AUGUSTA, Maine - The Maine Department of Corrections is expanding its program for medication-assisted treatment of opioid addiction to any person in jail or prison who medically qualifies.

In 2019, the department launched a pilot program with 100 participants, and has been slowly phasing it into more facilities. Research has shown that medication-assisted treatment can reduce cravings, which allows people to engage in counseling and treatment more effectively.

Corrections Commissioner Randall Liberty said they expect to treat up to 600 people once the program is fully implemented.

"Substance-use disorder is a disease," he said, "and the gold standard - to treat that and really provide the best care we can for the citizens of the state of Maine - is to provide medication-assisted treatment, and that means on the outside and on the inside."

More Mainers died of overdoses in January than in any month last year. Advocates of the program have called it a step in the right direction, but emphasized the need to get people into treatment rather than into jail or prison in the first place. Oregon recently became the first U.S. state to decriminalize possession of small amounts of illegal drugs; it's now a civil violation, with a fine and court-ordered therapy.

People who've returned to their communities after being incarcerated are far more likely to die of an opioid overdose than the general population. Liberty noted that the harm caused by addiction can be multigenerational, as whole families often are affected. He said those are some of the factors that have pushed the treatment program forward.

"Those individuals that have been in our care during the pilot phase of our program have had reduced cravings, reducing anxiety, increased interest in recovery," he said.

Liberty said rolling out the program also marks a culture shift in corrections because of misconceptions about using medication in recovery. However, he added, continuing discussions and education with staff and partners have made him optimistic about the program's future.


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Death rates in Maine have been on the rise among people who use drugs, not only from overdoses but also complications due to injection drug use.

Currently in Maine, syringe-service programs will only give someone the number of syringes that are being recovered, but advocates have noted this can be limiting, especially in a state as rural as Maine.

When people don't have an adequate amount of safe-use supplies, said June Evergreen, who is in recovery and runs the syringe-service program at the Maine Health Equity Alliance, they're more likely to reuse or share syringes.

"Some folks need a higher amount of supply due to lack of regular transportation and/or because of employment, and not having regular ability to access brick-and-mortar syringe exchange," she said. "Participants need a higher amount to help redistribute and share amongst the substance-use social networks. These are just a few examples."

A bill in the Legislature would end the "one-for-one" rule.

Evergreen said providing as many syringes as an individual's personal experience dictates does not result in more syringe litter, especially when they also provide disposal.

Dr. Kinna Thakarar, an infectious disease and addiction specialist with the Northern New England Society of Addiction Medicine and the Maine Medical Association, said she treats many patients with complications from injection drug use. This may include HIV, hepatitis, skin and soft tissue infections, or endocarditis, which is a heart infection.

"Maine has one of the highest rates of acute Hepatitis B, also one of the highest rates of 'Hep C' - I see many of these patients in clinic," she said. "And while we enjoy treating infections, it'd be much easier to prevent the infections; and we know that they're easily preventable through less restrictive syringe-service program policies."

A public hearing is scheduled for the bill next Tuesday. In 2021, Maine saw more than 600 overdose deaths, 77% due to fentanyl. Advocates have said it's important to also provide fentanyl test kits as part of safe-use supplies.

A bill before the Maine Legislature would expand the state's Good Samaritan law, which protects people seeking help for an overdose from arrest or prosecution.

Currently, the law protects the person who is experiencing the overdose and the person seeking medical assistance for them.

Courtney Allen, policy director for the Maine Recovery Advocacy Project, said it does not protect everybody at the scene, and does not protect people for things such as bail or probation violations. She explained the expanded bill would fill those gaps.

"This law is too weak to protect most of my community members, and drug-using communities are very well aware of it," Allen asserted. "We must pass a Good Samaritan Law that is clear and concise and able to be executed out to drug-using communities that they understand and that they trust."

The bill's sponsors note being arrested or convicted for drug-related offenses can have major impacts on people's ability to get housing, employment or student loans.

Sherri Talbot, a substance-abuse counselor and Narcan trainer, said it is important to call 911 when an overdose occurs, even if Narcan, a treatment for opioid overdoses, has been administered.

She said opioids can last longer than Narcan, and there may be other substances involved.

"The number of cases where people aren't calling 911 is absolutely overwhelming in the area I work," Talbot pointed out. "We hear about very few overdoses except for the ones where people don't make it. It is so vital, I cannot stress enough, it is vital that people feel safe to call, because right now they don't."

Forty-seven states plus Washington D.C. have a Good Samaritan Law, and nationwide, the Government Accountability Office found those states see lower opioid-related overdose deaths, and when people know about the law, they are more likely to call 911.

The Centers for Disease Control and Prevention has announced another staggering new death count amid the pandemic: more than 100,000 fatal drug overdoses from April 2020 to 2021.

Groups working to curb such preventable deaths in Brooklyn are also pushing for solutions statewide. The group Voices Of Community Activists and Leaders (VOCAL NY), distributes clean needles, fentanyl test strips and Narcan, which can reverse an overdose.

Darryl Roberson, senior peer in the group Voices Of Community Activists and Leaders, works on the ground with participants.

"Overdoses are common, but we've saved a lot of lives," Roberson explained. "I see down the road, that we can defeat it; we have to still have a lot of support."

VOCAL NY is among 240 organizations across the nation now calling for passage of federal legislation which could help prevent opioid deaths in every neighborhood. In a letter sent to Congress, they have called for swift passage of the federal STOP Fentanyl Act, which improves surveillance and detection of the potent drug.

New York City's Health Department reports fentanyl is the most common substance found in all overdose deaths.

Melissa Moore, director of civil systems reform for the Drug Policy Alliance, said its presence in so many illicit drug batches is a further reason for what she calls a "people-first" approach to addiction.

"We need a lot more shifting away from criminalization, and from tactics from the failed drug war that have really been ineffective," Moore asserted. "And a move to person-centered, health-centered policies."

In the meantime, New York City has taken drastic action to prevent overdoses by opening the nation's first publicly recognized safe consumption sites in Upper Manhattan.

The move has been controversial. At the Overdose Prevention Centers, people can use drugs, receive medical care and have their supply inspected for fentanyl.

Research has shown the centers to effectively prevent lethal overdoses for decades in other countries. Moore believes the need is clear in all five boroughs.

"Because we know that's going to be the thing that will actually save lives, in this moment," Moore contended.

Any New Yorker seeking help with an addiction, for themselves or a loved one, can call 877-8-HOPE-NY.