Maine people are keenly aware of a major epidemic that killed 272 Mainers in 2015: the opioid addiction epidemic. Many groups and individuals, significantly including the Maine Medical Association, are taking steps to address this crisis. Legislation has been passed to address various parts of the problem:

• 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2017 (1/1/17) Rule on opioid prescribing and use of the PMP 14-118 C.M.R. Chapter 11  NOTE: This form of the rule is no longer in effect. It has been superseded by the rule as stated in the next item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 is currently being updated and will be available again on June 1, 2017.  If you have any questions in the meantime, feel free to contact the MMA office.

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 clickiing on Rules Chapter 21. That rule is about to undergo revision, but the version in the link is currently applicable.

Gordon Smith, Esq., Executive Director of the MMA, wrote a letter to the Association membership explaining chapter 488.

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 as more initiatives are put into place, we will be updating this page to keep you connected with the resources that medicine is bringing to bear on this problem. As with many other epidemics, this is a serious public health challenge that the medical community and many others are working to solve.

Other useful links:

MMA website page on pain management

U.S. CDC Guidelines on Opioid Prescribing

Maine Quality Counts has a page of resources at https://www.mainequalitycounts.org/page/2-1488/caring-for-me

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