AUGUSTA — Sadly, there are few people today not directly impacted by substance use disorders. We have seen the opiate epidemic take hold and tear at the very fiber of our communities and the fabric of our families. As the Press Herald has been able to highlight through its series “Lost,” addiction impacts both men and women, young and old, and knows no socioeconomic boundaries. It is important to put a face to the heroin epidemic and to tell the stories of Mainers facing heartache and sometimes unbearable grief.
In my family I have experienced the devastating consequences of alcohol and drug addiction. There are no words to describe the pain and suffering. As commissioner of the Department of Health and Human Services, its impact is seen daily through the families and individuals we support.
We know there are no simple solutions to this crisis. The lethal nature of the heroin coming into our state and the increasing presence of fentanyl pose an unprecedented crisis and challenge. To truly address it, we must work together to support efforts that provide access to effective treatment the moment that someone is ready. Recently, while sitting in on a group treatment session I heard from individuals working toward recovery. Many of their statements were echoed by their peers: They want their lives back, they want to be able to participate in treatment and they want to continue being employed.
Treatment providers, health systems, primary care providers and law enforcement officials are all working together to rethink Maine’s approach to substance abuse treatment. I want to express my appreciation for all those who are part of these collaborative efforts. Providers and organizations in Portland and Bangor have convened to create and support regional responses while utilizing more integrated systems of care.
In my role, I must steward the funds entrusted by Maine citizens to make the greatest positive impact on this epidemic by investing in programs and services with demonstrable evidence and tangible outcomes. Medication-assisted treatment – treatment that involves medication with concurrent counseling – has shown the greatest rates of efficacy and outcomes in recovery. This modality of treatment is the strongest weapon in our arsenal.
At the state level, we have been making changes and prioritizing funds over the last several years. Last year, $3 million was authorized to increase access to services, and in December I prioritized $2.4 million to create 359 medication-assisted treatment slots throughout Maine for the uninsured. Most recently, the Legislature authorized $4.8 million to launch our Opioid Health Home model – making us only the third state in the nation to do so. This model will improve access to coordinated primary care and substance abuse treatment for more than 400 individuals facing opioid dependency.
Additionally, we know families are being impacted by this crisis – with more than 60 percent of the children coming into state custody due to parental substance use as a risk factor. We launched a pilot to help more than 250 at-risk families within the child welfare system that co-locates parenting education and substance abuse treatment, helping to create more stable families or to more quickly reunify children with their parents when appropriate.
This year, the department budget for treatment services is $80 million – this is a substantial increase from the $49 million spent on treatment in 2008.
What we cannot lose sight of is prevention, especially when 75 percent of heroin addictions begin with a legally prescribed pain pill.
To reduce incidents of inappropriate prescribing, we implemented a pain management protocol in the MaineCare program in 2012. This protocol required physicians to take advantage of physical therapy, osteopathic care, chiropractic care, occupational therapy and behavioral therapies before prescribing addictive pain medications. In 2016, 76 million opiate pills were prescribed in Maine, down from 80 million in 2014.
Public Law 488, adopted last spring by the Legislature and recently implemented by the department, builds upon these reforms by limiting the duration of narcotic prescriptions based on whether the pain is short- or long-term. It requires use of the Prescription Monitoring Program and it requires education for those prescribing these highly addictive pain medications.
We have, and will continue to urgently address this epidemic and will accept nothing less than leading the nation in our response. Too many lives have been cut short, too many children are growing up in homes broken apart by this crisis, too many families and communities are stigmatized and traumatized by the harms of opiate addiction.
The dedication, resolve and commitment of my department and this administration regarding this epidemic will not waiver.