April 24, 2019
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Maine’s addiction task force needs to act fast, emphasize treatment

Troy R. Bennett | BDN
Troy R. Bennett | BDN
Asked for the top item on his wish list for fighting Maine's opiate addiction crisis at a recent meeting, Portland Police Chief Michael Sauschuk said, "Medicaid expansion."

Maine doesn’t need another task force to study the addiction crisis facing the state and claiming more than one life a day.

Earlier this year, when lawmakers voted unanimously to form the Task Force to Address the Opioid Crisis in the State, we argued it was unnecessary. “With Mainers dying at the alarming rate of essentially one per day from drug overdoses, a legislative task force to assess the problem and offer solutions sounds like too little, too late,” we wrote.

When President Donald Trump launched a national commission of his own to study the opiate addiction crisis, we were similarly skeptical. It’s because, as we wrote, “We already know what works. For those in the grips of substance abuse disorder, medication-assisted treatment is the most promising pathway forward.”

And yet, as opiate addiction has ravaged Maine, the state has taken only small, belated steps to expand access to medication-assisted treatment to the level that’s clearly needed, while leaving significant hurdles in place.

Greater access to medication-assisted treatment is what Maine will need to overcome the current crisis. Research has repeatedly shown that patients’ chances of survival, of avoiding future drug use, of staying away from criminal activity and of future employment increase significantly when the treatment they receive involves medication — generally methadone or buprenorphine, sold commercially as Suboxone — and counseling.

At the state level, lawmakers should start with at least these three policy changes to expand access to medication-assisted treatment:

End the two-year limits on methadone and buprenorphine prescriptions under Medicaid. Maine is one of 10 states that impose a limit on the length of time a low-income resident with Medicaid coverage can access buprenorphine, according to a 2014 Substance Abuse and Mental Health Services Administration report. And Maine is the only state to impose a two-year lifetime limit on access to methadone. Such lifetime limits apply to no other medications, and there’s no scientific evidence showing that addiction patients should be time-limited.

Raise Medicaid reimbursement rates for methadone. Maine’s Medicaid program pays methadone clinics $60 per week for every Medicaid-covered patient they treat. That’s one of the lowest rates in the country, and a rate that has caused methadone clinics to cut back on the amount of counseling, a crucial component of effective addiction treatment, that they provide. The National Institute of Drug Abuse has determined that medication-assisted treatment with methadone, properly done, should cost $143 per week, more than double Maine’s current reimbursement rate.

Expand Medicaid. When the Task Force to Address the Opioid Crisis in the State convened for the first time on Friday, Portland Police Chief Michael Sauschuck delivered a critical message to members.

According to the Portland Press Herald, Sauschuck was asked at the meeting for the top item on his wish list for fighting the addiction crisis. His answer? “Medicaid expansion,” according to the Press Herald.

“It’s funny, as a cop sitting here, I’m not going to tell you that I need more drug agents. I’m going to tell you I need more treatment and I need more prevention work,” the police chief said. “If we’re not doing prevention, treatment and enforcement — and we’re not doing them equally — then we will fail and we are going to continue to fail. And when we fail in this conversation, people are dying. A person is going to die today, tomorrow and every day moving forward, [that] is what the stats show.”

The Task Force to Address the Opioid Crisis in the State has a due date of April 30 for its initial report recommending legislative action. A final report recommending further action is due Dec. 6.

The task force doesn’t have much time remaining before it must assemble its first report, but if the panel plans to recommend action that actually address the lack of access to treatment for those suffering from addiction, it should be clear what it needs to recommend.

And then the Legislature should act — unanimously and quickly.

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