Illicit Opioid and Methamphetamine Trends in Maine Marcella H. Sorg, PhD Margaret Chase Smith Policy Center University of Maine Objectives Provide an overview of the illicit opioid crisis in Maine, focusing on heroin and non-pharmaceutical fentanyl Provide a brief update of methamphetamine abuse indicators in Maine Maine Context Very rural state with 1.3 million population and low population density; 95% white; oldest median age in nation 1
3 Total Overdoses due to Pharmaceutical Opioids, Illicit Drugs, and Total Drug Deaths, Alone or in Combination 25 2 Total Deaths 15 Pharmaceutical Opioids 1 5 Illicit Drugs 1997 1998 1999 2 21 22 23 24 25 26 27 28 29 21 211 212 213 214 215 Data Source: Maine Office of Chief Medical Examiner 2 18 16 14 12 1 8 6 4 2 Total Overdoses Due to Heroin/Morphine & Non-Pharmaceutical Fentanyl All drug deaths Heroin Fentanyl 21 21 211 211 212 212 213 213 214 214 215 215 216 1st 2nd 1st 2nd 1st 2nd 1st 2nd 1st 2nd 1st 2nd 1st Data Source: Maine Office of Chief Medical Examiner 2
12 Heroin and Non-Pharmaceutical Fentanyl Deaths 1 8 6 4 2 21 21 211 211 212 212 213 213 214 214 215 215 216 1st 2nd 1st 2nd 1st 2nd 1st 2nd 1st 2nd 1st 2nd 1st Heroin Only Fentanyl Only Both Heroin and Fentanyl Data Source: Maine Office of Chief Medical Examiner Co-intoxicant combinations among drug deaths, 216 Heroin deaths 23% with pharmaceutical opioid 46% with fentanyl or fentanyl analog 25% with cocaine Fentanyl & fentanyl analog deaths with pharmaceutical opioid 26% with heroin 14% with cocaine 3
Profiling 17 heroin deaths in Maine, 215 88 (82%) had known prescription status Of the 88: 17% had Rx for pharmaceutical opioid within previous month 6 had Rx for pharmaceutical opioid within previous year 1 had a history of substance abuse 38% had a history of heroin abuse Percent male among decedents, 215-216 1H 55% male in pharmaceutical opioid deaths 74% male in heroin deaths 8 male in non-pharmaceutical fentanyl deaths 4
5 4 Decedent Mean Age By Sex and Opioid Category 215-216 1H 46.33 44.17 38.14 39.4 36.19 37.68 3 2 1 Pharmaceutical Opioids Heroin/Morphine Illicit Fentanyl Males Females Data Source: Maine Office of Chief Medical Examiner 45% 35% 3 25% 15% 5% Decedent Age Distribution By Opioid Category, Sexes Combined, 215-216 1H Fentanyl Heroin Pharm. Opioids -19 2-29 3-39 4-49 5-59 6-69 7-79 8-89 Pharmaceutical Opioids Heroin/Morphine Illicit Fentanyl and Analogs Data Source: Maine Office of Chief Medical Examiner 5
7 Impaired Driver Toxicology 6 5 3 Cocaine Heroin/Morphine Pharm Opioid 21 211 212 213 214 215 DATA SOURCE: Maine Health & Environmental Testing Lab Percent Primary Treatment Admissions for Pharmaceutical Opiates and Heroin, 21-215 3 21 211 212 213 214 215 Heroin/Morphine Pharm Opiates DATA SOURCE: Maine Dept. of Health & Human Services, WITS database 6
45% 35% 3 25% 15% 5% Age Distribution Among Primary Treatment Admissions for Pharmaceutical Opioids and Heroin, 215-19 2-29 3-39 4-49 5-59 6+ Heroin/Morphine Pharmaceutical Opioids DATA SOURCE: Maine Dept. of Health & Human Services, WITS database 45% 35% 3 25% 15% 5% Percent of Law Enforcement Seizure Items By Key Drug Category 21 211 212 213 214 215 Heroin/Morphine Illicit Fentanyl Pharmaceutical Opioids DATA SOURCE: Maine Health & Environmental Testing Lab 7
FENTANYL ANALOGS DEATHS SEIZURES Acetyl fentanyl 214-215 -33 216-18 Furanyl fentanyl 214-215 - 216-7 Desproprionylfentanyl 214-215 - 216-5 Fluorofentanyl 214-215 - 216-1 214-2 215-43 N/A N/A N/A Note : Deaths in 216: 2 cases U-477, a designer opioid METHAMPHETAMINE TRENDS 8
8 7 6 5 4 3 2 1 Number of Primary Methamphetamine Admissions, 21-215 21 211 212 213 214 215 DATA SOURCE: Maine Dept. of Health & Human Services, WITS database 6 5 Route of Administration for Primary Methamphetamine Admissions Smoking, 53% 3 214 215 Inhalation, 19% Injection, 17% Oral, 9% Missing, 2% 9
Number of Meth Lab Incident Responses by Maine Drug Enforcement Agency 12 1 12 8 6 4 2 216 25 26 27 28 29 21 211 212 213 214 215 3rd QTR Lab incidents 5 4 1 4 1 6 5 12 2 28 56 12 DATA SOURCE: Maine Drug Enforcement Agency In summary: Indicators for heroin & fentanyl have risen dramatically in Maine. In 215 heroin was responsible for 39% of deaths, found in 26% of impaired driver toxicology tests, implicated in 39% of MDEA arrests, 42% of law enforcement seizures, and 26% of primary admissions. Fentanyl & its analogs constituted 32% of deaths and was found in11% of law enforcement seizure items, the largest of any NDEWS sentinel site. Methamphetamine small labs have increased dramatically in the last two years, along with an upsurge in smoking as a route of administration among primary treatment admissions. Other indicators are low. 1