Maine is showing signs of progress in its battle against the opioid crisis. A recent report from the CDC found a 19% drop in overdose deaths from July 2023 to July 2024, reflective of a similar trend nationwide. Our state is taking unique steps toward overcoming this epidemic, including expanded treatment access.

At Acadia Healthcare, I’ve observed directly how increasing access to opioid treatment programs (OTPs) and medication-assisted treatment (MAT) has made a life-changing difference for people struggling with opioid use disorder.

OTPs offer holistic, individualized treatment, combining medications like methadone with counseling, behavioral therapies and case management to promote long-term recovery. When administered safely in conjunction with wraparound psychosocial services, methadone has been proven to be the most effective treatment for opioid use disorder, offering individuals the chance to regain control over their lives, according to the National Institute on Drug Abuse.

The COVID-19 pandemic accelerated essential national policy changes, which were recently cemented by the Substance Abuse and Mental Health Services Administration (SAMHSA). These changes have reshaped how care is delivered. For instance, stable patients can now receive up to 28 days of take-home methadone doses, providing them with more flexibility in their recovery journey.

At Acadia, we work collaboratively with patients to explore the option of take-homes once they’ve had a record of success with daily treatments, which has resulted in a significant portion of patients successfully moving to take-homes. These reforms also make it easier to access care through mobile treatment clinics and remote intake services, vital for reaching those in rural or underserved areas.

We’ve also noticed improvement in retention. When reviewing retention data from five of our OTPs in Maine, we saw an average retention increase of 6.1% from 2019 to 2024, with some clinics — particularly those in rural locations like Presque Isle and Rumford — showing dramatic improvements.

In Presque Isle, for example, retention jumped from 20% in 2021 to 64% in 2024. This trend aligns with the implementation of SAMHSA’s flexibilities allowing take-home methadone doses, highlighting the potential for these policies to enhance patient engagement and long-term treatment success.

Additionally, Maine’s leadership has been proactive, establishing key initiatives like the Advisory Council on Heroin and Opioid Prevention and Education to address the opioid epidemic through education, prevention and policy coordination. State regulators allow providers to individualize treatment plans, including adjusting starting doses to match the unique needs of each patient. This flexibility is critical as we continue to refine and personalize our approach to addiction treatment.

Sadly, we are still seeing pervasive barriers to treatment access across the state. According to a report from the U.S. Department of Health and Human Services’ Office of Inspector General, less than half (44.6%) of Office-Based Opioid Treatment providers in Maine treated Medicare beneficiaries with opioid use disorder. The report identifies issues such as low Medicaid reimbursement rates, provider reluctance, and burdensome administrative barriers as major obstacles to accessing care. In contrast, 92% of Maine’s OTPs treat Medicare enrollees, and all OTPs in the state serve Medicaid patients.

Additionally, rural communities face unique challenges when it comes to treatment access. The financial strain of operating OTPs in these areas, coupled with difficulties attracting clinical providers, underscores the need for additional policy reforms. To address this, lawmakers should consider introducing rural reimbursement incentives to help OTPs manage higher operational costs. Expanding federal loan forgiveness programs for addiction treatment specialists could also encourage professionals to work in rural areas.

Moreover, increased federal funding for mobile and satellite dosing units could ensure that MAT reaches patients in remote locations, improving continuity of care and increasing access to vital treatment. Additionally, the elimination of prior authorization requirements for Medicare Advantage plans could speed up access to MAT, allowing patients to receive timely care before returning to illicit drug use.

Maine’s fight against opioid use disorder is entering a new and promising phase, defined by evidence-based approaches, expanded access to care, and a growing recognition that recovery is possible. However, this progress is fragile and must be maintained through continued action from providers, policymakers and communities.

Fair reimbursement for providers and the removal of administrative hurdles and geographic barriers are essential for sustaining the momentum that Maine has built in combating the opioid crisis.