Focus Area 2023-2025: Infrastructure

The Focus Area 2023-2025: Infrastructure dashboard contains information and metrics regarding Priority A of the Maine Opioid Response 2023-2025 Strategic Action Plan which is to build a statewide infrastructure to support evidence-based and community focused actions in response to Maine’s opioid crisis. Metrics include the following:

• Increases in the capacity for the State to respond to the opioid crisis.
• The growth of keystone State initiatives
• Surveillance data regarding fatal overdoses and other actionable data that the State is using to respond to the overdose crisis that are not listed in the other five Focus Areas (Pubic Safety, Prevention, Harm Reduction, Treatment, and Recovery).

At the end of each metric and in the informational narratives below there are references to the Strategy or Sub-Strategy from the Maine Opioid Response 2023-2025 Strategic Action Plan that is being addressed or measured.

Substance misuse and substance use disorder remain a top priority for the State of Maine

The State is dedicated to provide strong leadership and coordination among prevention, public safety, harm reduction, treatment, and recovery strategies. The State also is working to improve internal systems, coordinate spending plans, enhance high-quality treatment, advance program efficacy and evaluation, and assess the Opioid Response 2023-2025 Strategic Action Plan.

This include leadership and direction from the following State-based groups and individuals:

• Director of Opioid Response
• Prevention and Recovery Cabinet
• Opioid Coordinating Council
• Clinical Advisory Committee
• Maine Recovery Council
• Substance Use Disorder Services Commission
• Opioid Data Sharing Committee

(Strategy 1)

The State is maintaining a robust data collection and analysis infrastructure

Beginning in January 2021, the Office of the Attorney General, the Office of the Chief Medical Examiner, and the Office of Behavioral Health began releasing a monthly fatal and nonfatal overdose report. This report surveils both the suspected and confirmed fatal overdoses as well as nonfatal opioid overdoses reported by Emergency Departments, ME EMS, law enforcement, and the Maine Naloxone Distribution Initiative.

For detailed information regarding the most recent monthly overdose report please visit The Maine Drug Data Hub: Monthly Overdose Dashboard. (Strategy 4)

Source: Maine Monthly Overdose Report

Comparing Maine’s Rapidly Reported Overdose Statistics to Federal Totals

In order to do rapid reporting of Maine’s overdose totals, we utilize slightly different totals than the final totals reported by the U.S. Centers for Disease Control, National Center for Health Statistics.  Maine’s Monthly Overdose Report differs in the following ways: 

• Includes all non-homicidal manners of death. In order to provide rapid monthly totals for Maine, we include all suspected and confirmed overdoses of any intent, identified before the medical examiner makes final decisions about cause and manner of death.  This includes all non-homicidal manners of death: accidental (unintentional), suicidal, and undetermined intent.  Final determination of the manner of death by the medical examiner occurs only after all postmortem tests have been done, including the toxicology testing, which can take months. The federal totals exclude suicides when reporting drug overdose statistics.
• Includes “occurrent” rather than “resident” deaths. Maine’s rapid monthly overdose reports count any overdose that occurs in the state, regardless of whether the decedent was a Maine resident, that is “occurrent” deaths.  The federal totals by contrast include only “resident” deaths, that is Maine deaths wherever they occur. In order to do this, the National Center for Health Statistics needs to inspect deaths from all states and sort them according to residence.  These final federal tallies generally take about two years following the death.
• Maine’s monthly totals are not “age-adjusted.” In order to be able to compare death rates between states, the National Center for Health Statistics performs age-adjustment calculations on the totals.  Maine, for example, has an older population than other states.  Without an age adjustment, Maine totals would tend to be larger due to the proportionally higher number of persons dying due to their older age.  
• The most recent national death age-adjusted overdose statistics available across all states for state residents are for calendar year 2022.

Fatal overdose decreased 16.2% in the State of Maine during 2023 compared to 2022.

Source: The Margaret Chase Smith Policy Center, University of Maine

Maine is reviewing and supporting economic studies regarding the cost of substance use disorder to families and businesses

The prevalence of drug misuse and the number of drug-related deaths have increased across time. Lost productivity has also increased across time. In 2019, lost productivity was $271 million (annual) from morbidity and $565 million (lifetime) from mortality. This reflects the lost value to Maine that occurs when individuals cannot fully contribute to the labor market or non-market activities.

Source: Drug-Related Morbidity and Mortality in Maine: Lost Productivity from 2015 to 2020.

