A task force created by Attorney General William Schneider to crack down on Maine’s painkiller abuse epidemic is set to present its first round of plans and recommendations to Gov. Paul LePage this week.

The group already is moving to set up a statewide diversion alert network so doctors will know whenever their patients are arrested for abusing or selling their medication.

It also is recommending steps to more aggressively use an existing database of prescriptions that can alert doctors and pharmacists if patients may be diverting the pills to the illegal drug market.

“I think there’s a lot in (the report) that is going to help,” Schneider said last week. “It’s a very serious problem, and I think people are waking up to that fact.”

The report focuses on initiatives that experts agreed could have the most immediate impact on the problem. Yet the task force ran into some of the same issues that have hampered anti-addiction efforts for the past decade: lack of funding and the historic tension between law enforcement and addiction treatment.

The report has been in the works since Feb. 1, when LePage created the task force by executive order. Schneider began assembling the group after convening a prescription drug abuse summit in October.

An investigation by MaineToday Media, published in October, showed that the statewide costs of painkiller abuse had reached record-setting levels a decade after it was first identified as an epidemic.

Nearly 1,400 Mainers died from overdoses of pharmaceutical drugs in the past decade, and more than 500 Maine babies born in 2010 faced potential opiate withdrawal and other effects of their mothers’ prescription drug abuse.

The task force will submit its report this week amid heightened concerns about drug-related crime.
Police blamed much of a 5 percent increase in the state’s crime rate in 2011 to increasing abuse of prescription drugs. And, halfway through this calendar year, the state has already tied the record set last year for the number of pharmacy robberies — 24.

The task force has focused on four core initiatives that experts identified at Schneider’s summit in October.
• Drug collection and disposal. The Maine Department of Environmental Protection has agreed to allow more unused medication to be incinerated in Maine, according to the report.

That could reduce the cost of future collection efforts dramatically and allow for more collection events. In-state disposal costs about $88 a ton, while disposal at an out-of-state hazardous-waste site can cost $8,000 a ton, the report says.

• Diversion alerts. The task force is planning to implement a statewide diversion alert program to notify doctors whenever patients are arrested or charged with drug offenses. It is seeking private and federal funding for a two-year pilot program, which is expected to cost $185,976.

• Education. The task force recommends that existing anti-drug websites be coordinated and enhanced with existing state resources. It includes plans for a more comprehensive statewide campaign — including radio and newspaper advertising— but that would cost about $406,000 and the report doesn’t say how the state might pay for it.

• Prescription monitoring. The task force recommends continuing efforts to increase use of the state’s prescription database by physicians and other prescribers.

It also recommends that the state seek more funding to manage the program, and that law enforcement be granted more access to the information. That would require a change in state law. Police now need a grand jury subpoena to look at a crime suspect’s prescription records.

A lack of communication between Maine’s medical and law enforcement communities has been widely seen as a barrier to containing the addiction problem. The diversion alert program, however, is still a subject of debate within the task force.

Guy Cousins, director of the Maine Office of Substance Abuse, said the report includes several initiatives that will help combat the abuse. But he has objected to the diversion alert proposal for a number of reasons, including the potential stigma that could keep people who get arrested from getting the treatment they need.

Physicians can cut off treatment to patients who need help if they get arrested and end up on the diversion alert notice, he said. “There’s no real clarity on how the information gets used.”

Schneider said he is confident that the information would be used to help the addicts.

“It’s additional information that the doctor can use to treat the person better. The intention is absolutely not to get somebody cut off from their treatment,” he said.

Gordon Smith, vice president of the Maine Medical Association and a task force member, agreed.

“The alert system is really helpful to the doctors. It’s one thing we can do that’s not expensive, and it’s public information,” he said.

Smith said doctors won’t stigmatize or drop patients who get arrested, “but I’d like to have them know that their patient was arrested for a drug-related offense if they are prescribing them opiates.”

Smith and others have separate concerns about granting law enforcement more access to prescription records, although that proposal has yet to be turned into specific legislation.

And many see funding, or the lack of it, as a major challenge for the task force.

Lack of money in the state budget hurt efforts to address the problem during the last legislative session. While lawmakers debated policies to reduce abuse, they also approved two-year limits on MaineCare insurance coverage for common forms of addiction treatment unless a patient gets state approval.

The restrictions on treatment will increase addiction and the problems that come with it, said Eric Haram, president of the Maine Association of Substance Abuse Programs.

“There will be more robberies, more burglaries and break-ins,” Haram said. “We just are not going to arrest our way out of this problem.”

Smith agreed, saying law enforcement and the medical community can’t solve the crisis because the pills can easily be brought in from other states.

“Long-term, the only way to really effectively deal with it is to decrease demand. We’ll never be able to kill the supply,” Smith said.

“You’re going to have to change the culture.”

Schneider said the task force is just one part of the solution, but he believes the state is taking the issue seriously. “I think it’s getting the attention it needs.”

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