Here’s my memory of how the opiate epidemic took a turn for the worse here in Maine.

In 2010, I was working in a medication assisted program counseling clients for whom we were prescribing Suboxone. Most of our clients were doing well and I thought the opiate problem in central Maine was improving.

Unfortunately, the 2010 state election changed all that. The governor and Legislature decided to limit medication assisted treatment to two years lifetime and to cut reimbursement rates for methadone from $80 per week eventually down to $60 per week.

The net effect was that people who were doing well on their medication had two years to get better and then they were cut off, despite all of the scientific research that made it clear that cutting off treatment would lead inevitably to relapse.

At the same time state and federal efforts were trying to reduce prescriptions for opiates so that paradoxically the only resource that was available for addicts was heroin, which actually became cheaper than diverted prescription medications such as oxycodone. So, in a way, the worsening of the opiate epidemic was a direct result of state and federal meddling.

I wonder if we will ever learn the lesson to keep the politicians out of the practice of medicine. Or at least make them ask for and heed the advice of the doctors and counselors who know how to help.

David Doreau


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