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$8 Million Proposal Would Expand Medication-Assisted Treatment for Opioid Addiction

Susan Sharon
Maine Public

Democratic Senate Minority Leader Troy Jackson says lawmakers and the LePage administration are discussing an $8 million proposal to expand medication-assisted treatment to roughly 700 Mainers suffering from opioid addiction.

The proposal, which combines $3 million in state and $5 million in federal funds, was brought forward by Department of Health Human Services Commissioner Mary Mayhew during a meeting with legislative leaders held Wednesday.

Jackson said Mayhew presented the treatment plan after Senate Democrats insisted that the governor’s supplemental budget include expanding access to methadone and Suboxone to deal with a opioid crisis that Attorney General Janet Mills announced last week killed 378 people. The overdose deaths last year marked a 40 percent spike in the previous record of 272 deaths in 2015.

Mills said the overdose death rate is over 1 person per day.

Gov. Paul LePage hinted during his State of the State address Tuesday that his administration was discussing a treatment proposal and, in doing so, praised Jackson, with whom he has previously clashed. While LePage has frequently questioned the effectiveness of medication-assisted treatment, Jackson said he allowed Mayhew to meet with Democrats to discuss the proposal.

“I think there’s great promise with the proposal and we’re very interested in going forward with this,” Jackson said.

The proposal is far from a done deal, but Jackson said he hopes the Legislature’s budget-writing committee will review it next week and that it will become part of the governor’s supplemental budget, which addresses spending for the current fiscal year ending in June.

Jackson said there had been some reluctance to add opioid treatment to the supplemental budget because some wanted to wait to include it in the next two-year budget. But he said the opioid epidemic is an emergency and should be addressed immediately.

If adopted the proposal would require emergency rulemaking, which could take between 60 and 90 days.

While details of the proposal are not yet public, Jackson said it’s a pilot program that pairs Suboxone and methadone treatment with counseling and a monitoring program to ensure patients are following through with their treatment. The latter component would appear to satisfy the LePage administration’s desire for more accountability in medication-assisted treatment, which LePage has repeatedly criticized.

In the prepared text of his State of the State address, LePage criticized Democrats who “simply want to throw money at treatment programs.” In his actual remarks, LePage questioned whether the $80 million the state spends on treatment is effective at all.

The governor’s position has been repeatedly criticized by treatment experts, who point to reams of studies showing that medication-assisted treatment is the most effective way to treat opioid addiction.

Earlier this year DHHS announced that it was spending an additional $2.4 million on medication-assisted treatment for the uninsured. Jackson said the latest proposal would also target the uninsured, but it would expand access to others as well.