Mainers who are concerned about the extent of substance abuse here got a rare piece of good news last week when the nation’s top drug policy official came to the state to award $7.5 million to help 19 community coalitions develop strategies for preventing drug abuse.

But for poor Mainers seeking treatment for addiction, resources are scarce and only becoming more so, because of cuts in MaineCare, the state’s Medicaid program, and the repeated rejection of MaineCare expansion funds. The toll of unchecked substance abuse is a high one. Victims lose their jobs, families and mental and physical health, requiring the average state to spend 15 percent of its budget on the associated health care and law enforcement costs.

Being addicted to drugs or alcohol isn’t a moral failing; it’s in the category of diseases called “substance use disorders.” And accepting federal money to expand eligibility for MaineCare – though not a perfect solution – is the most immediate and effective way to help fight addiction and put its victims on the road to recovery.

Addiction is the great leveler, affecting people of all ages, occupations and income levels. Access to treatment options, though, is limited by income, or lack of it – especially since the Le-Page administration made it tougher to qualify for state-funded medical care. As a result, about 25,000 parents and childless adults have been booted off MaineCare and lost drug treatment coverage. And the state has repeatedly rejected federal funds that would have covered substance abuse treatment for up to 70,000 currently uninsured Maine residents.

Lack of access to drug treatment can set up a cycle of defeat. Offenders in drug-related cases are routinely sentenced to addiction treatment, but low-income defendants who don’t qualify for MaineCare can’t afford the services that will keep them clean, raising the risk that they’ll re-offend and end up back in jail.

Low-income parents who lose custody of their children will also lose their MaineCare. That could stop them from getting substance abuse treatment that’s a court-ordered condition of family reunification, ensuring that more children remain in the foster care system – all outcomes that nobody wants.

Opponents of expansion will say that Maine already spends too much on Medicaid. But a recently released Kaiser Family Foundation study has found that state spending on Medicaid is growing more slowly in states that have taken expansion funds than it is elsewhere. There are preliminary indications that expansion has saved hospitals money, too, cutting ER visits and the admissions of uninsured patients, according to a Sept. 24 federal report.

Each dollar invested in addiction programs returns an estimated $19 to the community, in the form of reduced crime, lower criminal justice and public safety costs and higher wages and productivity. When the payoff of funding substance abuse treatment is so high, and when there’s a way to do it – expanding Medicaid eligibility – that’s been proven effective, it’s hard to make either a pragmatic or a moral case against making it happen.