Good morning and welcome to this edition of the Daily Brief(er). As promised yesterday, the Daily Brief is on a sort of on-again, off-again vacation between now and the end of the month and will emerge from hibernation when there’s a reason.
Well, this morning there’s a reason. Gov. Paul LePage’s administration is poised to make what sounds like a major announcement this morning in regards to an expansion of substance abuse treatment opportunities in Maine.
Mary Mayhew, commissioner of the Department of Health and Human Services, and Chief Medical Officer Dr. Christopher Pezzullo will brief reporters later this morning on a plan to fund 359 new medication-assisted treatment slots throughout Maine beginning on Jan. 1, 2017.
According to information provided in advance of today’s news conference, those slots will be targeted at people without health insurance in areas of Maine where the need for addiction treatment is most pronounced. The new medication-assisted treatment slots will be distributed as follows:
- Acadia Hospital in Bangor: 50 slots
- Discovery House in Bangor: 160 slots
- Discovery House in Calais: 100 slots
- Crooked River Counseling in Bridgton: 25 slots
- Central Maine: 24 slots
DHHS estimates that there is a waitlist of up to 450 Mainers seeking medication-assisted treatment, which involves inpatient or outpatient counseling and the use of Suboxone or Methadone, which are both medications used to help ease people off opioid addictions.
Funding for the new treatment options will be provided by the DHHS Office of Substance Abuse and Mental Health Services, which intends to further expand these treatment services as needed in Down East and western Maine.
Today’s announcement is notable for a number of reasons, starting with the terrible scope of Maine’s drug addiction problem. One Mainer dies every day, on average, from a drug overdose. According to DHHS data, 8 percent of live births in Maine were infants born exposed to drugs and more than 60 percent of children entering state custody come from families in which substance abuse is a risk factor.
It’s also notable because LePage, who has had a prolonged focus on fighting drug addiction in Maine, has often clashed with treatment professionals, political opponents and families over how to address the state’s surge in opiate addiction. LePage has repeatedly voiced opposition to the use of Narcan — which can immediately reverse the effects of an overdose — and earlier this year vetoed a bill that sought to make Narcan available over the counter and supply police and fire departments with the substance. LePage’s veto of LD 1547 was overridden by the Legislature and the law is in effect.
In 2015, LePage proposed cutting state-funded methadone treatment in an effort to transition people fighting opiate addiction to Suboxone, which is subject to Maine’s prescription monitoring program. In July of this year, the governor said publicly “I’ve been trying to close down methadone clinics since I’ve been governor.”
“When it comes to methadone, every expert I’ve talked to says there’s no clinical aspect to it. … It’s no help. It has to be in a program that’s monitored by clinicians.”
The governor later elaborated to say that counseling should be a condition of ongoing methadone treatment.
LePage has also argued with the Legislature when it came to a bill in early 2016 that provided money for more drug investigators in Maine. Democrats argued, successfully, that the $3.7 million bill should include funds for treatment and education, in addition to law enforcement. LD 1537 was eventually signed by LePage and is currently in law.
The counseling component of the new slots being announced today addresses what LePage apparently sees as a major weakness of the treatment addiction sector.
There are many pieces to this puzzle and here’s another one: Earlier this year, LePage spearheaded a bill that put strict new limits on the prescription of addictive opioid painkillers and benzodiazepines. Among other new prescription monitoring measures, the bill as amended and passed by the Legislature and signed by LePage limited prescriptions for chronic pain to 30 days and for acute pain to seven days. Some of the provisions of that bill went into effect earlier this year and some go into effect on Jan. 1, 2017. — Christopher Cousins
LePage ‘embarrassed’ by Electoral College vote
Gov. Paul LePage was full of criticism of Monday’s casting of Maine’s four Electoral College votes at the State House during a radio interview on WVOM this morning. LePage called the proceedings, particularly an energetic protest against President-elect Donald Trump outside the State House and an elector who tried to vote for Bernie Sanders instead of Hillary Clinton, “a joke.”
“I was very disheartened by one of the electors and certainly the people around the State House screaming ‘dump Trump,’” said LePage. “I don’t know the gentleman [David Bright, the Democratic elector who tried unsuccessfully to vote for Sanders] but I was embarrassed for the other people who were there, who were trying to do their duty in the electoral process.”
On another topic, LePage reiterated his intention to ask the Legislature to change the minimum wage law passed by referendum last month, specifically to restore the tip credit for employers of tipped employees and to eliminate the provision that ties future minimum wage increases to the consumer price index.
LePage also repeated his claim that the executive branch will need $5 million or more to set up a monitoring and enforcement mechanism to oversee legal marijuana, which was also passed at the ballot box last month. In the past, he said he would not include that funding in the two-year budget proposal that will be unveiled in early January. On Tuesday, he said legislators will have to come up with that money and that he would prefer to shift management of retail marijuana sales from the Department of Agriculture, Conservation and Forestry to the state agency that oversees alcohol and lottery sales.
Asked whether he will issue a proclamation on the certified results of the marijuana referendum, LePage said he is seeking legal advice about whether that would violate constitutional provisions, specifically as they relate to federal prohibitions against marijuana use.
“I’m concerned that’s going to violate my oath of office which is, in fact, an impeachable offense,” he said. — Christopher Cousins