What are we doing in Maine to address the opioid crisis?
Maine’s opioid epidemic claimed 272 lives in 2015 and shows no signs of slowing down. We are in a state of crisis, and the Maine legislature and the Maine Department of Health & Human Services have charged clinicians with getting resources and training to provide effective, patient-focused care in challenging circumstances. The independent experts at MICIS are here to help.
MICIS, the Maine Medical Association, and many more groups and individuals are all taking significant steps to address this serious situation:
- Public Law chapter 378 (LD 1537): new drug enforcement agents, treatment and prevention/harm reduction efforts
- PL c. 351 (LD 140) and c. 508 (LD 1547): increased access to naloxone to prevent overdose deaths
- PL c. 507 (LD 1552): syringe exchanges
- PL c. 488 (LD 1646): limits on amounts and timing of opioids prescribed; mandatory checks of the Prescription Monitoring Program; Opioid CME requirement (PowerPoint explanation)
- DHHS 2017 (1/1/17) Rule on opioid prescribing and use of the PMP 14-118 C.M.R. Chapter 11 NOTE: This form of the rule is no longer in effect. It has been superseded by the rule as stated in the next item
- DHHS Rule (3/31/17) on opioid prescribing and use of the PMP 14-118 C.M.R. Chapter 11
- MMA Comments on the DHHS Opioide Rule
- MMA’s Question & Answer document on chapter 488.
- MMA’s 2-page summary fact sheet on the opioid law and rules (6/1/17)
- Maine Prescription Monitoring Program (PMP) website
- MMA Comments on Proposed Rule RE: Chapter 21, Use of Controlled Substances for Treatment of Pain
New Documents Posted by DHHS (June & July, 2017)
- Opioid Prescription Requirements, User’s Guide
- Electronic Prescribing Clarifications
- Opioid Dispensing Clarifications
The various prescribers’ licensing boards (Medicine, Osteopathy, Nursing, etc.) have a joint rule on the use of opioids, called Chapter 21. It can be found by going to a board website, such as http://www.maine.gov/md/laws-statutes/rules-statutes.html, and clicking on Rules Chapter 21. That rule is about to undergo revision, but the version in the link is currently applicable.
Letter to the Association Membership Explaining Chapter 488
By: Gordon Smith, Esq., Executive Director of the MMA
View PDF of Letter to the Association Membership
In early 2016, the U.S. Attorney for Maine, the Maine Attorney General, and the Maine Commissioner of Public Safety (known collectively as the Maine Opiate Collaborative) created three task forces to study various aspects of the opioid addiction problem. On May 6, 2016 those task forces issued their reports, which include significant recommendations for dealing with the problem:
- Law Enforcement Task Force Report
- Treatment Task Force Report
- Prevention & Harm Reduction Task Force Report
- Summary of Recommendations
Education of the prescriber community, including physicians, nurse practitioners, dentists, podiatrists and even veterinarians, began well before this was big news in the press. The MMA has presented Continuing Medical Education (CME) programs on the topic. The Maine Independent Clinical Information Service (MICIS), an arm of the MMA, has been delivering free clinical education on opioids and naloxone to Maine’s physicians and nurse practitioners.
As time goes on,and more initiatives are put into place, we will keep you connected to medical resources as they become available. This is a serious public health challenge that the medical community and many others are actively working to solve.
- Pain Management
- U.S. CDC Guidelines on Opioid Prescribing
- Maine Quality Counts Resources
- How to Use Naloxone
- Naloxone for Opioid Safety
- Maine Voices: Steps Maine Can Take to Fight Addiction – Op Ed piece by Brian Pierce, MD, MMA President, Published in 1/10/16 Maine Sunday Telegram
- AMA President Steven J. Stack, MD: Confronting a Crisis: An Open Letter to America’s Physicians On the Opioid Epidemic