AUGUSTA — Maine has made steady progress in addressing the opioid crisis over the last year, but thousands of people with substance use disorders remain untreated and at risk, the state’s top opioids official told lawmakers Wednesday.
Gordon Smith, whom Gov. Janet Mills appointed as the state’s first director of opioid response in January 2019, said Medicaid expansion has provided access to medication-assisted treatment for 5,000 people, and more than half the state’s hospitals now offer that medication on essentially a walk-in basis.
However, Maine can’t meet the demand for housing, counseling, coaching and other support services that are critical to the long-term recovery process once people obtain access to treatment.
In a briefing for the Health and Human Services Committee, Smith said the state had trained 250 recovery coaches in 2019 and is coordinating their activities and connecting all of them with clients under a state plan that sets priorities and lays out strategies for reducing the impact of substance use disorder.
“There is a lot of great work being done, but we are still just building a foundation, in my opinion, which is why we needed a strategic plan,” Smith said.
Mills has made addressing the opioids crisis a priority of her administration.
“Fighting the opioid epidemic will be a long, difficult battle with ups and downs, but when it comes to the lives of our neighbors, friends, and loved ones, it is a fight that my administration will never shy away from,” the governor said in a statement Wednesday.
During his appearance before the committee, Smith explained how his office was spending the $5.5 million it was allocated by the Legislature from the Fund for a Healthy Maine, which is funded by tobacco settlement money.
He said his office had access to $6 million to $7 million in combined state, federal and philanthropic funds, which are often “braided” together to carry out its work. None of the money is from the state’s general fund.
“It’s quite a lot of money, but I want you to know that it’s not enough money to address the problem in my opinion, we will never have enough money,” he said.
Smith highlighted a $2 million effort to expand needle exchange programs, noting that they help guard against the spread of infectious diseases like hepatitis C and HIV while serving as an access point for people seeking treatment and recovery.
Rep. Patricia Hymanson, D-York, the committee’s House chairwoman, said the exchanges also are saving taxpayer funds by preventing the spread of infectious diseases. She pointed out that the medication used to treat hepatitis C costs $45,000 a year per patient.
“If you have 50 people and you had to treat 50 people that would be $2 million,” said Hymanson, a physician. “So if we prevent at least that many, which is easy to do with the clean exchange, then we are doing a good thing just from a financial point of view.”
Maine’s expansion of its Medicaid program, MaineCare, is helping many gain access to treatment. Smith said of the 50,000 new Medicaid enrollees in Maine, about 5,000 are seeking treatment for substance use disorders.
The state has added 1,420 providers of medicated-assisted treatment, he said, and 18 of Maine’s 33 hospital emergency departments also are offering nearly on-demand support for people who seek help for substance use disorder.
Along with increasing access to medication-assisted treatment, Smith described efforts to develop a public school prevention program that includes creating a curriculum in the Department of Education and professional development for teachers. The education department will spend $710,000 in 2021 developing the curriculum, according to documents Smith gave the committee.
He also said that some public school districts had expressed no interest in a prevention curriculum, saying the opioid crisis was not a problem in their communities.
Maine’s prisons and jails have added treatment programs for inmates, although fully funding those programs to cover the 70 percent of the inmate population that has a substance use disorder would cost the Department of Corrections another $9 million a year, Smith said.
He also shared details about the 1,322 children who were taken into state custody in 2019 – the most in five years. Smith said most of those children were under the age of 5 and that 51 percent were from homes where parents had substance use disorders. Twenty percent of the children were drug-affected newborns.
Smith said he expected opioid-related deaths would again decline slightly in 2020 as they did in 2019, but his report also shows that six Mainers a week are still dying from overdoses – down from 2017 when 417 deaths, or roughly eight per week, were attributed to an opioid overdose. And while opioid-related deaths may be on the decline, deaths related to cocaine and methamphetamine are on the rise, Smith added.
The Mills administration has pushed to make the overdose antidote naloxone, often known by its brand name Narcan, more available to the police and the general public. But some police departments still refuse to allow their officers to carry the medication, Smith said.
The committee is scheduled to hear at least two opioid-related bills next Wednesday. One measure would remove the requirement in the state’s Medicaid law requiring pre-authorization for substance use disorder treatment, and the other would set up a $1 million fund for the treatment of pregnant women who suffer from substance use disorders.