Gov. Janet Mills has relaxed restrictions on the state’s needle exchange programs to allow people with substance use disorder to return used needles and receive clean ones on an as-needed rather than one-to-one basis.

The executive order announced Saturday also allows providers to adjust their hours and the locations of their mobile sites to best serve clients.

Needle exchanges, which permit injection drug users to trade used needles for clean ones, are a proven harm reduction strategy that protects people from infections and diseases such as Hepatitis C and HIV. Additionally, the programs often help steer drug users to treatment.

Maine has three certified needle exchange programs that operate in seven locations – Portland, Bangor, Augusta, Waterville, Ellsworth, Belfast and Machias. Last year, they served nearly 5,600 people and distributed more than 220,000 clean syringes. In addition to thousands of tests for HIV and Hepatitis C, the programs made 2,610 referrals for substance use treatment.

The American Medical Association has urged states to adopt similar orders for the duration of the current public health crisis brought on by the coronavirus outbreak.

Saturday’s announcement is the latest in a series of steps the Mills’ administration has taken to protect the vulnerable population of Maine people who are struggling with substance use disorder.

“While physical distancing is our best tool to mitigate the spread of COVID-19, we also have to recognize its impacts on Maine people, like those with substance use disorder, many of whom rely on in-person support for treatment and recovery,” the governor said in a statement.

The Maine Department of Health and Human services has been following federal guidelines to allow methadone clinics greater flexibility to provide clients with take-home doses. Many clients who are deemed stable by their clinician can receive up to 28 days’ worth of doses. The state’s Board of Pharmacy has also enacted emergency rules to allow the pharmacist in charge at each clinic to oversee preparation of take-home doses by a nurse without being physically present.

DHHS also has helped distribute the overdose-reversing drug naloxone for patients to have at home due to the potential for overdose.

As the coronavirus outbreak has forced many to stay in their homes, the state has seen a dramatic increase in telehealth for counseling and medication-assisted treatment. According to DHHS, Medicaid claims for substance use disorder services provided via telehealth increased from an average of 100 weekly claims to more than 3,600 for the last week of March.

Since the Mills administration expanded Medicaid for low-income individuals, more than 68,000 people have cumulatively enrolled and approximately 9,000 are receiving treatment for substance use disorder.

“We are working to both prevent and treat substance use disorder during these unprecedented times,” DHHS Commissioner Jeanne Lambrew said in a statement. “I urge all Maine people to reach out to those who are struggling and their families to let them know that help is still available.”

Free and confidential peer recovery support is available seven days a week by calling 211. For more urgent needs, people can call the state’s crisis line at 1-888-568-1112.

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