BANGOR, Maine — With new limits set to take effect next year on how doctors in Maine prescribe narcotics, The Acadia Hospital has started a new program that teaches chronic pain sufferers drug-free ways to cope.
The eight-week program will help adults with persistent pain from injuries or illness to become more active and deal with the anxiety and depression that often accompany frequent pain. The therapy also has been proven to lessen patients’ reliance on prescription opioids, said Brent Scobie, director of research and planning at Acadia.
“Pain is not just a physical experience, but we don’t think of it that way,” he said.
Prescription painkillers can lead not only to addiction, but also to patients not living healthier, more fulfilling lives in the long term, Scobie said.
“Medical treatment of chronic pain can only do so much,” he said.
The Acadia program’s launch coincides with the development of new restrictions on opioids for residents covered by MaineCare, the state’s Medicaid program. As part of the supplemental budget process, lawmakers approved limits that include requiring MaineCare recipients with chronic pain to demonstrate that they have tried other pain therapies before they can receive their first prescription for opioids.
“Most doctors now understand that over the past decade people were put too quickly on these powerful medications and now they’re addicted,” said Gordon Smith, executive vice president of the Maine Medical Association.
Maine’s per-capita addiction rate for opioids is among the highest in the country. In 2011, opioids, such as methadone and oxycodone, were the number two substance Mainers sought treatment for, behind only alcohol.
Under the new regulations, set to take effect in January, MaineCare patients who are prescribed opioids for acute pain are limited to an initial 15-day supply. Two refills totaling 30 days will be allowed with prior approval from the Department of Health and Human Services, which oversees MaineCare.
If a doctor believes more than 45 days of opioids are needed, a second opinion from a physician outside the practice will be required for certain patients.
Some exceptions will be allowed for patients with HIV/AIDS and cancer, and those on hospice care. Patients recovering from surgery can receive two months of opioids before the new regulations kick in.
The regulations will affect about 60,000 MaineCare recipients now taking opioids, Smith said.
“This is considered to be standard practice,” he said.
Patients must abide by the new policies for MaineCare to cover the costs of their prescription painkillers, but can pay for their medications out-of-pocket without the restrictions.
People suffering from chronic pain, or pain lasting longer than three months, typically head to their doctor’s office for relief, Scobie said. But physical discomfort also can come with thoughts and feelings that heighten the perception of pain, which requires different treatment, he said.
Patients waiting for a diagnosis often get caught in a spiral of worry about the cause of their pain, while others may give up on activities they enjoy for fear of worsening their discomfort, Scobie said. Both problems can be alleviated through cognitive behavioral therapy, the basis of the new program, he said.
The therapy could be ideal for people who want to avoid taking narcotics or patients waiting for an appointment with a pain specialist, which can take up to a month, Scobie said.
“Chronic pain is already a tough thing to treat, especially in an outpatient office that’s extraordinarily busy,” he said.
The group therapy sessions will be held two times a day, at noon and in the early evening, beginning the last week of September. Acadia already is receiving referrals for the program and is scheduling initial consults, Scobie said.
While the hospital is seeking to work with local primary care doctors to refer patients to the program, those without a referral are encouraged to call Acadia, he said.
The program is not designed to treat substance abuse.
For more information, visit the hospital’s website at acadiahospital.org or call 1-800-640-1211.
Beyond overdue policy change…………
But we will still pay for methadone for addicts??
but of coarse…
That needs to go next!
Would you rather have addicts selling drugs or committing other crimes to support their habit? Methadone is cheaper than prison.
MaineBrookies – I am curious as to if you have any data that shows the effectiveness of methadone. do you happen to know the success rate of methadone treatment programs within the state of Maine?
mainemcq6 – you brought up a good point. On that note does anyone know where I can find the following information?
For the last 5 full years (2007 – 2011)
How many patients were checked into state methadone clinics in Maine?
How many patients were successfully weaned off of opiate drugs as a result on methadone therapy?
The number of years each patient was taking methadone before they were drug free
The cost of mileage (reimbursed by the state) per patient receiving methadone
The cost per dose of methadone given to each patient.
I’m doing a little research and this information would be really helpful. It should be public information.
Since the clinics and the State refer to methadone treatment as a methadone maintenance program(substitution for other opiates), their mission statement makes at least some of your questions moot.
beemare – As far as I know you are correct with your assesment of the program in that methadone is, in fact, a substitute for other opiates. It is my understanding that once the patient has replaced opiate drugs with methadone, also a drug, they can be gradually and safely weaned off of the methadone.
I do not, however, have any data that shows the effectiveness of this type of treatment and that’s what I would like to find out. I’m willing to guess there are many others who would like to know as well since the program and the drug itself is funded in part by taxpayers.
