LePage budget cuts methadone funds in effort to transition recovering opiate addicts to Suboxone

Posted Jan. 14, 2015, at 6:11 p.m.
Last modified Jan. 15, 2015, at 8:57 a.m.

AUGUSTA, Maine — Gov. Paul LePage is proposing the elimination of state-funded methadone regimens for Mainers addicted to opiates, a move that Democrats said is too drastic and underscores the governor’s focus on law enforcement over treatment to deal with addiction.

Department of Health and Human Services Commissioner Mary Mayhew said the cut is being proposed to transition opiate addicts seeking treatment from methadone to Suboxone, which she said is a safer and more controllable alternative.

LePage proposes to cut $727,000 in state funds in fiscal year 2016 and $868,000 in fiscal year 2017. Canceling that state funding would mean Maine would not receive annual federal matching funds of $1.2 million and $1.5 million, respectively.

“This seems dramatic and sudden, not a gradual lessening of the program,” said Sen. Anne Haskell of Portland, who is the ranking Senate Democrat on the Legislature’s Health and Human Services Committee. “For those for whom methadone is working, it’s an opportunity to have a job, to take care of a family, to stay stable and to be productive.”

Mayhew said in a written statement to the BDN that methadone cannot be reported to the state’s prescription monitoring program, which helps physicians track which medications their patients are taking — including those prescribed by other doctors. She said free-standing methadone clinics, of which there are nine in Maine, complicate the jobs of primary care physicians and make it more possible for patients to abuse the health care system.

“Transitioning recovering addicts from methadone to Suboxone is just one of several initiatives within the governor’s budget proposal designed to strengthen and encourage the use of primary care among Medicaid recipients,” said Mayhew. “Taking this preventative approach means lower costs and better outcomes. For addicts, it also means a safer and less addictive alternative to methadone that helps them on the road to recovery.”

Rep. Drew Gattine, D-Westbrook, who co-chairs the Health and Human Services Committee, said he sees the cut as another example of LePage being too focused on law enforcement to fight drug abuse and not focused enough on treatment. Elsewhere in the biennial budget, LePage is proposing millions of dollars in new spending for drug agents and prosecutors at the state and county levels.

“It shows a lack of understanding of the societal cost of drug addiction throughout the state of Maine,” said Gattine. “There has to be a multipronged solution to this problem that includes methadone treatment.”

Methadone clinics have been enduring cuts and attempts at cuts since at least 2012, when per-patient weekly payments to clinics were reduced to $60, the lowest of any states in the United States. Republican Sen. David Burns of Whiting, a retired police officer, proposed a two-year lifetime limit on methadone treatments in 2012, but that bill failed.

According to data from 2012, about 85 percent of methadone patients in Maine are covered by or eligible for Medicaid. In 2013, according to the BDN’s archives, about 4,760 Mainers were receiving methadone treatment, more than 65 percent of whom were Medicaid patients.

Maine has long been seen as having one of the worst opiate addiction rates in the country. LePage, Attorney General Janet Mills and numerous lawmakers have said in recent weeks that fighting drug addiction in Maine is a priority this year.

Officials from two methadone clinics and the Maine Association of Substance Abuse Programs did not respond to requests for comment.

Sen. Eric Brakey, R-Auburn, Senate chairman of the Health and Human Services Committee, said in a prepared statement that LePage’s budget is a jumping-off point for negotiations on the issue.

“The long-term effectiveness of this program and overall impact on the well-being of Mainers are worth exploring further,” said Brakey. “That said, this is just the start of the process, and no one knows where the final budget will land on funding for methadone treatment.”

Rep. Deb Sanderson, R-Chelsea, also a member of the committee, said the proposal deserves exploration.

“I realize there are many individuals who require drug-assisted treatment for addiction however, unlike Suboxone treatment, which is carried out directly under a physician’s care, methadone is not,” she said.

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