A new state report that examines drug-related deaths in Maine gives perspective to a growing but solvable problem here and many other rural states. The report was written to be the basis of future state policy on the issue, which it could well become, although the broad nature of the problem suggests plenty of help from other states the federal government also will be required.

The report was written by Marcella H. Sorg of the Margaret Chase Smith Center for Public Policy at the University of Maine and Margaret Greenwald, the Maine chief medical examiner with support from the state Attorney General’s Office and the Office of Substance Abuse. It estimates that Maine will have 161 accidental and suicidal drug deaths this year, compared with 60 in 2000 and 33 in 1997, a large and exponentially growing increase that mirrors the abundance of anecdotal evidence over the last couple of years. For perspective, just about everyone uses a car, relatively few abuse drugs, yet the drug death total has now reached the approximate number of Mainers killed annually in motor-vehicle crashes. A couple of points from the report are especially worth citing:

. “The increase in drug deaths is largely a problem with prescription drugs, particularly those frequently prescribed for pain, anxiety and depression. Prescription drugs cause 63 percent of accidental deaths and 94 percent of suicidal deaths.”

. Methadone and heroin are the most-frequent causes of single-drug death, with each responsible for about one-fourth of all cases.

. The authors say solutions to these problems lay in “systematic attention to prescription drug availability and refinements to drug death investigation protocols.” Maine should also pay more attention to the emergency-medical histories and prescription patterns of those who died as it makes and enforces drug policy.

Maine, of course, is just one of many rural states with rising drug problems. Dropping prices for illicit drugs, the introduction and abuse of legal drugs like OxyContin, in some places the spread of Methadone as a treatment for drug addiction all play a role in explaining this. Less direct causes, from the lack of good jobs in rural America to the practical collapse of community life, may also contribute to the problem. As more states examine this problem and look at border and drug distribution, it is likely to become evident that states individually have little chance of stopping the acquisition and abuse of drugs and that federal and multi-state cooperation will grow more important.

Maine already has taken a few steps toward trying to solve this problem. Starting next month, for instance, physicians here will be required to use tamper-resistant prescription forms when they prescribe certain narcotics. Steps to control methadone distribution at certain clinics may also help. But the modest number of sweeping proposals for action within the report suggest how difficult the problem is and how only by doing a hundred small things – from making more money available to hire law-enforcement officers to reviewing the standards for treatment clinics to monitoring abusers who doctor shop for painkillers – will slow the problem.

Whether or not the war on drugs can ever be won, Maine until very recently had relatively few deaths from drug abuse, suggesting that it could reduce the number it has now. The state report is a careful accounting of the problem and of what must be done to stop and reduce the number of Maine residents who are dying through the abuse of drugs.