Posted by & filed under Noah's Notes.

Last fall, U.S. Attorney Thomas Delahanty, Attorney General Janet Mills and Commissioner John Morris formed the Maine Opiate Collaborative following Senator King’s roundtable forums on opiate abuse and the governor’s forum on the same topic.

The Collaborative consisted of three task forces:  Prevention and Harm Reduction, Law Enforcement and Treatment.  Each of these task forces, which consisted of content experts, people with broad experience, people in the medical field and people in recovery, developed a set of goals, objectives and strategies which were presented on May 6th.  Over my next three blogs I will do my best to summarize these recommendations.  Though some require formal government action, many can be undertaken by caring and motivated medical personnel, community leaders, community members, friends and family.  So let’s start with Prevention and Harm Reduction:

  • Goal 1 – Promote good public health and safety and reduce the harmful effects of opiate use.  Objectives include:
    • Increase the understanding of the harms associated with opiate use and to address the stigma associated with the disease of addiction and its treatment through education of the public at large.
    • Decrease the use of opiates by our youth.  This will require a concerted and ongoing effort on the part of parents and family, government institutions like CDC and the Maine Office of Substance Abuse and Mental Health Services, the Department of Education and others.  Healthcare providers, schools and communities need to address adverse childhood experiences and the impact they can have on wellbeing.
    • Work to address and prevent child abuse and neglect.
    • Reduce access to opiates, through more effective use of the Prescription Monitoring Program and increase efforts aimed at the safe storage and disposal of prescription opiates.
    • Decrease the number of drug affected babies born in Maine each year through pilots of the already established Snuggle ME project, screening for substance abuse in pregnancy and guidelines for best care of substance use disorder in pregnancy, and improved support for families with infants exposed to substances.
    • Decrease overdose deaths in Maine by increasing the availability of naloxone.
    • Increase opportunities for treatment and recovery for people with substance use disorder with recovery centers in each public health district and establishing collegiate recovery communities at all Maine colleges, through reducing barriers to housing, education and employment for people in recovery, providing broader access to recovery coaches and increasing access to treatment.
  • Goal 2 – Strengthen Maine’s public health infrastructure to reduce opioid use disorder and overdose deaths.  Objectives include:
    • Improving Maine’s ability to take a comprehensive approach to the problem by creating a high level position to coordinate efforts across the state and empowering the Substance Abuse Services Commission to work to implement the recommendations of the Opiate Collaborative, and develop the existing “2-1-1” program into an information and resource hub for people seeking services for opioid use disorder.
    • Increase local capacity to work on prevention strategies by supporting Maine’s public health districts in collaborating with schools, recovery and wellness coalitions, healthcare organizations, faith communities, law enforcement and others to promote healthy communities and address public health challenges.

It’s a lot of information and I have condensed it!  Yet all of this, and the recommendations of the other two task forces (to be summarized in future blogs) can help us to address the most important public health challenge for Maine today.  As Senator King says, there is usually no silver bullet for solving big problems, but there often is silver birdshot.


Noah Nesin, MD

Dr. Nesin, Vice President of Medical Affairs for PCHC, is a family doctor with 30 years of experience.

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