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. Lawmakers can ensure this isn’t the case by fast tracking and removing impediments from what is known to work, such as medication-assisted treatment.
Last year, 378 Mainers died of drug overdoses. The number of deaths was 39 percent higher than in the previous year. Some 313 of the deaths were attributed to opiates; 243 were attributed to heroin or fentanyl.
We know what works. Those who receive medication-assisted treatment coupled with counseling are much more likely to overcome substance use disorder than those who do not.
“The research is unassailable,” the Pew Charitable Trusts said in a report last year. “Staying in recovery and avoiding relapse for at least a year is more than twice as likely with medications as without them. Medications also lower the risk of a fatal overdose.”
Yet only one in five Americans dealing with opioid addiction is receiving methadone or buprenorphine, the two most common anti-addiction medications, according to a November 2015 study by researchers at Johns Hopkins’ Bloomberg School of Public Health.
Barriers include a shortage of medical providers licensed and trained to provide the medications, a lack of insurance among those who need them, and limited coverage or none at all from some insurance plans. The result is long waitlists of people with substance use disorders who want to stop using drugs.
Numerous discussions and conferences on opiate addiction have been held in Maine. It is past time for action.
With regard to treatment, it is clear that more people need access. An $8 million state investment to expand opiate addiction treatment to another 700 Mainers, the product of negotiations between Gov. Paul LePage and Democratic Senate leader Troy Jackson, is an important step forward.
On Thursday, Sen. Cathy Breen, D-Falmouth, introduced a budget amendment to provide $4.8 million in state and federal funds to extend opioid addiction treatment to more uninsured Mainers and those covered by Medicaid and Medicare.
“By bringing together policymakers and experts, it’s my hope that we can take meaningful steps to save Maine lives,” Jackson said in a statement announcing the new task force.
There are other hurdles to addiction treatment that lawmakers must remove.
Maine has one of the lowest reimbursement rates in the country for treatment with methadone. Until seven years ago, methadone clinics in Maine received $80 per week to provide each patient on MaineCare a bundle of services: medication, individual and group counseling, drug testing and physician assessments.
In 2010 the rates were cut to $72 per week. Two years later they were reduced again to $60. Since then, clinics have had to double or triple the number of patients per counselor. They also have cut back on staff and patients themselves.
A bill to raise the rate back to $80, which was amended to $72 per week, failed in the Legislature.
Maine is one of just a few states that limit the amount of time that patients covered by Medicaid can access treatment with methadone and Suboxone, another medication used to treat addiction. Most patients can access only two years of treatment, during their lifetime.
There are more than two dozen bills titles that have been introduced by lawmakers that relate to the state’s addiction crisis. Many focus on treatment, but it is unclear if any seek to raise reimbursement rates or lift the time limits on treatment.
The task force can be most helpful by focusing attention on programs and treatments that work and directing state resources to these efforts.