February 23

Drug treatment funding in Maine is falling, but demand is greater than ever

The number of people seeking treatment for opiate addiction has increased 15 percent since 2010; funding has decreased by 7 percent during the same period.

By Eric Russell erussell@pressherald.com
Staff Writer

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Daniel Vassie Jr., recovering heroin addict from New Gloucester

Gabe Souza/Staff Photographer

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Drug courts have been effective in Maine: In 2010, 62 people graduated for a rate of 61 percent – higher than the national average of 48 percent. The re-arrest rate for all participants was 16.5 percent, compared to a rate of 33 percent for all criminal offenders.

But the drug courts cost money, too. They are funded through the Fund for a Healthy Maine, the state’s share of tobacco settlement money, but there have been attempts in recent years to divert those funds elsewhere.

“I think the Legislature and our state needs to be comfortable that there is a cost associated with prevention services, just as there is a cost associated with abuse,” said Peter McCorison, vice president of the board of the Maine Association of Substance Abuse Services and chairman of the governor’s Substance Abuse Services Commission.

Maine lawmakers also recently imposed a two-year cap for methadone and suboxone treatment. Dorney, however, said that someone trying to wean himself off methadone or suboxone in a short period of time is almost certain to relapse.

“Yes, it is just substituting one narcotic for another, but if you’re an addict, you have permanently changed the makeup of your brain,” she said. “It’s like emphysema. If your lungs are damaged, you’re not going to reverse that even if you stop smoking.”

Cousins, LePage’s top substance abuse counselor, said drug-based therapy has been proven to work better than abstinence, but it needs to be coupled with behavioral therapy.

“Providers are seeing considerable wait lists,” Cousins said. “The need is greater than the resources we have.”

The worst possible scenario is an addict reaching the point where he is ready for treatment and being told he has no place to go, Cousins said.

WHERE THE FUNDING GOES

The quickest and cheapest form of substance abuse treatment is detox, in which someone is admitted for a short period of time to a facility to rid the body of an addictive substance. Detox has proved to be an ineffective treatment for opiate addiction. Instead, most opiate addicts are offered drug replacement treatment with methadone or suboxone, which block the neuroreceptors in the brain in the same way heroin does.

In 2013, 1,820 Mainers sought treatment for heroin addiction. Of that total, 40 percent received methadone while half received some form of outpatient therapy.

Only 144 were admitted to hospitals as inpatients, while the rest went to rehab facilities, halfway houses or found other forms of treatment.

The best option, professionals say, is long-term treatment with drug replacement therapy. Dorney said 30 days of inpatient therapy, followed by at least six months in a sober-living environment, is ideal.

But MaineCare and many private insurance plans often do not cover inpatient treatment.

Patients who do get into residential treatment centers are lucky, given the small number of beds and the long waiting lists.

According to the Office of Substance Abuse, the state has 194 substance abuse beds – only 21 of them designated for women – and that number has not risen in several years, Cousins said. Sixty-seven agencies provide outpatient services ranging from methadone clinics to counseling practices, with only 16 of them also providing intensive outpatient care.

Services are available to those who can pay for it on their own: Earlier this year, Crossroads Back Cove in Portland, one of the few halfway houses for women in Maine, closed after losing $330,450 in funding from the state Department of Health and Human Services. A self-pay, 30-day residential rehabilitation center for women with private insurance or who can pay out of pocket opened in its place.

Phil del Vecchio, a licensed drug and alcohol counselor at SMART Child & Family Services in Windham, which offers substance abuse counseling, said the biggest problem in Maine is the lack of inpatient treatment.

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Steve Danzig, drug counselor in Windham and a former addict

Gabe Souza/Staff Photographer

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Sayra Small, recovering heroin addict from Durham

Gabe Souza/Staff Photographer

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Pharmacist Jim Pearce fills a suboxone prescription at Boston Healthcare for the Homeless Program in Boston last year. Suboxone is an opiate replacement therapy drug used to help treat opiate cravings and withdrawal. Drug treatment officials say addicts often have their doses of suboxone or methadone tapered gradually until they no longer need it, but that timeline can vary depending on the severity of one’s addiction.

File Photo/Reuters



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