MAINE MONTHLY OVERDOSE REPORT

For July 2023

Marcella H. Sorg, Daniel S. Soucier, Yimin Wang
Margaret Chase Smith Policy Center, University of Maine

Overview
This report documents suspected and confirmed fatal and nonfatal drug overdoses in Maine during July
2023 as well as for the period January 2022–July 2023 (Table 1). During July 2023, the proportion of fatal
overdoses averaged 6.6% of total overdoses. Monthly proportions of 2023 fatalities have fluctuated from a low
of 4.1% in March to a high of 8.1% in April. During the period January–July 2023, fatal overdoses constituted
6.2% of all overdoses, lower than the 6.9% for the year in 2022. The total of confirmed and suspected fatal
overdoses January–July, 2023, 366, is 7.8% lower than the total confirmed fatal overdoses for the same period
in 2022, 397.
Data derived from multiple statewide sources were compiled and deduplicated to compute fatal and
nonfatal overdose totals (Table 1). These include nonfatal overdose incidents reported by hospital emergency
departments (ED), nonfatal emergency medical service (EMS) responses without transport to the ED,
overdose reversals reported by law enforcement in the absence of EMS, and overdose reversals reported by
community members or agencies receiving state-supplied naloxone. There are also an unknown number of
private overdose reversals that were not reported and an unknown number of community-reported reversals
that may have overlapped with emergency response by EMS or law enforcement. The total number of fatal
overdoses in this report includes those that have been confirmed, as well as those that are suspected but not yet
confirmed for April, May, June, and July (see Figure 1).
The total number of fatal and reported nonfatal overdoses for July 2023, 821, is displayed in Table 1 near
the bottom row. Of those 821, there were 54 (6.6%) confirmed and suspected fatal overdoses, 328 (40.0%)
nonfatal emergency department visits, 248 (30.0%) nonfatal EMS responses not transported to the emergency
department, 173 (21.1%) reported community overdose reversals, and 18 (2.2%) law enforcement reversals in
incidents that did not include EMS.

Figure 1. Suspected and confirmed fatal overdoses, all drugs, January 2022–July 2023

80

70

60

50

40

30

20

10

0
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC JAN FEB MAR APR MAY JUN JUL
'22 '22 '22 '22 '22 '22 '22 '22 '22 '22 '22 '22 '23 '23 '23 '23 '23 '23 '23
Suspected 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 8 41
Confirmed 45 48 65 60 47 66 66 64 55 65 66 76 54 49 40 62 49 48 13

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Maine Monthly Overdose Report July 2023

Table 1: Composite reported overdose totals, all drugs, January 2022–July 2023

Nonfatal

Law
Community enforcement Total
EMS not reversals reversals with confirmed and
Emergency transported with naloxone and Total nonfatal suspected fatal Total
Dept. to emergency naloxone without EMS overdoses overdoses overdoses
January 2022 295 206 178 39 718 45 763
February 2022 333 185 153 37 708 48 756
March 2022 458 201 202 30 891 65 956
April 2022 290 178 189 26 683 60 743
May 2022 402 248 186 41 877 47 924
June 2022 482 250 177 44 953 66 1019
July 2022 347 287 183 40 857 66 923
August 2022 385 272 255 37 949 64 1013
September 2022 458 256 153 33 900 55 955
October 2022 283 238 177 27 725 65 790
November 2022 287 206 200 20 713 66 779
December 2022 362 212 198 14 786 76 862
2022 total 4382 2739 2251 388 9760 723 10483
% of 2022 total (41.8%) (26.1%) (21.5%) (3.7%) (93.1%) (6.9%) (100%)
January 2023 296 219 184 44 743 54 797
February 2023 347 226 192 27 792 49 841
March 2023 382 256 237 54 929 40 969
April 2023 270 218 202 27 717 63 780
May 2023 295 221 165 30 711 50 761
June 2023 377 228 219 26 850 56 906
July 2023 328 248 173 18 767 54 821
2023 YTD total 2295 1616 1372 226 5509 366 5875
% of 2023 YTD total (39.1%) (27.5%) (23.4%) (3.8%) (93.9%) (6.1%) (100%)

