A group of local and national substance abuse experts spoke out Tuesday against Gov. Paul LePage’s plan to eliminate state funding for methadone treatment.
LePage’s budget would transition opiate addicts seeking treatment from methadone clinics to Suboxone, a prescribed medication that patients must acquire from their doctors. Both Suboxone — a combination of two medications called buprenorphine and naloxone — and methadone serve as replacement drugs that patients are weaned off slowly, but they affect the brain differently.
Experts say Suboxone is more difficult to abuse than methadone.
The plan would eliminate methadone treatment from MaineCare, the state’s Medicaid program, which covers about 4,000 methadone patients. That’s roughly three-quarters of all methadone patients in the state.
LePage proposes to cut $727,000 in state funds in fiscal year 2016 and $868,000 in fiscal year 2017, a move that also would mean the state forfeits federal matching funds of $1.2 million and $1.5 million, respectively.
Creating additional barriers treatment undermines state and national efforts to reign in the opiate addiction and overdose epidemic, said Dr. Todd Mandell, president of the Northern New England Society of Addiction Medicine.
“Instead, we need work together to develop more clinically and cost-effective ways to address this disease and the devastating impact it is having on Mainers and on communities,” he wrote in a letter to Maine Department of Health and Human Services Commissioner Mary Mayhew.
Also signing on to the letter were the American Society of Addiction Medicine, the American Psychiatric Association, the Maine Association of Psychiatric Physicians, the American Academy of Addiction Psychiatry, and the American Osteopathic Academy of Addiction Medicine.
The groups took aim at the administration’s assertion that Suboxone is a safer and more controllable alternative to methadone. For many patients recovering from addiction, methadone is the recommended and more effective treatment, the groups said.
Recovering addicts visit clinics to get regular doses of methadone to curb cravings as they go through therapy. The daily structure, which isn’t required in office-based treatment with Suboxone, helps to keep patients accountable, the groups wrote. Transitioning patients from methadone to Suboxone is also a lengthy and difficult process, which can lead to relapse and death from overdose or withdrawal if forced too quickly, they wrote.
“Furthermore, this treatment alternative when effective is typically much more costly than comparable methadone treatment,” the letter reads.
The LePage administration counters that Suboxone, while costlier upfront, is at least as cost-effective as methadone over the long term, as patients become drug-free and get healthier.
Mayhew has said previously that methadone treatment isn’t reported to the state’s prescription monitoring program, which helps physicians track which medications their patients are prescribed by multiple health providers. Free-standing methadone clinics complicate the jobs of primary care physicians and allow patients to abuse the health care system, she said in a prior statement to the BDN.
“The LePage administration is committed to an opioid addiction policy that refocuses treatment away from mere harm reduction and toward full recovery; toward normalcy and away from lifelong dependency,” DHHS spokesman David Sorensen wrote in an email. “Seventeen other states decline to cover methadone with taxpayer-funded Medicaid and Maine’s move to do so is supported by extensive research.”