The $4.9 million drug bill making its way through the Legislature includes a host of law enforcement and treatment initiatives. But it does not include funding for what doctors and brain researchers regard as the most effective tools to fight addiction.

There are no provisions in the Legislature’s plan to increase access to buprenorphine, methadone and naltrexone. That’s not an accident. Although research favors prescribing those drugs to people suffering from addiction, there is a serious philosophical debate among policymakers and even treatment providers about whether fighting drug addiction with other drugs is the best approach.

The absence of medication-assisted treatment funding in the Legislature’s drug bill reveals just how contentious this issue is. As previously reported, legislative leaders crafted their drug bill with the hopes of passing it quickly. As Democratic House Speaker Mark Eves stated in early January, the proposal before the Legislature is what’s “politically possible.” That’s another way of saying that there’s a deep divide about medication-assisted treatment.

The divide is not unique to Maine. On Monday, a report by Stateline, the Pew Charitable Trusts’ news service, showed a number of barriers to medication assisted treatment. Roughly two-thirds of the nation’s medical clinics do not offer addiction treatment, private insurance often doesn’t cover it, use of medication can cut treatment centers’ revenue and the leaders of national detox and treatment chains are often recovering addicts who either beat their addiction on their own or harbor the belief that addiction drugs don’t address the underlying psychological problems that lead to addiction.

The result is that only one-fifth of the people who could benefit from addiction medication have access to it, according to a recent John Hopkins Bloomberg School of Public Health study.

The debate over addiction medication hasn’t yet fully developed in the Legislature, but it’s coming. The Stateline story and accompanying reports are a good primer.

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