Credit: George Danby

A recent campaign mailing in support of Rep. Bruce Poliquin proclaimed in bold print: Opioid Abuse Over. If only that were true.

In fact, here in Maine things are still getting worse, not better. Maine’s overdose deaths increased by 10.9 percent between January 2017 and January 2018, giving us the sixth worst overdose death rate in the United States, according to new federal data. In light of this, Poliquin seems woefully out of touch with Maine’s most pressing health problem.

I am a physician who has practiced in the 2nd Congressional District for the past 35 years, and I have been treating opioid addiction in my office in western Maine for the past 10. I have firsthand knowledge of the depth of this problem here in rural Maine.

We could be stemming the opioid crisis, but we are not. Treatments are available and they work, but they are unavailable without insurance. The scientific evidence on treatment is clear. With treatment people can subdue the dragon of addiction and have steady employment and rewarding home lives. Across the state I have heard from a number of treatment programs that the number of people entering treatment appears to be plateauing even as the mortality rate rises. The consensus is, this is a result of a lack of access to care, and Republican legislators in Washington are bent on a path to make this worse.

Opioid drug treatment can be expensive. The most effective drugs used in treatment cost about $5,000 a year, and the cost of office visits and counseling can double that. At the national level, the estimated cost of treatment is about $18 billion a year. Yet, those numbers look vanishingly small when stacked next to the White House’s $500 billion estimate for the direct and indirect costs of drug addiction.

What of Poliquin’s touted claims about his involvement in the Congressional Heroin Task Force and his co-sponsorship 21st Century Cures Act? It turns out the Cures Act was written to make it easier for pharmaceutical companies to get their drugs to market. Opioid treatment funding was put in as a sweetener or perhaps to screen the real intentions. The act appropriated $1 billion over two years to help drug treatment research and implementation. Unfortunately, this is a paltry sum. Poliquin and Congress had the capacity and knowhow to do better, but they chose not to.

If the key issue is the availability of health insurance, we can see why Poliquin and his colleagues are making this worse. By 2026, roughly 13 million more people nationally and 50,000 in Maine will be uninsured thanks to Congress repealing the Affordable Care Act’s individual mandate in the recent tax bill.

Poliquin also joined the Republican effort to repeal and replace the Affordable Care Act by voting for the American Health Care Act last year. If the repeal and replace bill had gone into law, Medicaid would have taken a big hit, to the tune of $880 billion over the 10 years. The Henry J. Kaiser Foundation estimated that would have resulted in 14 million fewer on Medicaid and pushed up the number of uninsured by 21 million by 2026. The biggest percentage of people affected would have been low-income individuals, exactly the population at highest risk for opioid use and addiction.

We all know the 2nd District is economically disadvantaged. Its counties are among the poorest in the state, and opioid addiction disproportionately affects those of low income, the very people most dependent on their insurance for care. Here in Maine, 20,000 Mainers have lost coverage under MaineCare, the state’s Medicaid program, through program cuts, which Poliquin applauded in 2012. It is not a coincidence that our opioid problem has worsened while our uninsured rate has ticked up.

Whatever his intentions, Poliquin seems indifferent to the needs of his most vulnerable constituents. He puts ideology over the needs of his constituents and is failing to act where he could. Opioid addiction is a terrible disease, but there are evidence-based treatments that work. The job of government ought to be to harness our economic and scientific resources to connect those in need with treatment. Mainers deserve no less.

Steve Bien is a family physician. He lives in Jay.

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