Dr. Lynn Ouellette, a psychiatrist from Brunswick, Maine, asks herself "What if?" a lot these days. What if they had found her son just a few minutes earlier? What if they had gotten him to the hospital sooner?
What if they'd had the overdose antidote Narcan in the house?
"What we know is that this saves lives and it gives addicts another chance," she says.
Her son, Brendan Keating, 22, had struggled with addiction. He'd been in and out of rehab and tried other types of treatment. But Ouellette says she constantly worried that her exuberant, fun-loving, big-in-the-world clown-of-the-family would harm himself or someone else.
On Dec. 13, her worst fears came true. Keating was found in the family basement, in respiratory distress from an overdose. He later died at the hospital.
"I would have done anything to save my son's life," Ouellette says. "And that's true for so many other people, and they're not throw-away lives."
This week federal drug officials encouraged more widespread use of Narcan, and some states have already moved in this direction.
But not the state of Maine. Republican Gov. Paul LePage opposes a bill that would put Narcan in the hands of more first responders as well as relatives of addicts. LePage vetoed a similar measure last spring, saying it would provide a false sense of security to drug abusers.
For several years, overdose deaths in Maine have come close to or exceeded the number of fatal traffic accidents in Maine. In 2012, the last year for which statistics are available, there were 163, most involving opiates and a combination of other drugs. In Keating's case it was heroin and sleeping pills.
Narcan, also known by its generic name, naloxone, attaches to the same receptors in the brain as opiates, reversing overdose effects when someone is in respiratory distress.
"Had we had it right with us, it might have made a difference," Oullette says.
Maine, like so many other states, has a high rate of opiate addiction. But in his recent State of the State address, LePage proposed hiring 14 more drug agents and expanding drug courts. He did not address treatment.
"We must hunt down the dealers and get them off the street," he said. "We must protect our citizens from drug-related crimes and violence. We must save our babies from life-long suffering."
The last reference is to the number of drug-affected babies born in Maine last year: 927. Many of their mothers are Medicaid recipients, another reason the LePage administration objects to the bill. It would require the state's Medicaid program to pay for Narcan prescriptions.
Jay Bradshaw, director of Maine's Emergency Medical Services, says Narcan is effective in reversing the effects of opiate overdose, but it takes special training to handle patients who go into rapid withdrawal and experience other side effects.
"Seizure, even cardiac arrest, become very violent, nausea, vomiting are all common side effects," he says.
Bradshaw says most paramedics and advanced medical technicians already carry Narcan and are trained to safely administer it under certain protocols. He fears making Narcan more widely available could discourage people from calling those best equipped to deal with an overdose emergency.