AUGUSTA — Health care providers in Maine are preparing for a state law that will go into effect July 1 that limits how many opioid painkillers they can prescribe to their patients.

The VA Maine Healthcare System, headquartered on the Togus campus in Chelsea, is trying to lessen the doses of addictive painkillers that are prescribed to Maine veterans, but it’s not clear the federal program will be able to get all its patients below the state limit of 100 morphine milligram equivalents per day that was enacted to address Maine’s opioid epidemic.

About 70 veterans enrolled at Togus are being prescribed higher doses of opioid painkillers than the 100-milligram limit, said Stephen Sears, chief of staff at Togus.

But Togus has been weaning its patients to lower doses over the last couple of years, Sears said. Just a year and a half ago, he said, more than 250 veterans were being prescribed doses above 100 mme.

“I think we’ll get there for most people,” Sears said. “But I can’t say that for everyone. There are some (veterans) with complex medical issues. … You have to look at every individual case.”

Under the law passed in 2016, physicians will not be allowed to prescribe more than 100 mme per day to their patients. The law includes a handful of exceptions, including for terminal cancer patients and those seeking palliative care.

Those prescribing limits were approved by lawmakers as part of a larger package of rules designed to fight the opioid epidemic. The death toll reached 376 in 2016, driven almost entirely by opioids – prescription painkillers, heroin and now fentanyl, a powerful synthetic. Four out of five new heroin users develop their addictions as a result of prescription opioids, according to the American Society for Addiction Medicine.

Because Togus is federally run, it’s not bound by many state laws, and it’s unclear if the Maine Department of Health and Human Services will try to penalize the system’s physicians if their patients are being prescribed more than 100 mme per day after July 1. Two department officials did not respond to requests for comment Tuesday.

But Togus providers still are trying to bring as many patients as they can down to that state limit. For one thing, Sears said, both the VA Maine Healthcare System and its parent agency have recognized the dangers of overprescribing opiates.

“We’ve been working on this for several years,” he said. “We started even before the (Maine) law was passed, as part of the overall, long-term strategy by the VA to address long-term pain management.”

Another reason Togus is trying to bring its patients down to the Maine prescribing limit is so they can receive treatment outside the health care system without their prescriptions being interrupted.

While Togus is trying to taper patients off painkillers, rather than cut them off cold, some advocates worry that it will be too much change in too little time.

“I’ve spoken to vets going through the process right now,” said Jerry Dewitt, commander of the Department of Maine AmVets and a licensed social worker. “Some of them are a little concerned that the VA put them on the meds to begin with, and now they’re trying to take them away. Unfortunately, they have been overprescribed to begin with, and that made a lot of veterans addicted to meds. Now they’re weaning them off of it. You can’t just stop taking a medication and be careful, especially if you’re addicted to it.”

Charles Eichacker can be contacted at 621-5642 or at:

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