’s veto. The rules were held up, at first, by what board members said was unclear language that required clarification. Lawmakers then passed a revised bill last June and the board unanimously approved the rules last August. But the rules were never finalized because the board opted – without justification, some argued – to send them to LePage’s office for approval, where they languished for six months.
In a compromise with the LePage administration, the board voted in February to revise the rules to only allow pharmacists to dispense naloxone without a prescription to Mainers age 21 and older.
Maine Board of Pharmacy Chairman Joe Bruno alluded to that compromise after numerous people spoke against the 21-and-over restrictions on Thursday.
“I want you to know that the 21 age limit is there for a reason to at least get these rules in front of us right now to discuss what’s going on,” Bruno said. “None of us, I don’t believe, want to deny naloxone access to anyone.”
But Myles Ouellette, a certified drug and alcohol counselor who has been in recovery for five years, recalled that the first overdose he personally witnessed was of a 15-year-old girl. An overdose survivor himself, Ouellette said while that teen survived, the day has haunted him ever since.
“People overdose at any and every age,” said Ouellette, who works with prison inmates to help them transition to life after jail. “It is inhumane and inconceivable that anyone would want to keep naloxone away from kids who could use it to save their lives. It’s like an EpiPen. It’s preventive maintenance that we don’t want to have to use but it will be there to save someone’s life.”
The Maine Medical Association also urged the board to lift the age restriction. Peter Michaud, associate general counsel with the trade association, said pharmacists should be allowed to use their “clinical judgment” to decide when someone should be able to receive naloxone.
The board is accepting public comment on the proposed rules through April 15. Meanwhile, a separate bill is moving through the Legislature that would allow pharmacists to dispense naloxone without regard to age to drug users, family members or anyone who may come in contract with overdose victims.
That bill, L.D. 1892, is sponsored by House Speaker Sara Gideon, D-Freeport.
Kevin Miller can be contacted at 791-6312 or at:
Twitter: KevinMillerPPH
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