Maine is one of 39 states that permit the dispensing of the anti-overdose drug naloxone to opioid addicts without a doctor's prescription. But while state regulators issued rules last August to provide guidance to pharmacists selling the drug, they have yet to be approved by Gov. Paul LePage.
The Board of Pharmacy says it will wait for a response from LePage before instructing pharmacists on the new policy - even though it's not legally obligated to do so.
Many Mainers with opioid addiction say they need easy access to the overdose reversal drug naloxone that was approved for over-the-counter dispensing by the Maine Legislature last year. But the implementation of that policy has been delayed by the Maine Board of Pharmacy, pending an awaited review by Gov. Paul LePage.
Now, five months later, the rules are still not in place - and Maine Attorney General Janet Mills says the board has waited too long to apply them.
"They're ready to go out the door," Mills says. "They're ready to be promulgated and invite some public comment. They're routine technical rules, though, so it's not a major process."
Although the Board of Pharmacy is following the informal past practice of allowing the governor's office to respond to the proposed rules, Mills says that, with lives on the line, political courtesies must be set aside.
"Like some of the governors before him, this governor apparently has asked to review these rules," Mills said. "I'm assuming he's had sufficient time to review the rules at this point, and that they should just go out the door. And the pharmacy board has the authority to do that, and perhaps the responsibility to do that in this instance."
"Is she technically correct that we can release them as a board? The answer is: 'Yes,' " says Board of Pharmacy Chair Joe Bruno. "Are we going to do that? No, we're following protocol."
Protocol, in this instance, is simply another word for politics, a factor that Bruno says cannot be overlooked. Bruno, appointed to the panel by Democratic Gov. John Baldacci, was elevated to chair by LePage. Heis a former Republican House leader who owns a chain of drug stores throughout Maine.
Despite the board's approval of the rules, LePage has alternately said that he believes naloxone, also known as Narcan, saves lives. Yet he's also said that the drug provides addicts with another opportunity to overdose.
Mills has been a supporter of the over-the-counter naloxone policy, a vocal critic of LePage on a number of issue, and - as Bruno notes - she is also a Democratic candidate for governor. "This is nothing new, this has just become a political issue for the Democrats," he says.
The Maine Democratic Party Friday issued a press release pointing out that LePage's former Department of Health and Human Services Commissioner Mary Mayhew has now joined four of five GOP candidates for governor who support over-the-counter access for naloxone, or Narcan. Mayhew confirmed that position Friday.
"As a mother of two boys, if I were faced with this situation, I would want access to Narcan," Mayhew says.
Julie Rabinowitz, the governor's press secretary, says he has the proposed naloxone rules and that his response is "pending."