As far as I’m able to determine, Pro, a large percentage of those on methadone programs in Maine never voluntarily stop taking methadone. That’s why the last legislature and DHHS under Governor LePage have mandated a two year cap on methadone treatment programs if I recall correctly, and why Acadia and others have instituted programs to help keep people off opiates with the often resulting addiction and need for methadone maintenance programs. There’s not much doubt that Maine DHHS would have the data that you’re requesting, but I’m not sure that it’s information that’s available to the public. Perhaps an email or call to someone on the legislative committee responsible for budgeting funds for addiction treatment(Peggy Rotundo comes to mind) would get you the answers that you want.
I wonder if anyone thought about or included in their calculations those Mainers who will end up cultivating their own opiate from Poppy too manage their pain at home. It is a lot cheaper then dealing with State Regulations but it’s not safer.
Get your own insurance then. It will be a lot “cheaper ” for taxpayers.
I was thinking more on the lines of more robberies, assults. People have been growing marijauna for decades won’t matter if they could get poppie seeds cops aren’t looking or busting people for marijauna growing now…unless it’s for medicinal purposes it would seem.
I would truly hope that people who are in hospice would be able to access pain relief.
what about people with terminal illness like cancer who are going die
Read the article and it will tell you.
“Some exceptions will be allowed for patients with HIV/AIDS and cancer, and those on hospice care. “
i dont like painkillers to take them i dont like medication at all but there comes a time when it is a life and death issue. i feel for the pain people who have chronic pain who depend on pain killers. i really do. its really cruel for people to have to suffer. no amount of couseling will make the pain go away. this is when euthanasia should really be considered especially people wh have serious chronic medical conditions. at this point we euthanize pets because we dont want them to suffer we should do the same to humans
@facebook-100000655412147:disqus I’ve said for a long time us humans should have the right to die if we choose to do so. As you stated we euthanize pets all the time, we do it without a second thought so they no longer have to suffer but if you dare take that step as a human you would have to leave the country to make it happen.
I would rather be able to say goodbye to friends and family and die on my own terms instead of wasting away in pain. My mother died in a lot of pain as cancer destroyed her brain. She simply wasted away without a clue in the world to what was going on. Not a very dignified way to die, but that is how she did.
I don’t like pain killers either. I think that sometimes; people are more “afraid” of the pain returning than they are of the pain itself. Maybe, a program like this will help address that. And even though I believe that I should be able to control and even cause the end of my life; NO ONE has the right to make those decisions FOR ME or anyone else. Individuals can make decisions that society as a whole can not.
As a chronic pain sufferer, i feel somewhat offended that you would rather euthanize me than let me have access to medication that allows me to live a less painful existence.
So, Acadia has not been doing this all along?!? What DID they do?!? What a waste of money.
I don’t believe it is their fault. Imagine that you’re in a lot of pain….and a nurse comes in and says she is going to teach you guided imagery to manage that pain…what would you be thinking? What would most people be thinking?
Most people would not believe it could help…it probably sounds a bit crazy to some people.
I wonder what the predicted cash flow for this 8 week program is ?
Wow, that was nasty.
Medical marijuana is a good medication for chronic pain without all of the side effects and other worries of opiates.
From the story: If a doctor believes more than 45 days of opioids are needed, a second opinion from a physician outside the practice will be required for certain patients.
Some exceptions will be allowed for patients with HIV/AIDS and cancer, and those on hospice care. Patients recovering from surgery can receive two months of opioids before the new regulations kick in.
Hello, people, use your reading skills before you comment.
great to see limits finally put on these medications that can be so addictive. Before some of you get up in arms about this, try reading the article again. A second opinion can allow you to get more pain medication if needed. Too many doctors out there hand these pills out like candy when other, healthier options, should be explored. I’ve seen many 300lb people with chronic back, hip and knee pain. Pain killers won’t fix that, but losing 100+ pounds will, plus it’s much healthier and reduces many other risks of chronic diseases.
Let’s also make rules and notifications of people who end up in the ER/WIC looking for more medications. Yes, it is a sad statement that some sell their meds and some trade for alcohol or whatever. This seems like making people with legitimate pain having to suffer for all the addicts and people who are looking to make a buck. No one can put restrictions on pain treatments but it is good to see that Acadia will be able to make money from this.
Several years ago, Maine voters rejected a “right-to-die” referendum question. At that time, several prominent physicians informed the voting public: “We have ways of managing, even eliminating most pain.” So for awhile, people injured in our labor intensive workforce, people who suffer from terminal disease, and those who have other painful conditions were given drugs to stop or mimimize their pain.
Now because some people choose to abuse prescription painkillers, Everyone who is in pain will be treated the same.
I say legalize all drugs for adult consumption. To paraphrase folks in the gun lobby; If drugs are outlawed, only outlaws will have drugs.”
Funny, not a WORD in this article that PERHAPS this change was driven in part because of the burgeoning illegal drug trafficking in these drugs, most often by those who claim to have valid prescriptions.