Nearly a year ago, Elana Madigan asked her sister to take her to the emergency room to get help for her alcoholism.
Her family had just met with her for a facilitated intervention. She agreed to get help.
Her older sister, Rep. Colleen Madigan (D-Waterville), had just arrived home from a day at the State House.
“She asked me to get her bag and her pocketbook,” Madigan said.
The sisters, just three years apart, joked about whether she would be allowed to bring a razor with her.
“She asked me to put the letters we had all written at the intervention in her purse,” Madigan said. “Then she said grab my shoes. I took her hands and said I love you, Elana. She said I love you too Coll. And then the seizures started.”
Madigan called 911 and rode in the back of the ambulance. Her sister was in cardiac arrest. She died 12 hours later.
She was 54.
The Jan. 6 death of her sister prompted Madigan to ask legislative leaders for special permission to introduce a bill that sought to establish a court process to require a person with substance use disorder to get treatment.
It’s an idea she had been kicking around for a while. She told her sister there were times when she wished she could “blue paper her,” a reference to the process of having a person with mental illness sent for treatment if they pose a threat of harm to themselves or others.
She said her sister agreed it was a good idea and encouraged her to move forward.
But during the March public hearing, members of the recovery community told lawmakers they were split on the bill, with some expressing concerns that forcing people to get treatment violated their civil rights and often doesn’t work.
Madigan said last week that it wasn’t her intention to violate anyone’s civil liberties, but that when someone is struggling and can’t make decisions for themselves, there should be a way to intervene.
“The only difference between Elana and someone who’s homeless down by the river is Elana’s family didn’t give up on her,” she said. “It doesn’t matter. That person, all those people, shouldn’t be treated like that.”
Ultimately, the Legislature turned the bill into a study committee that reviewed what services are available for those with substance use disorder, potential constitutional rights issues and recommendations for treatment options.
When lawmakers reconvene in January, they will see the final report that recommends more funding for substance use disorder treatments, including alcohol use disorder.
Last year, more Mainers died of alcohol-related causes (667) than from overdose deaths (631), state data shows. And Madigan believes that the alcohol deaths are undercounted, in part because her sister’s death certificate didn’t list it as a cause of death, even though she struggled for years.
During those years, she cycled in and out of treatment and suffered multiple physical setbacks, including a diagnosis of cyclic vomiting syndrome, which is thought to be related to migraines.
She was prescribed opiates, which led her back to alcohol.
She would be sober for a number of years and worked at Kennebec Behavioral Health. Her sister remembers her sense of humor, her love of the beach, her dedication to her two rescue dogs.
“Most days when I was at the State House she would text me funny stuff,” Madigan said. “Maybe a song lyric, made up swear words. She was very, very funny.”
Moving forward, Madigan is hopeful that she can change the stigma associated with alcohol use disorder. She wants families to be more involved when a loved one is discharged from the hospital.
In the last year of her life, Elana was hospitalized nearly a dozen times for alcohol withdrawal.
There were times when her sister was deemed OK to leave and sent home in a taxi. For other serious medical issues — Madigan recalled their father’s heart condition — family members are given specific instructions about their at-home care.
She hopes for something similar for those with alcohol use disorder.
“Every time my sister stopped drinking, she wanted to stop drinking,” Madigan said. “The pain was so intense she would do anything. She just didn’t know what to do.”