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Evie Clement is a communication and psychology student at the University of Maine where she is studying the impact of language and stigma in relation to drug use and treatment as a drug policy research fellow. These views are hers and not those of the fellowship or institution.
We know there is a problem with substance use disorder in Maine. Approximately 88,000 Mainers were addicted to a substance in 2016. Opioid use disorder is especially relevant in Maine, where opioid-related deaths are rising at alarming rates. Over the last half of 2019, overdose deaths in Maine increased by 27 percent over the same time period in the previous year. In 2020 alone, over 500 people in our state died from overdoses.
People are suffering and people are dying. LD 967, a bill proposing to restructure drug sentencing laws in Maine, offers a hopeful solution to support rather than punish these people in our community.
The current “solution” to addiction and overdose is criminalization, but this solution fails to address the root of the problem: stigma. Stigma, especially about people who use drugs, underpins substance use disorder, perpetuating stereotypes and misconceptions about nearly every aspect of drug use. Although substance use disorder is a medical condition with complex contributing factors, it is often misunderstood as a moral failure. Viewing substance use disorder as a result of insufficient willpower ignores and discredits factors such as traumatic histories, mental health and physical and chemical brain changes that likely contribute to addiction.
This stigma runs deep. As Maine Commissioner of Corrections Randall Liberty notes, the gold standard is to treat addiction with medicine, known as medication-assisted treatment or MAT. MAT helps a person avoid withdrawal symptoms, allowing them to participate in other forms of recovery.
But research shows doctors certified to prescribe these medicines are often hesitant to do so. These doctors face a limit on the number of patients (often 30) they can treat with medication-assisted treatment. Unfortunately, only 44 percent to 66 percent of providers are meeting these limits. Among other factors, stigma about people who use drugs remains a barrier to providing treatment to those who need it.
Stigmatizing beliefs and policies can also make people less likely to seek treatment and contribute to a general dehumanization of people with a substance use disorder. A punitive approach fails to address these issues of stigma and access to treatment. A drug-related felony exacerbates them.
To directly address the pitfalls of the punitive approach, LD 967 would make possession of small amounts of drugs a civil rather than a criminal violation, and create opportunities for people to get connected to treatment. Considerable evidence suggests such human-centered initiatives work.
Portugal provides a promising example, showing a decrease in overdose deaths, HIV infections, problematic drug use, and incarceration for drug-related offenses, along with an increase in voluntary enrollment in treatment. Johann Hari, author of “Chasing the Scream,” praises Switzerland and Portugal’s success in beating their opioid crisis, noting in the book: “They didn’t do it by demonizing the drug, or the addicted person. They did it by dealing with the reasons people wanted the drug in the first place.”
Imagine if Maine’s drug policy recognized underlying contributing factors to substance use disorder and provided support to address those factors rather than villainizing and blaming individuals.
When holding stigmatizing beliefs, we fail to see those with substance use disorder as fully human. How are we expected to support them if we do not actually value them or their lives? A shift in perspective from punishment to health, as seen with LD 967, is needed to combat stigmatizing beliefs, promote well-being, and give hope to those for whom it has been denied for so long.
It is time to recognize the humanity of our friends, family, and fellow Mainers in the grips of addiction. It is time to stop punishing and to start helping people.
As citizens, I urge you to support this bill; it is one step in the right direction toward treating all Mainers, including people who use drugs, with compassion and dignity.