Law Enforcement Response to Fatal and Nonfatal Overdose Incidents

Due to the method we used to deduplicate nonfatal overdose incidents to derive a composite number of
overdoses for the month, the total amount of activity of law enforcement officials is underrepresented in the
above table. The process used to deduplicate overdoses begins by removing fatal overdoses from the emergency
department and EMS overdose incidents. Then the number of patients transported to emergency departments
by Maine EMS are removed from the EMS overdose incidents. Finally, EMS involvement and fatal overdose
incidents are removed from law enforcement responses.
Table 2 shows the public safety response to fatal and nonfatal overdose events in January–July 2023 as
well as 2022. During January–July 2023, law enforcement officers responded to a reported 1,038 overdose
incidents (343 fatal; 695 nonfatal), and Maine EMS responded to a reported 5,545 incidents (296 fatal; 5,249
nonfatal). During 2022 as a whole, law enforcement officers responded to a reported 2,143 incidents (672
fatal; 1,471 nonfatal), and Maine EMS responded to a reported 9,958 incidents (582 fatal; 9,376 nonfatal).

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July 2023 Maine Monthly Overdose Report

Table 2: Fatal and nonfatal overdose emergency response counts from law enforcement and EMS,
including overlapping cases

Nonfatal Nonfatal
Fatal overdose overdose Total overdose Fatal overdose overdose Total overdose
response response response response response response
Jan–Dec 2022 Jan–Dec 2022 Jan–Dec 2022 Jan–Jul 2023 Jan–Jul 2023 Jan–Jul 2023
Maine EMS 582 9376 9958 296 5249 5545
Law enforcement 672 1471 2143 343 695 1038
*Please note numbers will fluctuate from month to month as public safety agencies catch up their reporting. Due to methodological convention, alcohol-only cases
are excluded from this table. However, we recognize that alcohol is a large part of substance misuse epidemic. Cases with both drugs and alcohol are included.

County Distribution of Suspected Nonfatal Overdoses with EMS Response

Table 3 shows the frequency distribution of nonfatal overdoses at the county level. Due to how overdose
reversals are reported by community partners and emergency departments, only EMS cases have county
frequencies. Often, law enforcement officers are also present at these nonfatal overdose events. The July 2023
monthly totals in the far right column can be compared to the percentage of the census population on the far
left or the percentage of nonfatal overdoses for the year in 2022, or for the year-to-date in 2023. Caution must
be exercised viewing single counties with small numbers for a single month. These may fluctuate randomly,
without reflecting any significant statistical trend. January–July 2023 percentage totals for most counties
fall within 0 to 1 percentage points of the 2020 census distribution. Penobscot County and Androscoggin
County are 3 percentage points higher than the 2020 census proportion. York County is 4 percentage points
lower than the 2020 census proportion.

Table 3: County of EMS incident among suspected and confirmed nonfatal overdoses

% 2020 estimated Jan–Dec 2022 Jan–Jul 2023 Jul 2023

Census population Est. N = 9377 Est. N = 5249 Est. N = 870
Androscoggin 8% 1055 (11%) 556 (11%) 96 (11%)
Aroostook 5% 490 (5%) 241 (5%) 52 (6%)
Cumberland 22% 2194 (23%) 1207 (23%) 196 (23%)
Franklin 2% 140 (1%) 78 (1%) 13 (1%)
Hancock 4% 287 (3%) 169 (3%) 30 (3%)
Kennebec 9% 922 (10%) 527 (10%) 81 (9%)
Knox 3% 245 (3%) 182 (3%) 31 (4%)
Lincoln 3% 162 (2%) 95 (2%) 14 (2%)
Oxford 4% 410 (4%) 205 (4%) 39 (4%)
Penobscot 11% 1293 (14%) 750 (14%) 124 (14%)
Piscataquis 1% 90 (1%) 67 (1%) 14 (2%)
Sagadahoc 3% 130 (1%) 81 (2%) 16 (2%)
Somerset 4% 392 (4%) 254 (5%) 25 (3%)
Waldo 3% 199 (2%) 116 (2%) 19 (2%)
Washington 2% 221 (2%) 99 (2%) 17 (2%)
York 16% 1147 (12%) 622 (12%) 103 (12%)
*EMS nonfatal overdose counts include incidents where a patient may have died after admission to the ED. Please note
numbers will fluctuate from month-to-month as public safety agencies catch up their reporting. Due to methodological
convention, alcohol-only cases are excluded from this table. However, we recognize that alcohol is a large part of substance
misuse epidemic. Cases with both drugs and alcohol are included.

