Maine is on track once again this year to set a record for the number of drug overdose deaths.
Recently released data show that Maine in 2012 had the second-highest rate of infants born exposed to substances in utero and that Maine’s rate of drug overdose deaths climbed at the third-highest clip nationally between 2013 and 2014.
While talk of addiction has dominated political debate, policymakers haven’t made needed investments to increase treatment capacity. In fact, the state is spending less on treatment today than it did at the start of the decade.
Gov. Paul LePage vetoed a bill in April to make the life-saving overdose antidote naloxone more widely available to people with addictions and their families, saying that naloxone — which can be administered to immediately reverse the effects of an opiate overdose — “does not truly save lives; it merely extends them until the next overdose.”
LePage declared in June, “I’ve been trying to close down methadone clinics since I’ve been governor.” His administration this summer proposed impossibly onerous requirements on treatment clinics that could force some to close. And he’s been staunchly opposed to a primarily federally-funded Medicaid expansion that would make treatment accessible to many low-income people with addictions.
This, apparently, is the picture of a state “making progress” when it comes to addressing the opioid addiction epidemic. That’s the conclusion of the National Safety Council, which recently awarded the “making progress” distinction to Maine and four other states. Every other state was either “lagging behind” or “failing.”
The Maine Department of Health and Human Services issued a celebratory news release Monday to mark the occasion.
Indeed, the reason the National Safety Council boosted Maine’s ranking was the spring passage of LePage-supported legislation that limits opioid prescriptions and enhances monitoring of such prescriptions. Four of five heroin users say their addiction started with prescription opioid pain medications.
But, if LePage had his way on other policies championed by the National Safety Council, Maine would certainly be no standout.
One indicator the council used to judge states’ progress was whether naloxone was available without a prescription. That’s precisely the policy change LePage vetoed in April. Thanks to the Maine Legislature’s veto override, naloxone is on track to be more readily available to those who need it.
So, it’s odd to see the LePage administration touting Maine’s high ranking in a report that champions the increased naloxone access LePage attempted to thwart.
It also is odd to see a report laud Maine for the availability of medication-assisted addiction treatment. The National Safety Council rightly recognizes the key role medication-assisted treatment — namely, methadone and Suboxone — plays in addressing addiction. In its June report, the council also rightly states that “caps on the length and duration of [medication-assisted treatment] should be eliminated.”
Yet Maine — thanks to a change LePage signed into law in 2012 — is the only state with a limit on the length of time its Medicaid program will fund methadone treatment. It’s one of 10 states with a similar limit for Suboxone.
To top it off, Maine’s Medicaid program reimburses methadone clinics at one of the lowest rates in the nation — $60 per patient per week, when research from the National Institute on Drug Abuse has shown that methadone maintenance therapy, delivered properly, should cost $143 per patient each week. Lawmakers earlier this year declined to fund a bill to raise the rate.
The only reason Maine was among three states the National Safety Council lauded for the availability of medication-assisted treatment? The capacity of Maine doctors to prescribe Suboxone.
A 2015 study in the American Journal of Public Health found Maine was one of three states where doctors, under federal rules, could theoretically prescribe Suboxone to at least 100 percent of patients who required addiction treatment.
But the reality is much more complicated. Far from every doctor permitted to prescribe Suboxone is prescribing the anti-addiction medication, much less to the maximum number of patients allowed, and Suboxone isn’t the right treatment for everyone suffering from an addiction.
Maine is falling well short of adequately addressing its addiction epidemic. It certainly doesn’t deserve national plaudits for its anti-addiction policies.
