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.
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.”
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.”
Brian MacQuarrie can be reached at firstname.lastname@example.org.