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Maine Monthly Overdose Report July 2023

County Distribution of Suspected and Confirmed Fatal Overdoses

Table 4 shows the frequency distribution of fatal overdoses at the county level. The July 2023 monthly
totals in the far right column can be compared either to the percentage of the census population in the far-left
column or the percentage of all Maine fatal overdoses for the 2022 year as a whole, or to the year-to-date total
for 2023. Caution must be exercised when viewing single counties with small numbers for a single month.
These may fluctuate randomly, without reflecting any significant statistical trend. The 2023 percentages for
most counties fall within 0 to 2 percentage points of the 2020 census distribution. Androscoggin County
is 5 percentage points higher and Penobscot County is 4 percentage points higher than the 2020 Census
proportions. York County is 4 percentage points lower than the 2020 Census proportions.

Table 4: County of death among suspected and confirmed fatal overdoses

% 2020
estimated
Census Jan–Dec 2022 Jan–Jul 2023 Jul 2023
population Est. N = 723 Est. N = 366 Est N = 54
Androscoggin 8% 69 (10%) 46 (13%) 5 (9%)
Aroostook 5% 47 (7%) 20 (5%) 4 (7%)
Cumberland 22% 134 (19%) 78 (21%) 10 (19%)
Franklin 2% 13 (2%) 5 (1%) 1 (2%)
Hancock 4% 24 (3%) 8 (2%) 1 (2%)
Kennebec 9% 54 (7%) 37 (10%) 4 (7%)
Knox 3% 20 (3%) 8 (2%) 2 (4%)
Lincoln 3% 14 (2%) 6 (2%) 1 (2%)
Oxford 4% 36 (5%) 10 (3%) 2 (4%)
Penobscot 11% 109 (15%) 54 (15%) 7 (13%)
Piscataquis 1% 9 (1%) 12 (3%) 2 (4%)
Sagadahoc 3% 11 (2%) 4 (1%) 3 (6%)
Somerset 4% 35 (5%) 16 (4%) 4 (7%)
Waldo 3% 21 (3%) 4 (1%) 0 (0%)
Washington 2% 24 (3%) 15 (4%) 1 (2%)
York 16% 103 (14%) 43 (12%) 7 (13%)

Age and Sex Distribution of Fatal Overdose Victims

Table 5 displays the age and sex composition1 of the July 2023 fatal overdose population, the 2023
and 2022 fatal overdose population, and the 2020 estimated census population. When comparing the July
2023 data with 2023 year-to-date and 2022 data as well as the census population proportion, caution must
be exercised as the small number of cases in each month is vulnerable to random fluctuation that may not
reflect a significant statistical trend. The cumulative proportion of males is the same in 2023 and 2022 (73%).
The 2023 totals were 269 males and 97 females. The cumulative age distribution for 2023 compared to 2022
shows 3 deaths under 18 in 2022 and 1 in 2023, a decrease of 5 percentage points in the proportion of those
aged 18–39, an increase of 4 percentage point in those aged 40–59, and a 1 percentage point increase in the
proportion of those 60 and above.

1 Note that death certificate data contain sex as a recorded category and do not contain gender categories.

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July 2023 Maine Monthly Overdose Report

Table 5: Decedent reported age group and sex among suspected and
confirmed fatal overdoses*

% 2020
estimated
Census Jan–Dec 2022 Jan–Jul 2023 Jul 2023
population Est. N = 723 Est. N = 366 Est. N = 54
Males 49% 527 (73%) 269 (73%) 36 (67%)
Under 18 19% 3 (<1%) 1 (<1%) 0 (0%)
18–39 26% 295 (41%) 131 (36%) 12 (22%)
40–59 27% 333 (46%) 182 (50%) 37 (69%)
60+ 29% 92 (13%) 52 (14%) 5 (9%)
*Percentages may not total 100 due to rounding.

Table 6 displays the reported race and ethnicity of confirmed and suspected fatal overdoses in 2022 and
2023 compared to the 2020 census population. Note that race and ethnicity are not finalized until the full
death certificate is entered into Vital Records, and a small number of decedents’ records lack information
about these variables. Out of 363 decedents for whom race was reported January through July 2023, 90% of the
victims were identified as White, 3% as Black/African American, and 2% as American Indian/Alaska Native.
Out of 356 decedents for whom Hispanic ethnicity status was reported, 1% were identified as Hispanic.

