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Descriptive, observational study of pharmaceutical and non-pharmaceutical arrests, use, and overdoses in Maine
  1. Kevin J Simpson1,
  2. Matthew T Moran1,
  3. Michelle L Foster2,
  4. Dipam T Shah1,
  5. Daniel Y Chung1,
  6. Stephanie D Nichols3,
  7. Kenneth L McCall4,
  8. Brian J Piper1
  1. 1 Medical Education, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA
  2. 2 Diversion Alert, Houlton, Maine, USA
  3. 3 Pharmacy Practice, Husson University, Bangor, Maine, USA
  4. 4 Pharmacy Practice, University of New England College of Pharmacy, Portland, Maine, USA
  1. Correspondence to Dr Brian J Piper; bpiper{at}; psy391{at}


Objectives The Maine Diversion Alert Program grants healthcare providers access to law enforcement data on drug charges. The objectives of this report were to analyse variations in drug charges by demographics and examine recent trends in arrests, prescriptions of controlled substances and overdoses.

Design Observational.

Setting Arrests, controlled prescription medication distribution and overdoses in Maine.

Participants Drug arrestees (n=1272) and decedents (n=2432).

Primary outcome measures Arrestees were analysed by sex and age. Substances involved in arrests were reported by schedule (I–V or non-controlled prescription) and into opioids, stimulants or other classes. Controlled substances reported to the Drug Enforcement Administration (2007–2017) were evaluated. Drug-induced deaths (2007–2017) reported to the medical examiner were examined by the substance(s) identified.

Results Males were more commonly arrested for stimulants and schedule II substances. More than two-thirds of arrests involved individuals under the age of 40. Individuals age >60 were elevated for oxycodone arrests. Over three-fifths (63.38%) of arrests involved schedule II–IV substances. Opioids accounted for almost half (44.6%) of arrests followed by stimulants (32.5%) and sedatives (9.1%). Arrests involving buprenorphine exceeded those for oxycodone, hydrocodone, methadone, tramadol and morphine, combined. Prescriptions for hydrocodone (−56.0%) and oxycodone (−46.9%) declined while buprenorphine increased (+58.1%) between 2012 and 2017. Deaths from 2007 to 2017 tripled. Acetylfentanyl and furanylfentanyl were the most common fentanyl analogues identified.

Conclusions Although the overall profile of those arrested for drug crimes in 2017 involve males, age <40 and heroin, exceptions (oxycodone for older adults) were observed. Most prescription opioids are decreasing while deaths involving opioids continue to increase in Maine.

  • opioid
  • stimulant
  • heroin
  • oxycodone
  • fentanyl
  • arrest
  • cocaine

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  • KJS and MTM contributed equally.

  • Contributors KJS and MTM performed the data analysis, prepared figures and wrote the first manuscript versions. KJS, MTM, MLF and DYC performed data collection. DTS and DYC provided technical assistance. KJS, MTM, SDN, KLM and BJP were responsible for study design. All authors approved the final version.

  • Funding This publication was supported by Fahs-Beck Bund for Research and Experimentation.

  • Disclaimer Its contents are solely the responsibility of the authors and do not necessarily represent the official views of our affiliated institutions.Funders had no role in the research or dissemination process.The depiction of boundaries on the map(s) in this article do not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities.The map(s) are provided without any warranty of any kind, either express or implied.

  • Competing interests This research and KJS, MTM and SDN were supported by the Fahs-Beck Fund for Research and Experimentation, a non-profit organisation. MLF was an employee of Diversion Alert. BJP has received research support and travel related to medical marijuana. The other authors have no relevant disclosures.

  • Ethics approval The Wright Center IRB approved the DAP procedures (GCSOM03232017BP) and the UNE IRB approved ARCOS and overdose procedures (#20180410–009).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Prescription data are publicly available at: Overdose information is available at: Our data sharing and use agreement preclude sharing the raw Diversion Alert (arrest data). Data may be made available on request.

  • Patient consent for publication Not required.

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