There’s an old proverb that begins, “For want of a nail, the shoe was lost; for want of a shoe, the horse was lost.” It describes a chain of causation that culminates in disaster, from the loss of a man’s life to the fall of a kingdom.

Paul LePage, the Governor of Maine, is responsible for a similar though shorter chain of causation that has and will continue to lead to more deaths: he declines to sign or veto a bill that would make the anti-overdose drug naloxone (brand name Narcan) available without a prescription.

Naloxone is a drug with no possibility of abuse. You cannot get high from it. Its only purpose is to reverse an overdose of an opioid such as heroin by blocking the effects of the opioid. It can bring on instant withdrawal symptoms in addicted individuals, and it’s not a cure for addiction, but by preserving life it makes addiction recovery possible.

The President’s Commission on Combating Drug Addiction and the Opioid Crisis, as well as most drug treatment professionals, think naloxone should be available without a prescription, and so far more than 46 states have agreed. In many states, first responders, including firemen, routinely keep naloxone on hand to administer as needed. Some advocate for naloxone being given out with all opioid prescriptions in case it is needed.

LePage won’t sign the bill because he disapproves of making drug use safer. He feels this will encourage people to abuse opioids if they know they have an antidote on hand if they misjudge a dose, or are given a stronger opioid than they are used to, such as fentanyl (as much as 50 times more powerful than heroin).

He apparently won’t veto it either because he knows or suspects his veto will be overridden, as was an earlier version. (That version didn’t go into effect because the Board of Pharmacy said the language was unclear.) Instead, he has resorted to a pocket veto. If he doesn’t veto it, the legislature can’t override it. If he doesn’t sign it, it can’t go into law. The bill has remained on his desk for more than five months.

This isn’t the way addicts think. They are far more worried about not getting their drug than they are of dying. A first-time drug user can die of an overdose. Addicts in recovery who haven’t used in days or weeks or years can die from a relapse because their body is no longer used to what was once an accustomed dose.

LePage has written, “Naloxone does not truly save lives; it merely extends them until the next overdose. Creating a situation where an addict has a heroin needle in one hand and a shot of naloxone in the other produces a sense of normalcy and security around heroin use that serves only to perpetuate the cycle of addiction.”

Whether LePage truly believes this will save more lives in the long run or merely feels they deserve to die if they abuse drugs is unclear. What is clear is that this is an undemocratic act that lacks compassion for the addicts, their families, and even the first responders. It will cost lives.

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