For years now, Maine’s response to a mounting drug crisis has been missing one key component. Medication-assisted treatment with Suboxone or methadone is the gold standard for opiate addiction, yet its availability in Maine, particularly to the uninsured, pales in comparison to the need.
But with an average of one Mainer dying each day from a drug overdose, there is now real movement to fill that void.
The Maine Department of Health and Human Services announced this week that it will use $2.4 million in state and federal funding to create 359 new medication-assisted treatment slots for the uninsured spread among five locations, targeted specifically where the agency says it has found waiting lists.
Along with a nascent effort by Maine Behavioral Healthcare to offer Suboxone-based treatment and counseling to anyone in its coverage area who needs it, the state’s initiative represents a significant step forward in the fight against the devastating opioid epidemic.
It also represents, if not always in policy at least in rhetoric, a departure for the LePage administration.
The administration has in the past expressed support for medication-assisted treatment as long as it is prescribed along with counseling, and the DHHS has repeatedly said that the state should follow the best evidence-based practices, a category into which medication-assisted treatment would surely fall.
But Gov. LePage himself rarely has been that precise with his own wording. Nor has he been accurate in his descriptions of addiction and treatment.
He has denigrated methadone treatment before, based in part – ridiculously – on what he said he saw while sitting in a car outside of a methadone clinic. He has time and time again presented addiction as a moral failing, and he has said that so few heroin addicts recover that policy should focus on the next generation.
In this case more than most, words matter. The stigma that surrounds drug addiction contributes in a significant way to perpetuating the crisis. When addiction is seen as a failure of will and not the chronic brain disease that it is, people in the throes of addiction are less likely to seek help, doctors are less likely to take the steps necessary to prescribe Suboxone, and the public is less likely to support investments in treatments that are proven to work.
In fact, both the Maine Opioid Collaborative – created by the U.S. Attorney’s Office for Maine, the Maine Department of Public Safety and the Maine Attorney General’s Office – and the U.S. surgeon general say overcoming the stigma associated with addiction is one of the true hurdles to addressing the drug crisis.
Dr. Christopher Pezzullo, the state’s chief medical officer, agrees, saying at the news conference announcing the state’s plan that “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,”
So while it is undoubtedly good news that the state initiative will provide treatment to nearly 400 Mainers, that does not include the thousands more who have not yet sought help and who will need it before the crisis subsides.
Bringing those people into treatment – ending the despair felt by so many families and eroding the demand for illegal narcotics – should be the focus of the state’s efforts.
LePage can start by matching his public rhetoric to the very positive step forward his administration took this week.
He can also address the low reimbursement rates for medication-assisted treatment that have hampered care and closed clinics, and move quicker to get the anti-overdose drug naloxone into more hands, two policies that he’s opposed in the past.
Those actions, along with those already taken by LePage and the Legislature to limit opioid prescriptions and bolster law enforcement, will truly give Maine the comprehensive approach to the drug crisis that is necessary.
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