Public hearings held in Augusta on April 11 by the legislature's Health and Human Services Committee on a series of proposed bills to address the opioid crisis in the state brought home the "cry for help" coming from two of Maine's rural counties hit hardest, said committee Co‑chair Rep. Patricia Hymanson. Washington County had the highest rate of drug overdose deaths in the state between 2012 and 2014 and has the second highest rate of drug‑affected babies, nearly double the state average. One of the proposed bills that garnered attention and support with public testimony is a bill for a substance use disorder treatment pilot project sponsored by State Senator Joyce Maker of Calais and co‑sponsored by Rep. Will Tuell of East Machias.
If passed, LD 812, Resolve, To Establish a Pilot Project To Save Lives and Support People with Substance Use Disorder in Washington County, would implement an opioid treatment pilot project in Washington County that would: train non-healthcare entities that are on the front lines to serve as points of entry to treatment and recovery; provide training, comfort packs and referral systems to emergency departments; add eight additional detox beds; work with medication assisted treatment (MAT) prescribers to pair them with counselors; provide MAT to people without insurance; add the option for partial hospitalization for those without insurance; add low or no cost prescriptions for those without insurance; eliminate barriers such as child care and transportation during treatment and recovery; provide treatment and recovery support in county/local jails. These are only a few of the measures included in LD 812 that were recommended by the county's healthcare providers, community members and public safety officials as a result of numerous meetings and forums held over the last year.
At the April 11 hearing, Maker introduced the legislation saying that the opioid crisis "can be discussed all you want, but if you have no money" to address it, the crisis will continue to escalate. In Washington County, "this affliction has had a devastating effect on our communities, yet the treatment options available in our region are far from adequate." According to a 2017 report issued by the Margaret Chase Smith Policy Center, there were 376 drug‑induced deaths in 2016, 104 more than the previous year. Twenty of those deaths were in Washington County, with all of them attributed to opioids. Oxford County was the only other county listed where 100% of the overdose deaths, in this case 10, were attributed to opioids and not a mixture of two or more drugs and/or alcohol.
Maker and Tuell stressed the importance of having detox beds in the county. Currently, the state's only detox beds are located in Portland, a four- to five-hour drive in the best of weather and road conditions. Gordon Smith, executive vice president of the Maine Medical Association, told the committee that while funding had been allocated for the addition of 10 detox beds in Bangor in 2016, "We're still looking to see where they are going to go." Tuell stated, "If you do nothing else with this legislation, please make a commitment to putting detox in our area hospitals." He noted that the difficulty of driving a minimum of two hours, if the Bangor beds materialize, or over four hours to Portland during winter weather was compounded by the problem of finding a driver and navigating dangerous road conditions, and that was if a bed was even available at the facility.
However, once out of detox, the support network of resources "is where we lose people," said Malory Shaughnessy, executive director of the Alliance for Addiction and Mental Health Services, Maine. The alliance represents the majority of Maine's licensed community mental health and substance use disorder treatment agencies. She explained the pilot project "would build such a system of connecting links and supports to walk someone through the path of treatment and into recovery in a way that we are simply not doing well now." She added, "Treatment is just one component for many struggling with this disorder. For many, it has interrupted housing, employment, their family cohesion and their personal mental health."
Pointing to Washington County communities and their readiness for help, Smith told of attending a meeting in Machias with about 400 in attendance. He said, "These communities are really suffering." He added that with a pilot project, the state will see the results of a specific program of actions with targeted funding which, if successful, could then be used statewide. "We can't ask the legislature to dump money all over the state," he explained. But the need is severe, he illustrated. "It's incredible to me that someone comes to the Machias emergency room and has to go to Portland."
Department of Health and Human Services' (DHHS) Office of Substance and Mental Health Director Sheldon Wheeler noted that the "primary treatment admission rate for residents of Washington County seeking treatment for synthetic opioids is more than twice the statewide rate." The department has recently provided some additional supports for the uninsured in the county for opiate use disorders. However, he said, "In order to provide a more detailed response, the department would need more detail and direction with LD 812." Specifically, he pointed out the department's time‑intensive request for proposal process, "especially for entirely new treatment and recovery solutions."
The bill includes funding of $1.6 million over the 2018‑2019 fiscal biennium, with DHHS required to report on the planning and implementation of the pilot project to the legislative committee no later than November 30, 2018.
The legislation will be discussed by the committee at an April 25 workshop. Hymanson said of the workshop, "We're looking for a serious discussion to see what we can do to move forward."