AUGUSTA, Maine — A bill that increases constraints on doctors and other health care providers while requiring pharmacies to check photo IDs when dispensing opioid-based painkillers got an initial hearing before the Legislature’s Health and Human Services Committee on Monday.
The bill, sponsored by Rep. Jon Hinck, D-Portland, is modeled after a Washington state law that’s set to go into effect next month.
When it came to opioid-based painkillers such as OxyContin, Maine’s track record for abuse was horrible, Hinck told the committee.
“Maine’s statistics on addiction are abysmal, we literally lead the nation. It is an unfortunate situation of Dirigo gone the wrong way,” Hinck said.
A recent federal study showed that admissions to drug treatment programs for painkiller addiction in Maine were eight times the national average, Hinck said.
On a per capita basis, Maine is the state with the biggest painkiller addiction problem in the nation. Hinck said the Legislature has made inroads on the problem but more needs to be done on the “front end,” or the prescribing side, of the equation.
Hinck’s bill, LD 1501, also would require patients receiving the highest doses of pain medications and those with health histories predisposed to addiction to consult with a pain management specialist. The bill also would require certain patients to provide urine samples during their course of treatment with painkillers to help prevent abuse.
The measure further increases the amount of continuing education doctors, dentists and other health care providers who write prescriptions for pain medicines are required to have in order to remain licensed.
Opponents to the measure, including the Maine Civil Liberties Union’s Alysia Melnick, said basing Maine law on a yet untested law in Washington state seemed like a bad plan.
While the MCLU understands the seriousness of the state’s problem, Melnick urged caution in crafting law that would limit doctor’s flexibility to manage individual patient needs.
“We do understand that we have a serious problem,” she said. “But this approach to enshrine in Maine’s law untested rules stemming from Washington’s very recently, fast-tracked legislation, may unnecessarily restrict access for patients with serious chronic pain without addressing the problem.”
Melnick also said it is unlikely there would be enough pain management specialists in Maine to address the demand that would be a result of the legislation. Others later said there were only an estimated 15 doctors in Maine who are considered qualified as pain management specialists.
Sen. Margaret Craven, D-Lewiston, said she didn’t agree that any new restrictions would be overreaching from a civil rights perspective and that the problem was too big to ignore.
“To me, OxyContin is a fairly new drug and we had pain management before now without this level of addiction,” Craven said. “So I just don’t agree that there shouldn’t be some safeguards put in there.”
Craven also said that powerful pain medicines already were highly restricted and regulated so the perception that any new efforts to help reduce or prevent addiction shouldn’t be looked at as new or overburdening.
Restrictions already exist and curtail people’s rights in that regard, Craven said.
Others in opposition to the measure, including Gordon Smith, the executive vice president of the Maine Medical Association, said the group acknowledges Maine’s problem.
Smith said much of what would be made law under the Hinck bill was already in practice in Maine. “Most responsible doctors are actually already doing this,” he said. But by putting into law more standards of medical practice, the association saw a range of problems emerging, including medical malpractice issues and adequate doctor training.
Smith also acknowledged the problem was immense in Maine and that Hinck’s bill was carefully considered.
“We stand in opposition to this bill but that wasn’t a decision that was lightly reached. This bill has caused us more reflection and difficulty this session than any other,” Smith said.
Lawmakers on the committee seemed anxious for a measure they could still pass this session and they urged opponents and proponents of the bill to work it out and bring suggestions back Tuesday afternoon.
“This is probably our No. 1 most serious issue for the health of Maine citizens and also our substance-abuse issues and all of the relative crime pieces that go with it,” said Rep. Meredith Strang Burgess, R-Cumberland. “I want to pass something that keeps this process moving.”
Strang Burgess, the committee’s co-chairman, said the measure needed some work but she felt both those supporting and opposing it ultimately wanted the same results. She urged those with stakes in the bill to use the next 24 hours to bring a compromise measure back to the committee on Tuesday afternoon.
But it remained unclear whether any new law would be passed in the limited few weeks of this lawmaking session.