Table 6: Decedent race and ethnicity among suspected and confirmed fatal overdoses*

% 2020
Estimated
Census
Population: Race Jan–Dec 2022 Jan–Jul 2023 Jul 2023
& Hispanic/ Race N = 720 Race Est. N = 363 Race Est. N = 54
Latinx Ethnicity Ethnicity N = 706 Ethnicity Est. N = 356 Ethnicity Est. N = 53
White alone, non-Hispanic 91% 670 (93%) 327 (90%) 51 (94%)
Black/African American alone, non-Hispanic 2% 17 (2%) 12 (3%) 0 (0%)
American Indian/Alaska Native, non-Hispanic 1% 14 (2%) 7 (2%) 1 (2%)
Other race and 2+ races combined, non-Hispanic 7% 11 (2%) 7 (2%) 1 (2%)
Hispanic/Latinx alone or in combination 2% 7 (1%) 3 (1%) 0 (0%)
*Race and ethnicity data for some cases are unavailable until drug deaths are confirmed.
†Percentages may not total 100 due to rounding.

Military Status and Housing Stability of Fatal Overdose Victims

Out of the 364 cases for which military background was reported January–July 2023, 22 (6%) were
identified as having a military background. Out of the 54 cases in July 2023 where military background was
reported, 5 (9%) was identified as having a military background.
Of the 366 total suspected and confirmed overdose cases year-to-date in 2023, undomiciled or transient
housing status was reported for 41 (11%) of victims. Among those 41, the largest proportions of undomiciled
persons were found in Cumberland County (14, 34%), Penobscot County (10, 24%) and Androscoggin
County (6, 15%). In July 2023, 6 decedents (11%) were identified as undomiciled.

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Maine Monthly Overdose Report July 2023

Basic Incident Patterns of Fatal Overdoses

Table 7 reports some of the basic incident patterns for fatal overdoses. July 2023 can be compared to
either 2023 year-to-date or 2022 as a whole. Caution must be exercised interpreting a single month of data as
numbers may fluctuate randomly and not reflect a statistically significant trend. In addition, data totals may
change slightly as suspected cases are confirmed or eliminated. Both EMS and police responded together to
most fatal overdoses (75%) in 2023. Law enforcement was more likely to respond to a scene alone (19%) than
EMS (6%). The overwhelming majority (90%) of confirmed fatal drug overdoses were ruled as, or suspected of
being, accidental manner of death. Of the 366 confirmed or suspected fatal overdoses in 2023, 138 (38%) had
a history of prior overdose. Although most cases had bystanders or witnesses present at the scene by the time
first responders arrived, the details about who was present at the time of the overdose were frequently unclear.
However, responding family and friends or bystanders administered naloxone for 57 (16%) of the 2023 fatal
overdoses, higher than 2022 (11%), 2021 (9%), and 2020 (4%). Often, bystanders or witnesses administered
naloxone in addition to EMS and/or law enforcement. During 2023, 25% of suspected and confirmed fatal
overdose cases had naloxone administered at the scene by EMS, bystanders, and/or law enforcement. This rate
is lower than in 2021 (30%) and the same as 2022 (25%).
Of the 296 suspected or confirmed drug death cases with EMS involvement during 2023, 167 (56%)
victims were already deceased when EMS arrived. In the remaining 129 (44%) cases, resuscitation was
attempted either at the scene or presumably in the ambulance during transport to the emergency room. Of
those 129 who were still alive when EMS arrived, 35 (27%) were transported, and 93 (72%) did not survive to
be transported and 1 had an unknown status. Thus, out of 296 ultimately fatal cases with EMS response, only
35 (14%) remained alive long enough to be transported but died during transport or at the emergency room.
This outcome is likely due to a combination of the high number of cases with fentanyl as a cause of death and
individuals using alone. Fentanyl acts more quickly than other opioids, and there is less time for bystanders to
find an overdose victim alive, administer naloxone, and call 911.

Table 7: Incident characteristics among suspected and confirmed fatal overdoses

Jan–Dec 2022 Jan–Jul 2023 Jul 2023

Est. N = 723 Est. N = 366 Est N = 54
EMS response alone 38 (5%) 21 (6%) 3 (6%)
Law enforcement alone 131 (18%) 68 (19%) 6 (11%)
EMS and law enforcement 541 (75%) 275 (75%) 45 (83%)
Private transport to Emergency Dept. 13 (2%) 1 (<1%) 0 (0%)
Naloxone administration reported at the scene 182 (25%) 93 (25%) 17 (31%)
Bystander only administered 44 (6%) 24 (7%) 4 (7%)
Law enforcement only administered 31 (4%) 8 (2%) 2 (4%)
EMS only administered 49 (7%) 27 (7%) 3 (6%)
EMS and law enforcement administered 11 (2%) 5 (1%) 2 (4%)
EMS and bystander administered 26 (4%) 23 (6%) 6 (11%)
Law enforcement and bystander administered 5 (1%) 8 (2%) 2 (4%)
EMS, bystander, and law enforcement administered 6 (1%) 2 (<1%) 1 (2%)
Naloxone administered by unspecified person 0 (0%) 1 (<1%) 0 (0%)
History of prior overdose 269 (37%) 138 (38%) 25 (46%)

