Medication-assisted treatment for opioid addiction is coming under fire this week from the administration of Gov. Paul LePage.
Methadone and Suboxone are medications that, in combination with behavioral therapy, are considered the most effective way to treat opioid addiction. But on Tuesday the governor took to the airwaves to say he’d like to close the state’s 10 methadone clinics.
Since taking office, LePage has successfully pushed for a two-year cap on methadone and Suboxone treatment unless patients get special permission to continue. He has tried and failed to end MaineCare coverage for methadone treatment. And this week, the Maine Department of Health and Human Services announced that it wants to impose additional requirements for methadone and Suboxone providers, including additional counseling.
In a telephone interview on Monday, state Health Officer Dr. Chris Pezzullo said the LePage administration supports medication-assisted treatment.
“I would say the administration supports evidence-based treatment for substance-use disorder. So whether it’s methadone, whether it’s Suboxone, whether it’s other evidence-based initiatives, certainly, you know we support that,” he says.
But LePage remains a skeptic, despite the fact that his state health director is on board with it, the fact that the federal government has made it a priority to get more people into methadone and Suboxone treatment, and the fact that decades of science show methadone is the gold standard for treatment of opioid addiction.
“I’ve been trying to close down methadone clinics since I’ve been governor and we’re raising the price and everything and I tell you, when it comes to methadone, every expert I have spoken to says if there’s no clinical aspect to it, if it’s just, you stop by, get your drug and leave, it’s useless,” LePage said on a guest appearance on WVOM Tuesday morning.
Methadone clinics are regulated by half a dozen state and federal agencies. Counseling is required. And Portland addiction specialist Dr. Mark Publicker says the governor’s position is “astonishing.”
“Astonishing that at a point where Maine has yet to peak in its severe opiate epidemic, where hundreds of people are dying of overdoses, that the governor is doing everything he can to increase the death rate and suffering of Mainers,” he says.
Last year the Legislature rejected a proposal by the LePage administration to end MaineCare coverage for methadone treatment. Doctors, providers and patient advocates said it would be a disastrous move.
LePage told WVOM he relies on the best available science to make his decisions and he expects others to do the same.
“That’s what I ask people to do, use the best science and move forward,” he said, going on to say that he has been told that only ten percent of heroin addicts can recover.
Publicker says he isn’t sure where that statistic comes from. He says with methadone treatment, research shows a patient has a 60 percent or better chance of maintaining sobriety.
