Re: “Many resist LePage administration’s bid to drop methadone as MaineCare benefit” (March 6):
I am writing to add my voice to the growing chorus of addiction medicine professionals who oppose Gov. LePage’s proposal to eliminate methadone maintenance as a reimbursable MaineCare benefit.
As a native Mainer and a primary care physician with a sub-specialization in addiction medicine, I take special interest in this issue.
While I applaud the governor’s aspirations to mobilize the primary care workforce in the fight against the opioid epidemic, his current plan is nonsensical.
The proposal’s flaws are numerous and have been expounded by many before me. To name a few:
• The non-equivalence of buprenorphine (suboxone) and methadone in treating opioid use disorder.
• The lack of buprenorphine-certified primary care physicians accepting Medicaid.
• The inevitable increase in social-service spending on individuals whose addictions spiral once they lose access to care.
• The troubling precedent of “big government” making medical decisions rather than doctors (“Death panels,” anyone? With the current rates of opioid overdose, this sarcastic comparison is not far off).
I currently live and practice in Connecticut, but hope to move back to my home state next year with my fiancée (also a primary care physician).
However, if the governor’s proposal were enacted, we would likely change our plans and “vote with our feet.” It would be professional suicide to practice addiction medicine in the state with the most regressive addiction policies in the country.
The governor’s proposal to eliminate methadone maintenance as a MaineCare benefit would harm patients, harm the budget and damage the field of addiction medicine.
Maine already has a shortage of primary care physicians and mental health providers, especially those interested in substance use disorders. Don’t make Maine an undesirable practice location for those with the skills and training necessary to fight this epidemic.
Jacob “Gus” Crothers, M.D.
New Haven, Conn.
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