Maine appeared in national media a couple of years ago because of its problems with abusing painkillers and, shortly after, heroin. It returned this week as one of the leading places where the treatment for drug abuse itself has turned deadly.

Stories in both The New York Times and The Washington Post looked at the larger problem geographically – The Times wondered about rural areas, The Post focused on New England – but both carried the dateline of Portland because Maine’s crisis is among the most remarkable. Rapid rises in prescription opiate abuse and death, followed by increased heroin abuse and death followed by methadone abuse and death. Maine, a state with a historically low drug problem, is now gaining a nationwide reputation of the sort it does not want.

The state has responded, most recently, with a calm, methodical strategy of education, public awareness and medical preparedness that suggests both the complexity of the problem and the inability of some more definitive action. It wants to present the problem of opiate abuse to “key stakeholders,” provide anti-stigma education to professionals who work with opiate users; develop guidelines with hospital administrators for “overdose prevention education”; “participate in work group initiatives now being undertaken … to explore the methadone diversion issue and develop a diversion management protocol.” The strategy, developed by the Maine Center for Public Health and the Maine Public Health Association, contains 17 such policy recommendations. All presumably necessary, none indicating any special urgency.

The report does say the picture of drug abuse in Maine is “a grim one.” Yes. A slightly earlier report for the state estimated that Maine had 161 accidental and suicidal drug deaths in 2002, compared with 60 in 2000 and 33 in 1997, a large and exponentially growing increase. For perspective, just about everyone uses a car while relatively few abuse drugs, yet the drug death total has now reached the approximate number of Mainers killed annually in motor-vehicle crashes. Maine is experiencing an epidemic of deaths from drug abuse – if it were afflicted with this number of deaths from something like West Nile virus, there would be panic in the streets and demand for round the clock aerial spraying. Mosquitoes can be the subject of such rage; drug abuse is something else, because blame is assumed to lie with the victim.

Blame is also being popularly placed upon the drug, and methadone, an unpopular choice of treatment for many people and many reasons, is now a target. There are a couple of theories why people are overdosing on a drug that does not provide the kind of high associated with other opiates – it doesn’t take effect for a long time and the abuser, not knowing any better, keeps taking more. Another thought is that the delay means the abuser is more likely to no longer be with friends when the drug takes effect or that the friends do not recognize the signs of a methadone overdose.

Methadone is no more an absolute culprit in this problem than it is an absolute answer for treatment. It is, instead, part of a much larger story that goes beyond a single drug, beyond a single impetus for abuse and beyond Maine, afflicting first the rural places of the country then traveling toward the cities. But if the state is going to fix the problem and impress the larger world that it has, it will need to do more than education or requiring the use of tamper-resistant prescription forms or increasing control of methadone distribution at certain clinics.

Maine until very recently had relatively few deaths from drug abuse, suggesting that it could sharply reduce the number it has now. But a little more panic and a little more outrage may be necessary before it does.