April 1, 2019


Maine Family Planning is a proud organizational member of the Maine Coalition for Sensible Drug Policy, and today we will be delivering the below testimony in support of LD 949, An Act to Prevent Overdose Deaths, sponsored by Representative Mike Sylvester of Portland. Over the past few years, MFP has been seeking out points of appropriate intervention in the opioid epidemic, given who we are, the services we provide, and our organizational values. We are aligning our clinical programming and advocacy with a belief in the inherent dignity and value of people who use drugs. We invite all supporters of reproductive health, rights, and justice to read the below testimony and reflect upon the intersections of our movement and the practices of harm reduction.

Testimony In Support of LD 949

Maine Family Planning is a health care provider serving majority low-income and rural Mainers in 18 clinic sites from Lewiston to Fort Kent, and Rumford to Calais. Because most of our patients are women, we feel the need to highlight gendered effects of the opioid crisis. According to data from Kaiser Family Foundation, men in Maine are dying from opioid overdoses at three times the rate of Maine women. This gender disparity in overdose deaths is reflected across the entire New England region. These statistics reflect something truly painful and important about this epidemic for women and families. It means mothers outliving their sons, children outliving fathers, siblings burying brothers. It means partners mourning their partners. Women survive more often and carry forward their grief, in the absence of whatever emotional, childrearing and financial support the men in their lives may have provided. Women also lack equal access to gender-responsive treatment and recovery options. Women of Color are the fastest growing prison population, often for non-violent drug offenses. Women are often primary caregivers. Pregnant and parenting women face compounded stigma and scrutiny from their communities, providers, DHHS, and law enforcement. While the opioid epidemic affects every single one of us—it come as no surprise that women experience this crisis in particular ways that are too often erased.

We also want to illustrate how MFP’s model of sexual & reproductive health care aligns with harm reduction approaches like overdose prevention sites. MFP trusts that our patients know what they need and how to make the best possible decisions for themselves within complex and unique circumstances. We provide direct services in a non-judgmental and compassionate way, as well as educate and advocate for culture and policy change to end stigma around women’s sexuality and abortion.

It is not possible, nor desirable, for every patient we see to use the most effective birth control method, or any contraceptive method consistently. It is not feasible to expect our patients to abstain from sex as an exclusive method for avoiding pregnancy. It is not for us to determine when a pregnant person is ‘ready’ to carry a pregnancy and parent a child, or when they need an abortion. We do not provide abortion services based on someone’s birth control use when they became pregnant.  We do not treat pregnancy and parenting as pre-determined ‘consequences’ of sex. We know stigma harms our patients and keeps too many from seeking out our services. We know making abortion illegal and forcing people to end pregnancies in the shadows led to death and criminalization for too many. We are there to guide our patients in navigating their reproductive lives in a world that too often denies them real options for self-determination. In our movement, there are sayings like “Good people have abortions every day” and “Everyone loves someone who had an abortion.”

The harm reduction movement aligns with Maine Family Planning’s values as we just described them, but applies this same judgment-free approach to the issue of addiction. Anyone who knows how addiction works knows it is not feasible, nor medically-advisable, to expect people to practice abstinence. It is not always possible for someone to access treatment. Treatment and recovery are not always desirable or something people are ready to try. Stigma surrounding drug use isolates and pushes away people who need connection and services the most. Stigma and criminalization lead to death and despair in an infinite loop that is devastating our entire country. We cannot treat death as a foregone consequence for drug use, and we do not support withholding care and support from those who need it. We know good people use drugs every day. We all love someone who has used drugs, and far too many of us have lost someone we love.

We are facing an emergency. That means you throw everything you have at the problem right away—because lives are in immediate danger. No one is suggesting the solutions are simple, nor that we can build a way out of this epidemic quickly. Those of us who support overdose prevention sites are simply saying:  We have to keep our people alive. Our people have a right to life-sustaining care.

Without people who use drugs remaining alive, all other approaches to this crisis are pointless. We need major structural changes and redistribution of resources to address drug-related crises in our state. But if our loved ones continue to die, we are just spitting in the wind. Overdose prevention sites are one necessary piece of the emergency response plan to end suffering and devastation caused by this epidemic.

Maine Family Planning urges members of the Health & Human Services committee to vote Ought To Pass on LD 949.