Maine is making progress in its battle to help Mainers struggling with opioid use disorder, and Maine’s opioid treatment providers (often called “OTPs”) are part of an expanding and comprehensive statewide effort to get more Mainers into treatment and recovery.

Currently, there are 14 OTPs throughout the state who use methadone as part of a comprehensive treatment approach that includes medication, counseling, case management and more to treat over 5,000 Mainers at any given time, nearly 70% of whom are Medicaid-eligible. OTPs have gathered together as the Maine Opioid Treatment Provider Coalition for more than a decade to work collaboratively with state, local and federal officials to help make treatment more available and affordable.

Like many states, over the years, Maine has not been immune to the nationwide opioid epidemic that annually claims the lives of tens of thousands of Americans across every demographic. These are our friends, neighbors, co-workers and relatives. However, in the last two years in Maine, the statistics bear out that years of good work are making a difference as overdoses and overdose deaths have continued to decline. But no one is declaring victory.

Part of the improvement comes from increased levels of support on the state and federal level. In Maine, with support from Gov. Mills, the Office of Opioid Response, the Maine Department of Health and Human Services and the Maine Legislature, more resources have been made available for treatment, community interventions and prevention. Law enforcement agencies have increasingly shifted away from trying to arrest our way out of the problem to focusing on getting individuals into treatment. And stigmas continue to decline relative to individuals receiving treatment and the availability of proven modalities like OTPs.

On the federal level, changes in law have reduced barriers to treatment, making it easier for providers to get patients into and remain in treatment. Many of these changes have flowed through to Maine, where onerous regulations have been cut back so that treatment decisions can be tailored to the unique needs of patients with guidance from trained professionals. These changes have removed unneeded requirements that discouraged Mainers from seeking and remaining in treatment.

For decades, OTPs have been considered the gold standard for treating individuals with opioid use disorder, but only in recent years has public perception caught up with this reality. Now the focus has turned to opportunities to expand access to OTPs further so that more individuals can benefit.

In Maine, important steps have been taken in recent years to reduce unneeded regulations and increase funding, and the result has been the addition of new clinics in Saco, Rumford, Presque Isle and Manchester, with more on the way. Limits on patients in individual clinics have been lifted, clinics no longer are regulated as pharmacies, and rigid treatment requirements have been ditched in favor of more patient-centric models.

On the federal level, the Substance Abuse and Mental Health Services Administration recently relaxed requirements on how often a patient needed to physically visit an OTP, a change long sought by providers and patients. Now, depending on how a patient is doing, the patient can go as long as 28 days with take-home medication before needing to return to a clinic for medication – similar to temporary rules that were successfully put in place during COVID. In fact, data from one provider with nearly 600 patients show that 47% of patients come to the clinics just once per week or less, and with the new rules, those patients doing well in treatment will be able to defer coming into the clinic for medication even longer. This reduces a long-standing barrier to treatment.

Of course, key to the success of any of these changes is maintaining the relationship between provider and patient in a clinic setting. Methadone is a powerful synthetic opioid that does not create a high when properly administered, but if incorrectly administered could be harmful to patients. Reducing unneeded barriers to treatment is important, but the clinic setting of OTPs with comprehensive care remains essential to patient safety and success.

Maine is making progress on the opioid crisis, with much more to go. Along the way, Maine’s OTPs are proud to be part of the broad coalition of state, federal and local leaders and organizations helping us get there.