Maine could benefit from Trump's opioid-crisis emergency declaration

Aug. 11--Maine drug treatment providers, doctors and public health officials are optimistic about getting federal resources to fight the state's opioid addiction epidemic, now that the president has decided to declare a national public health emergency.

President Donald Trump is following the advice of the White House opioid commission, led by New Jersey Gov. Chris Christie, that recommended officially declaring the opioid crisis a national emergency so that federal funds and other resources can be used.

"Certainly, making more funding available for treatment and making more money available for medications like Narcan, which can save the life of a person overdosing on opioids, we see it as a positive," Dr. James Raczek, chief medical officer of Eastern Maine Medical Center in Bangor, said Friday.

Hospital and community leaders in the region identified "opioid use as a crisis for some time now," Raczek said, adding that he is pleased federal resources may soon be tapped to address the problem. Narcan is the brand name for naloxone, an opioid antidote that can help a person overdosing to breathe again.

Trump's announcement came two days after the federal Centers for Disease Control and Prevention released a report showing that more than 64,000 Americans died of drug overdoses in the first nine months of 2016 -- a 22 percent jump compared with the 52,404 who died in all of 2015.

During the same period, Maine saw nearly a 40 percent increase in deaths by drug overdose, which last year claimed the life of more than one person a day. The vast majority of those 376 deaths -- 313 or 84 percent -- were caused by opiates or by another drug in combination with an opiate.

The Commission on Combating Drug Addiction and the Opioid Crisis report suggests that Trump use the Robert T. Stafford Disaster Relief and Emergency Assistance Act of 1988, known as the Stafford Act, which would call the Federal Emergency Management Agency into service, or the Public Health Service Act that would tap the U.S.Public Health Service, to declare the national emergency.

Trump met Tuesday with Thomas Price, the secretary of Health and Human Services, who can unilaterally declare a public health emergency under the Public Health Service Act.

The first key factor identified in the opioid commission's report is one that would increase treatment capacity by changing the rules for inpatient facilities that are limited to 16 beds in order to receive federal funds. That change to the Social Security Act would require action by lawmakers, or Price could immediately grant waivers to each state that requests one.

"This is the single fastest way to increase treatment availability across the nation," the report states.

The commission's other suggestions include educating doctors and other prescribers about substance abuse disorder; establishing a fund to enhance access to medication assisted treatment; provide a standing order for naloxone; provide funding for fentanyl detecting devices and increase searches at the U.S. Postal Service; create prescription drug monitoring program data sharing to prevent doctor's shopping; update privacy laws to allow doctors and other prescribers to look up a patient's medical history; and enforce laws that ensure health care policies are fair to those with substance abuse disorders.

If federal dollars were released, they would help Maine providers, according to Suzanne Farley, executive director for Wellspring Substance Abuse and Mental Health Services, a residential and outpatient services program in Bangor.

"I think the thing I would really, really advocate for is for the state to increase reimbursement rates for substance abuse providers," Farley said. "They only reimburse us for so many dollars for services we provide, and it's difficult to attract qualified staff. The other thing I would really advocate for is so that law enforcement had greater access to Narcan."

The Trump Administration released $485 million in the form of grants in April to all 50 states and the District of Columbia to help address the epidemic on the local level, and Maine was awarded $2,039,029.

Specifics about how the Maine grants will be used were not available, but Samantha Edwards, spokeswoman for the Maine Department of Health and Human Services said several programs designed to combat the state's drug addiction problem are underway or in the works.

The state increased medicated-assisted treatment for the uninsured, launched a pilot program at Penobscot County Jail to provide Vivitrol, a monthly shot that makes it impossible to get high on opioids or alcohol, to female inmates, and is funding the launch of Maine's Opioid Health Home model, she said.

Patty Hamilton, Bangor Public Health director, said any federal funding would be used to make sure nobody falls through the cracks.

"We would first determine the state of Maine responsibilities and then assess local needs and work with community partners to fill the gaps," Hamilton said.

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