In early 2017, a policy was unveiled in Maine that severely limits the prescribing of opioids, both in terms of dose and volume. This has limited access to pain management for many people with chronic pain, demonized patients receiving such prescriptions and established a near-police state at many area pharmacies. It also implied that prescribers were responsible for the opioid crisis, even though 92 percent of patients who are exposed to opioids never go on to develop substance use disorder.

This policy, which was created with very little input from medical professionals in either the realm of pain management or substance use disorder, was trumpeted as a definitive move that would reduce the public’s access to opioids and thereby reduce overdoses.

It was not accompanied by improved access to evidence-based treatment for opioid use disorder; in fact, funding cuts to medication-assisted recovery and mental health care in Maine have become the norm rather than the exception.

Many of us in the recovery world strenuously objected to this policy, predicting not only that it would be limited in its effectiveness at actually addressing the problem, but also that it would result in more use of more dangerous street opioids, including by people who are genuinely trying to manage a pain complaint for which they can no longer get treatment. These concerns were dismissed as hysteria, and everyone behind the new policy got a big pat on the back for “finally doing something.”

By the end of 2017, the number of overdoses in Maine had climbed to 418, up from 272 in 2015. Isn’t it time we start focusing on treatment access rather than supply-side drug policy? For every $1 spent on treatment, according to the National Institute on Drug Abuse, we save $12 in reduced drug-related crime and criminal justice and health care costs. Isn’t that a better use of everyone’s energy?

Merideth C. Norris, D.O.


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