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2 11 15 SuboxoneDHHS Odt
2 11 15 SuboxoneDHHS Odt
Background
According to the Substance Abuse and Mental Health Services Association, the integration of physical
health and addictions care can help negate barriers to primary care, as providing primary care to
individuals with addictions enhances their recovery from substance abuse. Primary care treatment
yields better health outcomes for individuals, in contrast to back-and-forth referrals between behavioral
health and primary care offices that leave up to 80 percent of individuals without care.
In addition to having substance abuse disorders, many of these individuals suffer from interrelated
physical illnesses and/or co-morbid conditions that are not addressed when Methadone dosing occurs at
a treatment center. For example, studies have shown that people with substance abuse disorders have:
Prevention and treatment of chronic diseases does not occur at Methadone clinics. The high
quality treatment that individuals with addiction need requires a team of diverse professionals that
includes both specialty substance abuse providers and primary care providers. Under the integrated care
of a primary care provider, members receive prevention, education, and treatment for health issues,
including substance abuse disorders.
In addition, primary care providers maintain ongoing engagement with MaineCare members and
oversight of prescribing patterns as well as an awareness of a members substance abuse history. This
further enhances a holistic approach to health care delivery, rather than perpetuating a fragmented one.
Treatment of addiction and opiate habits is complex, and there are factors that need to be considered in
determining one treatment over another. For example:
Withdrawal symptoms will occur for individuals trying to break an addiction habit. Suboxone
has been shown to have less severe withdrawal symptoms than Methadone treatment.
Suboxone is considered to be less addictive than Methadone.
Suboxone is much more difficult to abuse, therefore patients are allowed to take this medication
at home versus Methadone where individuals have to travel seven days a week to a treatment
center until they can prove they will not abuse the treatment, at which point they are permitted
to take home doses.
Initiative
This initiative proposes to eliminate reimbursement for Methadone clinics. While the State of Maine
spends more than $8 million annually disbursing Methadone, only a percentage of those expenditures
would be realized as savings due to the fact that many of the individuals currently receiving Methadone
would likely transition to Suboxone treatments.
Savings*
Year
State
Federal
Total
SFY 16
$726,921
$1,209,986
$1,936,907
SFY 17
$867,657
$1,456,632
$2,324,289
*The savings estimates assume 80 percent of current Methadone users will transition to Suboxone with
the implementation of this initiative.
Buprenorphine possesses many clinical benefits such as lower abuse potential, lower level of
physical dependence, a ceiling effect at higher doses, and greater safety in overdose compared
to full agonists (including Methadone). (Mady Chalk, PhD; Kelly Alanis-Hirsch, PhD; Abigail
Woodworth, MS; Jack Kemp, MS; A. Thomas McLellan, PhD. The Effectiveness of
Pharmacotherapies for the Treatment of Opioid Disorders: A Systematic Review. Treatment
Research Institute. 2013.)
The risk of overdose on this medication is very small. (Substance Abuse and Mental Health
Services Agency. Buprenorphine for treatment of opioid addiction. 2011.)
______________
David E. Sorensen
Director of Media Relations and Policy Research
Maine Department of Health and Human Services
david.sorensen@maine.gov | 207.205.7793 (c)
Feb. 4 press release:
ACLU Response to State of the State: Drug Problem Calls for New
Approach
Gov. LePage Once Again Focuses on Law Enforcement; Neglects Treatment
and Prevention
FOR IMMEDIATE RELEASE
February 4, 2015
CONTACT: Rachel Healy, 774-5444 x2 or 409-5509; rhealy@aclumaine.org
AUGUSTA - For the second year in a row, Gov. LePage used his State of the State address to
demand more taxpayer dollars be spent on the failed war on drugs. According to the ACLU
of Maine, spending more on law enforcement while cutting treatment programs is a misguided
tactic that has failed to curb drug abuse in Maine over the last three decades.
The following can be attributed to Alison Beyea, executive director of the ACLU of Maine:
Last night, Gov. LePage called for more efficient, effective, and affordable government. But
he also called on the state to dump more money into the war on drugs, one of the least
efficient, least effective, and least affordable government programs in history. In the last three
decades, drug arrests in Maine have increased by 240 percent. We spend $60 million a year
punishing people for drug offenses. Yet the demand for drugs in this state continues to go up.
As long as the demand exists, there will always be a supply we simply cant arrest our way
out of the problem. If the governor is serious about curbing addiction in Maine, he should
focus our limited resources on programs that help Mainers recover and prosper not on
putting more people in jail where they wont get the treatment they need.
Feb. 5, 2015
Alex Milliken clinics have been working with Jim Cohen regarding Legislative issues