A proposal to provide an additional $2 million for medication-assisted addiction treatment for the uninsured is helpful but wouldn’t come close to meeting demand for such programs in Maine, specialists said Friday.

“It’s a nice start, but we shouldn’t be congratulating ourselves,” said Dr. Mark Publicker, a leading addiction expert in Maine. “In proportion to the severity of the problem, it’s lacking by a magnitude of an order of at least 10 times what’s needed.”

The $2 million in state money was announced Thursday by the Department of Health and Human Services as part of a $4.8 million initiative – funded by federal and state dollars – to address the opioid crisis. The other $2.8 million would help ensure access to treatment for those covered by Medicaid.

Steve Cotreau, program manager for Portland Community Recovery Center, a support group for recovering addicts, said he’s happy to see more attention and resources to combat the opioid crisis, but the proposal rolled out Thursday is “not going to move the needle.”

Maine reported a record 378 drug overdose deaths in 2016, up from 272 in 2015. Heroin, fentanyl and prescription opioids accounted for 313 of the 378 deaths last year, according to statistics from the Maine Attorney General’s Office.

The $2 million will help about 250 to 300 additional people without insurance get medication-assisted treatment. Most would be prescribed Suboxone.


While the number of uninsured Mainers addicted to opioids isn’t known, about 25,000 to 30,000 Mainers say they are seeking drug treatment but don’t have access to it, according to a survey by the U.S. Substance Abuse and Mental Health Services Administration. How many truly lack access and how many have an opioid addiction versus other drug problems is unknown.

The $2 million for medication-assisted treatment for the uninsured would build on $2.4 million DHHS set aside in December for that use.

“It will only help the tip of the iceberg, but any help is welcome and should be encouraged,” said Dr. Mary Dowd, who treats those with opioid addictions at the Milestone Foundation’s detox center in Portland and through Catholic Charities. “We have so many patients who don’t have insurance.”

Several organizations that offer medication-assisted treatment, which helps curb drug cravings, have said at least 40 percent of people who seek treatment are uninsured, often because they’ve lost jobs and emptied bank accounts because of their addiction.

Because Suboxone combined with counseling – considered the gold standard to treat opioid disorders – can cost $6,000 to more than $10,000 per year, most who lack insurance can’t afford treatment.

A bill submitted by Rep. Karen Vachon, R-Scarborough, and backed by MaineHealth would spend $6.7 million on the uninsured, more than three times the amount announced by the DHHS on Thursday. About 1,000 additional uninsured patients would have access to medication-assisted treatment under Vachon’s bill.


Katie Fullam Harris, senior vice president of government relations for MaineHealth, the parent company of Maine Medical Center, said MaineHealth concluded 1,000 patients was a realistic number. It would have an impact on the problem, but wouldn’t provide funding for more people than existing Suboxone treatment capacity could handle.

The federal government caps the number of Suboxone prescriptions that each doctor can write at 275, to discourage “pill mills,” but recent efforts should increase the number of medical professionals trained to prescribe Suboxone.

Doctors’ groups in Maine are trying to persuade more physicians to be trained to become Suboxone providers. Also, starting this year, nurse practitioners and physician assistants will be able to prescribe Suboxone.

Fullam Harris said MaineHealth is “very encouraged” by DHHS’ plan but will keep pushing for more financial help for the uninsured.

“This is an important first step,” she said. “Will it address the full scope of the epidemic? No.”

Medicaid expansion is expected to be on the Maine ballot this fall. That would increase access to medication-assisted treatment for thousands of additional Mainers who might be added to Medicaid rolls.


At the same time, congressional Republicans are threatening to repeal the Affordable Care Act, which provides funding for Medicaid expansion.

Under the ACA, health plans must include substance abuse treatment coverage. If the ACA is repealed, it’s unclear whether a Republican-written replacement would mandate such coverage.

Dr. Elisabeth Fowlie Mock, a Suboxone prescriber from Holden, said recent moves by the DHHS are a “good start.”

“Anything we can do to increase affordability and access is good,” Mock said. “This is something to build on.”

Joe Lawlor can be contacted at 791-6376 or at:

[email protected]

Twitter: joelawlorph

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