Maine can’t get out of its own way when trying to deal with the opioid epidemic. After another record year for overdose deaths, the vast majority caused by heroin and prescription pain killers, a request for proposals to run a 10-bed “social” rehab facility in Bangor may attract zero bids, because of the category of the patients it would be required to serve.

By law, 40 percent of the new facility’s patients have to be people who don’t have health insurance. That requirement would make it difficult for the program to balance its budget on the income it could get by billing private insurance and Medicaid, known here as MaineCare. Providers have until Aug. 24 to submit proposals, but people in the medical community are concerned that there will be no interest unless the uninsured requirement is lifted.

The requirement may look like a flaw in the law, but it’s not. A major component of the crisis is a lack of treatment options for opioid abusers who don’t have health insurance, and any new facility that excluded that population would be aggravating the problem, not curing it.

It’s no accident that there are a significant number of drug dependent people who don’t have health insurance — it is the direct result of the LePage administration’s human services policy — a blind rush to cut the MaineCare rolls without considering the consequences. Not only did the governor veto legislation that would have extended health coverage to 60,000 people, he and allies in the Legislature pushed through cuts that made thousands of childless adults ineligible for coverage.

The people who are now being denied drug treatment — and who in some cases are overdosing and dying — include the “able-bodied adults” the administration was so proud of dropping from the program. That’s not only a problem for those individuals, it hobbles treatment efforts generally. Without the ability to bill MaineCare, the Mercy Recovery Center had to close its doors last year, and the same problem could doom the Bangor detox, denying care not just to uninsured patients, but anyone else who would need its services.

The crisis can be seen as simple matter of supply and demand. The number of people seeking treatment for heroin use alone tripled in five years, going from 1,115 in 2010 to 3,463 in 2014. In 2015, there were about 15,500 people who received treatment for all opioid use, including heroin. The response by the public sector has been nowhere near enough.


This year President Barack Obama signed a $94 million initiative to fight opioid use around the nation, with $1.2 million going to Maine clinics for medication assisted treatment. That might sound like a lot of money, but it’s not by a long shot.

Before the bill was sent to Obama, the Senate failed to approve a $600 million, despite the support of Maine Sens. Susan Collins and Angus King. During that debate, King told his colleagues that “We can’t solve this problem without money … The old saying in Maine, and I suspect elsewhere, is ‘put your money where your mouth is.'”

That same challenge should go to Augusta. Everyone agrees what the problem is and there is substantial agreement over what to do about it. We need law enforcement to disrupt supply chains, education to deter new users and treatment for the people who are addicted. A half century of data shows that medication-assisted treatment has the best rate of success. It costs between $5,000 and $7,000 per patient per year. The math is simple.

We know where trying to solve a public health crisis on the cheap will lead — more addicts in the community, more overdoses, more deaths. It’s time for the administration to get out of the way, and get treatment to the people who need it.

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