AUGUSTA, Maine — Gov. Paul LePage’s administration announced Tuesday it has targeted $2.4 million toward eliminating waitlists of uninsured Mainers who need medical assistance to kick opiate addictions.
Health and Human Services Commissioner Mary Mayhew said Tuesday that the new spending will serve at least 359 new patients throughout Maine and that the department is monitoring substance abuse treatment specialists with the intention of further expanding the program.
“Through the work of this department we believe these slots will help to nearly eliminate the current waitlists for medication-assisted treatment,” Mayhew said Tuesday during a news conference in Augusta.
The expansion announced Tuesday more than doubles the state’s capacity to offer medication-assisted treatment — which involves prescription drugs such as methadone or Suboxone to ease an addict’s cravings while he or she undergoes counseling.
Currently, there are 215 slots for uninsured Mainers funded by the Office of Substance Abuse and Mental Health Services, although more than 8,600 Mainers received the treatment in fiscal year 2016 when Medicaid recipients are counted.
The $2.4 million in funding will come mostly from the state’s Substance Abuse General Fund and a federal substance abuse block grant. That sum of money is a fraction of what Maine already spends on treating addicts. Mayhew said the state spent $74 million on substance abuse treatment for about 22,000 people in the most recent fiscal year and that does not include taxpayer-funded transportation costs.
Without insurance, the average cost for medication-assisted treatment involving a drug such as Suboxone would be approximately $6,500 a year, according to DHHS.
After a survey of providers earlier this month, the department estimates that there are as many as 450 individuals actively seeking medication-assisted treatment services in Maine.
Those numbers don’t come close to revealing the scope of Maine’s addiction problem. Thousands more addicts may not be ready to start treatment or don’t see their addictions as problematic, said Dr. Christopher Pezzullo, Maine’s chief medical officer.
“We must remember, although substance use disorder is one of the bigger problems facing our nation, there remains a stigma associated with it that stops many from seeking help,” Pezzullo said.
The five organizations where the 359 new slots will be funded — Acadia Hospital in Bangor, Discovery Houses in Bangor and Calais, Crooked River Counseling in Bridgton and Central Maine Counseling in Lewiston — already serve several hundred people.
The expansion of these services comes as Maine’s addiction problem grows increasingly deadly. According to DHHS, one Mainer dies every day, on average, from a drug overdose and 8 percent of live births in Maine last year were infants born exposed to drugs. More than 60 percent of children entering state custody come from families in which substance abuse is a risk factor.
The new availability of medication to assist addicts in treatment is at odds with some of LePage’s past statements about their effectiveness.
LePage has often clashed with treatment professionals, political opponents and families over how to address the state’s surge in opiate addiction. He 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.
In 2015, LePage proposed cutting state-funded methadone treatment in an effort to transition people fighting opiate addiction to Suboxone, which is 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.”
“When it comes to methadone, every expert I’ve talked to says there’s no clinical aspect to it. … It’s no help. It has to be in a program that’s monitored by clinicians.”
The governor later elaborated to say that counseling should be a condition of methadone treatment.
LePage has also argued with the Legislature when it came to a bill in early 2016 that provided money for more drug investigators in Maine. Democrats argued successfully that the $3.7 million bill should include funds for treatment and education, in addition to law enforcement. LD 1537 was eventually signed by LePage and is currently in law.
The counseling component of the new slots announced Tuesday addresses what LePage apparently sees as a major weakness of the treatment addiction sector.
Democratic Rep. Drew Gattine, who in recent years has been legislative Democrats’ point man on health and human services issues, reacted positively to Tuesday’s news.
“I hope this signals a change of heart and renewed openness to increasing availability of treatment,” said Gattine in a written statement. “Maine has a severe lack of treatment capacity statewide, especially in rural areas, so we need to be aggressive and take advantage of every opportunity possible to expand capacity.”
Thomas Kivler, director of behavioral health for Mid Coast Hospital’s Addiction Resource Center in Brunswick, said additional resources in the fight against drug addiction are welcome.
“That’s fantastic,” he said. “We can’t treat people if they’re not sitting in our chairs.”
Kivler said more than half of patients, in his experience, have funding and that no one is turned away. He said medication-assisted treatment and outpatient therapy are the most effective places to pour additional resources.
“If these slots are for FDA-approved anti-craving medications, that’s the best way to spend this money,” said Kivler.
The additional treatment slots come as the addiction problem is being fought on multiple fronts. The state has awarded a nearly $1.2 million contract for Wellspring Substance Abuse and Mental Health Services to build a 10-bed detoxification facility in the Bangor area.
There is progress at the federal level as well. Earlier this month, Congress passed and President Barack Obama signed the 21st Century Cures Act, which among other provisions will provide $1 billion in state grants to fight opioid abuse and other diseases.
DHHS has more plans in the works, including expanding medication-assisted treatment opportunities Down East and in western Maine, as well as the launch in February 2017 of a program that allows nurse practitioners and physician assistants to prescribe buprenorphine, which is a medication used to help opioid addicts.
Those efforts face a seemingly unending tide of drug dealers and addicts in Maine. On Tuesday afternoon, police arrested a dozen people in Augusta and charged them for trafficking crack cocaine and heroin. Drugs valued at approximately $10,000 were seized in the bust.