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July 2023 Maine Monthly Overdose Report

Table 8 displays the frequencies of the most prominent drug categories causing death among confirmed
drug deaths. As expected, within the 315 confirmed drug death cases so far in 2023, nonpharmaceutical
fentanyl was the most frequent cause of death, mentioned on the death certificate of 252 (80%) victims.
Fentanyl is nearly always found in combination with multiple other drugs. Heroin involvement,
declining rapidly in recent years, was reported as a cause of death in 9 (3%) of 2023 deaths. Xylazine and
nonpharmaceutical tramadol were identified as co-intoxicants with fentanyl for the first time in 2021. Among
315 confirmed deaths in 2023, there were 28 cases (9%) with xylazine listed in addition to fentanyl as a cause
of death, and 1 case (<1%) with tramadol listed along with fentanyl.
Stimulants continue to increase as a cause of death, usually in combination with other drugs, particularly
fentanyl. Cocaine-involved fatalities constituted 108 (34%) of confirmed cases in 2023, an increase from 29%
in 2022. Fentanyl is mentioned as a cause in combination with cocaine in 92 cases, 85% of 2023 cocaine
cases. Methamphetamine was cited as a cause of death in 101 (32%) of the confirmed fatal overdoses in 2023,
the same percentage as in 2022; 83 (82%) of the methamphetamine deaths also involved fentanyl as a co-
intoxicant cause of death. Cocaine and methamphetamine are named together on 26 (8%) death certificates
in 2023, in most of those cases (22, 85%) as co-intoxicants of fentanyl.

Table 8: Key drug categories and combinations causing death among confirmed overdoses

Cause of death (alone or in combination with other Jan–Dec 2022 Jan–Jul 2023 Jul 2023
drugs) Sample size for confirmed cases only Est. N = 723 Est. N = 315 Est. N = 13
Fentanyl or fentanyl analogs 560 (77%) 252 (80%) 9 (69%)
Heroin 19 (3%) 9 (3%) 0 (0%)
Cocaine 213 (29%) 108 (34%) 6 (46%)
Methamphetamine 234 (32%) 101 (32%) 5 (38%)
Pharmaceutical opioids** 156 (22%) 56 (18%) 4 (31%)
Fentanyl and heroin 18 (2%) 9 (3%) 0 (0%)
Fentanyl and cocaine 171 (24%) 92 (29%) 4 (31%)
Fentanyl and methamphetamine 189 (26%) 83 (26%) 5 (38%)
Fentanyl and xylazine 46 (6%) 28 (9%) 2 (15%)
Fentanyl and tramadol 10 (1%) 1 (<1%) 1 (8%)
**Nonpharmaceutical tramadol is now being combined with fentanyl in pills and powders for illicit drug use. When found in
combination with fentanyl, and in the absence of a known prescription, tramadol is categorized as a nonpharmaceutical opioid.

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Maine Monthly Overdose Report July 2023

Highlight of the Month

Governor’s Updated Opioid Response Strategic Action Plan

Governor Mills’ strategic action plan for opioid response is one of the most comprehensive in
the nation. Since day one, she has made this a priority in her administration.
—Michael Botticelli, Former Director, White House Office of National Drug Control Policy

Governor Janet T. Mills presented her updated Opioid Response Strategic Action Plan on July 20 at her 5th
Annual Opioid Response Summit. Held at the Cross Insurance Arena in Portland, the Summit attracted 1400
attendees, all of whom received a copy of the updated Plan. A pdf version of the Plan can be found at https://
www.maine.gov/future/opioids. The updated Plan focuses on six areas: Prevention, Treatment, Harm-Reduction,
Recovery, Public Safety, and Leadership. Within the six areas, there are nine priorities, thirty-four strategies, and
dozens of activities under each of the strategies. The original Plan was adopted in September 2019 and updated
mid-way through the global pandemic in 2021. Among the new provisions in the updated Plan are strategies and
activities supporting Maine’s veterans, immigrant populations, and faith-based treatment programs. Each section of
the updated Plan begins with a “Progress Update” indicating what has been accomplished since 2019. The document
opens with letters from Governor Mills and Gordon Smith, the state’s Director of Opioid Response. The Governor
closes her letter with the following:

There is no simple solution to ending the opioid epidemic, but this new strategic plan outlines
the latest steps we are taking to save lives, to prevent substance use disorder, and to ensure that our
people can achieve their full potential. I welcome your partnership and I thank you for all
your efforts to support these goals.

