Democratic Gov. Janet Mills has picked a former lobbyist from the state's leading physician organization to oversee Maine's response to the opioid crisis.
Gordon Smith, former vice president of the Maine Medical Association, will become what Mills is calling the “Director of Opioid Response.” It's a position created to tackle the epidemic that's claimed over 1,600 lives over the past five years. Mills and Smith say their focus will be on medication-assisted treatment and destigmatizing the illness of addiction.
While Mills hasn’t overtly criticized the LePage administration's approach to the opioid problem, she has made it clear that she’ll take a very different tack, focusing on treatment instead of law enforcement, and on addiction as an illness instead of a moral choice.
"These people are not junkies. These are our neighbors, our co-workers, family members, schoolmates ... They are our sons and daughters. They are people without labels, citizens without stereotype," she said.
Smith will lead what Mills is calling the Prevention and Recovery Cabinet, which will include several state agency chiefs and Attorney General Aaron Frey. The Cabinet will coordinate law enforcement, prevention, treatment and recovery responses to the epidemic.
Smith told reporters that increasing access to medication-assisted treatment requires building an infrastructure to support it, including easing restrictions on physicians' ability to prescribe it, and convincing recovery centers to accept patients who are taking suboxone or methadone.
"We know much of what needs to be done," he said. "But we need the political will to do it."
In Smith, Mills has chosen a person well-acquainted with the political forces in Augusta. He has been a lobbyist for the Maine Medical Association (MMA) for 25 years. In 2011, the organization opposed a bill designed to limit and track opioid prescribing by doctors and convinced the Legislature to study the issue instead. But in 2016, the MMA did back a bill that put in place limits on opioid prescriptions and monitoring, a move that highlights the organization's evolution on the problem of over-prescribing opioids for pain.
Smith also says that doctors now fully endorse medication-assisted treatment.
"The medical community, I think, is fully onboard that the gold standard is medication-assisted treatment. The problem is that not all aspects of the population are on board with that," he said.
Smith was referring to the sentiment among some people that medication-assisted treatment is expensive and essentially swaps dependence on one drug for another. He says changing that belief will be critical to tackling the crisis, a role that he says Mills has already embraced.
"Executive leadership helps,” he said. “I mean, we have not had a situation here in recent years where the executive leadership of the state has been saying the things that Gov. Mills is saying, that this is a chronic illness, these are our sons and daughters and they need to be loved. They need to be treated."
Smith didn't mention former Gov. Paul LePage by name, but the reference was clear. LePage expressed a dim view of treatment, and he also vetoed bills that expanded access to the overdose reversal drug naloxone.
Mills is taking a different approach. She says she'll sign an executive order directing state agencies to begin taking steps towards combating the epidemic in about two weeks.
Updated 4:42 p.m.