For more information regarding the economic impacts of substance misuse and substance use disorder in Maine see:

Daley et al, Drug-Related Morbidity and Mortality in Maine: Lost Productivity from 2015 to 2020.

Rogers et al, The Cost of Alcohol and Drug Abuse in Maine, 2010

(Strategy 4.d.)

The State is committed to sharing key data regarding problematic substance use and substance use disorder to inform the public and guide policy and program design

In January 2021 the State of Maine partnered with the Margaret Chase Smith Policy Center at the University of Maine to launch the Maine Drug Data Hub. The goal of the Hub is to act as a one-stop-shop for data, reports, and resources regarding timely and actionable substance use, substance use disorder, and overdose data. Most metrics on the Hub are reported at a monthly cadence to increase public transparency around the opioid epidemic in Maine and the State’s response. Further, having a central data location informs policymakers and aides in programatic design, interventions, and informed policy formation (Strategy 4.e.).

From January 2021 to March 2024 there has been a total of 90,361 unique individual users that have been served by the Maine Drug Data Hub. These individuals have visited 2,102,333 pages while on the Hub and have downloaded over 52,626 documents and reports.

The overdose mapping tool, ODMAP, allows for real time analysis and spike alerts of community and county nonfatal and fatal drug overdose.

The Overdose Detection Mapping Application Program, or ODMAP, seeks to provide near real-time data regarding suspected overdoses responded to by public safety officials. The goal is to utilize these law enforcement overdose responses to organize public health efforts to mobilize an immediate response to a sudden increase, or spike in overdose events.

In Maine, over 85 state, county, and municipal law enforcement agencies collect overdose data and report it to ODMAP. The map below shows enrolled counties in yellow, enrolled municipal law enforcement agencies as dark blue circles, and enrolled statewide agencies in light blue. Currently unenrolled counties are colored black and unenrolled municipalities are gray circles. The State promotes the utilization of ODMAP by law enforcement agencies as well as the sharing of overdose spike data with public health officials, clinicians, and community partners. (Strategy 5.h; 5i)

Essential to the success of ODMAP is the timeliness of data reporting. To make overdose data actionable, clinicians, community partners and public health officials need identify increases in nonfatal and fatal overdoses quickly. The following graph shows the percentage of ODMAP entries that were made within 24 hours each month. (Strategy 4.g.)

If you would like to sign up for the SPIKE Auto Text Program to receive overdose spike alerts directly to your cellphone please text the word SPIKE to (855)-963-5669. If you are a community partner who would like to sign up for ODMAP access talk to your local police department. (Strategy 4.g.)

Law enforcement is dedicated to enhancing the flow of public safety data related to illicit substances in Maine

The Maine State Bureau of Identification (SBI)

SBI collects and maintains criminal history information throughout the State including drug related arrests. These metrics track the number of drug arrests by substance and the number of opioid arrests by county. It does not include federal charges or dispositions. It includes data for all participating local, county, and statewide law enforcement agencies in Maine. These data do not include federal law enforcement arrests or seizures that take place in Maine. This data is reported monthly through the Drug Monitoring Initiative (DMI) report compiled by the Public Health Analyst working alongside NE-HIDTA (New England High Intensity Drug Trafficking Areas)

Source: New England High Intensity Drug Trafficking Areas (NE-HIDTA).

View the most recent full report: Drug Monitoring Initiative Report, March 2023

(Strategy 4.h.)

The State of Maine is committed to educating individuals and organizations regarding the realities of substance use disorder, how individuals are affected, and that recovery is not only possible, but probable

The State continues to develop and implement evidence-based public messaging campaigns, provide educational opportunities for clinicians, and promote recovery friendly workplaces, campuses, and communities. Through public forums, the promotion of film and storytelling, as well as the OPTIONS campaign, the State is creating more opportunities for individuals, families, and others affected by substance use disorder to tell their personal stories of addiction and recovery. (Strategy 4.j.)

Voices of Survival

For more voices of recovery from Maine, visit the “Stories” page of of the Know Your OPTIONS website. (Strategy 4.j)

Maine is investing in local and statewide efforts to improve public understanding and reduce stigma and discrimination

Each year the State hosts the Opioid Response Summit which convenes leaders from across Maine as well as the Federal government to share ideas, strategies, and best practices to help Maine people and families affected by the overdose crisis. Each month, there also is a related webinar series that explores emerging issues or initiative throughout Maine.

Archived Opioid Response Summit and Opioid Seminar Series recordings can be accessed on AdCare Educational Institute of Maine’s website. (Strategy 6.a.)