To address the ongoing crisis, the process of revising and updating the Plan began in 2022. Many partners, both
external and internal, were engaged to comment on the existing plan and to make recommendations for the update.
This updated plan is the result of this inclusive process, which resulted in nearly 1,000 comments being submitted
for consideration.
This Plan will not be stagnant. We will continue to update it as needed to serve the needs of Maine people. Our
work is not done, but we are in a much better position now than during earlier times, partly because of the settlement
funds coming into the state. But, most of all, we are in a better position because of the thousands of Mainers who are
helping everyday to reduce the shame and stigma associated with substance use disorders and supporting persons who
are on a pathway to recovery. This updated Strategic Action Plan provides us all with a roadmap to saving lives and
preventing substance use disorders. Thank you for caring and for your support.

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July 2023 Maine Monthly Overdose Report

Background Information about this Report

This report, funded jointly by the Maine Office of Attorney General and the Office of Behavioral Health,1 provides
an overview of statistics regarding suspected and confirmed fatal and nonfatal drug overdoses each month. Data for
the fatal overdoses were collected at the Office of Chief Medical Examiner and data regarding nonfatal overdoses were
contributed by the Maine CDC, Maine Emergency Medical Services, Maine ODMAP initiative, Maine Naloxone
Distribution Initiative, and Office of Attorney General Naloxone Distribution. Year-to- date numbers are updated as
medical examiner cases are finalized, and their overdose status is confirmed or ruled out, and as occasional lagged EMS,
ED, and ODMAP data totals are finalized. The totals are expected to shift as case completion occurs. In addition, due to
the small sample size in each month, we expect totals to fluctuate from month to month because of random variation. The
monthly reports are posted on mainedrugdata.org.
A “drug death” is confirmed when one or more drugs are mentioned on the death certificate as a cause or significant
contributing factor for the death. Most drug-induced fatalities are accidents related primarily to drug lethality, the
unique vulnerability of the drug user, such as underlying medical conditions, and the circumstances surrounding drug
use during that moment.
A “suspected” drug fatality is identified by physiological signs of overdose as well as physical signs at the scene and
witness information. To be confirmed as a drug death, the medical examiner must have issued a final death certificate
which includes the names of the specific drugs. A forensic toxicology exam must also have been done, which includes a
minimum of two toxicology tests, one to screen for drugs present, and another that will quantify the levels of drugs in the
decedent’s system. All cases receive a thorough external examination and comprehensive toxicology tests. In some cases,
a complete autopsy is also done. Additional data, such as medical records and police incident reports are also collected.
Normally cases are completed within one month; however, due to recent problems being experienced by our national
toxicology testing service, completion of cases is occurring at about 6–8 weeks after death, and occasionally longer.
By highlighting drug deaths at the monthly level, this report brings attention to the often-dramatic shifts in totals
that can occur from month to month. These fluctuations are common with small numbers and will tend toward an
average over time. Whereas the overall number of overdose deaths are a critical indicator of individual and societal
stress, this metric itself can be quite resistant to public policy interventions due to its complexity. Overdose fatalities
occur because of multiple unique and interacting factors, as mentioned above. For that reason, these reports will seek to
monitor components that can be directly affected by specific public health education and harm reduction interventions.
The statistics in this report reflect both suspected and confirmed “occurrent” deaths, that is, deaths that occur in the State of
Maine, even though they may not be Maine residents. These totals also do not include Maine residents who die in other
states. For these reasons, totals will differ slightly from the statistics reported by the National Center for Health Statistics,
which reports only confirmed “resident” deaths. In addition, due to recently reported updates of toxicology results and
newly confirmed or eliminated drug death cases, both the 2021 and 2022 statistics have changed slightly from those
reported in the previous monthly report.

1 The Office of Attorney General supports ongoing regarding research on fatal overdoses by the University of Maine. Additionally, the Overdose
Data to Action cooperative agreement from the U.S. Centers for Disease Control & Prevention also provides funding to the State of Maine’s
Office of Behavioral Health and Maine Center for Disease Control, which also supports University programs involving fatal and nonfatal
overdoses surveillance and enables the collection of nonfatal metrics included in this report. The conclusions in this report do not necessarily
represent those of the U.S. Centers for Disease Control and Prevention.