At the end of a year that saw a person die every day, on average, from drug overdoses in Maine, it is encouraging that the LePage administration is increasing its support of medicine-assisted treatment, which research has shown to be the most effective method to address substance use disorder.
On Tuesday, the Maine Department of Health and Human Services announced it would dedicate an additional $2.4 million to helping Mainers access treatment. The money will fund treatment for an additional 359 people who are seeking treatment but don’t have insurance to pay for it. The money will go to clinics in Bangor, Calais, Lewiston and Bridgton.
This additional funding will eliminate the state’s wait lists for treatment, DHHS Commissioner Mary Mayhew said. According to DHHS, 8,627 Mainers received medication-assisted treatment in fiscal year 2016. However, only 215 slots were available for those without insurance. Between 300 and 450 people are seeking treatment but are unable to receive it, the department said.
As of September, 286 Mainers had died of drug overdoses. That’s more than the 272 deaths in all of 2015. Sixty-four percent of the 2016 deaths involved illicitly manufactured opioid drugs, including heroin.
The rising death toll confirms that Maine, like many other states, is failing to stem the rise in drug abuse.
And while it is encouraging to see the LePage administration step up funding for needed and effective treatment, the administration has taken a slow and winding path to this point.
LePage, for example, has repeatedly voiced opposition to the use of Narcan — which can immediately reverse the effects of an overdose — and earlier this year vetoed a bill that sought to make Narcan available over the counter and supply police and fire departments with the medication. LePage’s veto of LD 1547 was overridden by the Legislature and the law is in effect. That didn’t stop the governor from making up stories about Narcan misuse.
In 2015, LePage proposed cutting state-funded methadone treatment in an effort to transition people fighting opiate addiction to Suboxone, which is dispensed in medical offices and subject to Maine’s prescription monitoring program. In July of this year, the governor said publicly, “I’ve been trying to close down methadone clinics since I’ve been governor.”
Maine is the only state in the nation with a limit on the length of time its Medicaid program will fund methadone treatment. It also reimburses methadone providers at one of the lowest rates in the nation.
Early this year as lawmakers worked to craft comprehensive legislation to address the addiction crises, LePage continued to prioritize funding for additional law enforcement personnel over treatment resources. The bill that he finally signed contained both.
LePage also has fought efforts to expand Medicaid to cover more people in Maine. An expansion, paid for with mostly federal dollars, would have helped at least 60,000 low-income Mainers access medical care, including substance abuse treatment.
We are glad that the LePage administration now understands the benefits of medication-assisted treatment and is putting more money behind it. But more fundamental problems remain to be addressed.
The state, for example, should increase its reimbursement rates for medication-assisted treatment to ensure that the 359 people it will soon add to this therapy, as well as the hundreds of others who also receive it, can continue to get this needed care.
It should also remove time limits on medication-assisted treatment for low-income Mainers so their treatment is based on medical standards, not an artificial cap.
Lawmakers may need to revisit a law, passed this spring over a veto from LePage, to allow pharmacists to dispense Narcan without a prescription. The Maine Board of Pharmacy has delayed writing rules to implement the law because its members are confused by how it was written.
Increased funding for medication-assisted treatment is good news, but it is only a small step in the continued work that is needed to better respond to Maine’s addiction crisis.
