Maine's Comprehensive Opioid, Stimulant, and Substance Abuse Site-Based Program

The State of Maine continues to experience the horrific effects of a burgeoning crisis of persons experiencing substance use disorder throughout the state. In 2020, there was a 33% increase in the number of deaths associated with drugs and overdoses. Maine Department of Public Safety (hereafter Department) seeks funding to assist in the ongoing statewide response. This proposal offers creative statewide strategies that are built upon existing systems to ensure sufficient support and offer capacity for long-term sustainability. The cornerstone program is the field-initiation of medication-assisted treatment (MAT) by emergency medical services (EMS) clinicians. This has been piloted in Camden, New Jersey and the State of Maine seeks to create a statewide system for supporting this program including training and education; online medical direction, oversight, and guidance; as well as comprehensive monitoring and evaluation. Multiple reports have cited Maine’s deficiencies in access to MAT for persons experiencing substance use disorder. This program will bring MAT to the field and capture those persons who refuse transport (~15%) to the hospital following reversal with naloxone. These individuals are at significantly higher risk for fatal overdose in the year following a reversal event. In addition, this proposal includes funding and support for the creation and implementation of a statewide naloxone leave-behind program within EMS. Not only will they be able to initiate persons on MAT, but they will also be able to leave the patient, their family members, and/or their friends with naloxone to help prevent tragedy in the future.

            The Department seeks to implement a recovery coach training program that will be delivered quarterly throughout the State of Maine. This will focus on law enforcement professionals working in the field, including those working for the Maine Drug Enforcement Agency. By training these officers, the system expands capacity to connect persons experiencing substance use disorder with resources in their community – building relationships and destigmatizing substance use disorder for some law enforcement professionals. This program will be intricately connected with the state’s existing Overdose Prevention Through Intensive Outreach, Naloxone, and Safety (OPTIONS) Program that is staffed with peer recovery coaches and has an existing network in communities throughout the state. Connecting persons in crisis and extremis with resources within their own communities and support networks is critical for long-term success with recovery efforts – this program seeks to mobilize law enforcement professionals to help bridge those gaps.