I am writing to ask my friends, neighbors, colleagues, and community to support LD 360: Resolve, To Reduce Barriers to Recovery from Addiction by Expanding Eligibility for Targeted Case Management Services.

As the rule is written, adults with substance use disorder must be pregnant, living with their own minor children, and/or using drugs intravenously in order to qualify for targeted case management services through MaineCare. This severely delimits access to services that support safety and recovery at a time when Maine needs to step up to do more.

Groups that are currently excluded from receiving targeted case management services include (but are not limited to): childless adults, including younger adults, aging adults, and some LGBTQ+ adults; non-custodial parents of children; and adults with substance use disorder who do not use drugs intravenously. All of these populations (and more) deserve access to treatments and support that are effective in addressing substance misuse.

In 2020, Maine had 502 fatal overdoses, surpassing the previous high of 417 in 2017. This is a 20.38% increase, and the data available for 2021 indicate a continued and alarming trend upward. There were 58 fatal overdoses in January and 45 fatal overdoses in February of this year. These two months each saw more fatal overdose deaths than the average of 42 deaths per month in 2020, indicating a worsening shift that demands our attention. Without intervention, Maine is on track to break the record number of fatal overdoses again in 2021.

These data points mirror national trends that point to the COVID-19 pandemic as a factor in increased overdose deaths, though Maine’s drug fatalities have been trending upward since 2014. Isolation, changing access to medical and mental health care, and economic impacts from the ongoing pandemic are more likely to impact adults with substance use disorder than the general population. This makes effective and accessible substance use disorder treatment and management services more critical now than at any other juncture in Maine’s history. Amending the MaineCare Benefits Manual to increase access to targeted case management services is a necessary investment in the people of Maine.

I think that we all understand firsthand the impact that substance use disorder and overdose deaths have had on the Farmington community and the greater Farmington area. This is an issue that exists here, something that we are dealing with right now and that we need to approach in a different and better way. This is not about other people from elsewhere — this is about us.

From January through December 2020, there were eight fatal overdoses in Franklin County. Already in 2021, two fatal overdoses have been recorded here. That is 10 of our friends, family members, neighbors, colleagues and community members. That is 10 lives that mattered, and it’s time that we step up and advocate for prolonged and sustained investments in treating substance use disorder, especially as we recover from the COVID-19 pandemic and its myriad impacts on our community.

Currently, there are too many barriers for adults seeking effective and appropriate intervention for substance use disorder. Stigma within our community and society at large stimulates the spread of misinformation about substance use disorder, which is a disease that alters the brain’s structure and functioning. Ensuring that adults affected by substance use disorder have access to services like targeted case management will decrease strain on acute intervention services like emergency rooms, jails, and residential psychiatric facilities — all of which are costly to individuals and to the public. Investing in resources to support members of our community affected by substance use disorders will reduce our total financial burden of care.

Substance use disorder does not discriminate. Adults who are currently eligible for targeted case management comprise only a fraction of adults living with substance use disorder in Maine. Every person with MaineCare benefits and a diagnosis of substance use disorder who is seeking approved treatment services should be eligible for targeted case management.

Every person with substance use disorder deserves a chance at meaningful recovery. Please support this legislation.

The public hearing before the Committee on Health and Human Services is at 1 p.m. on Thursday, April 15.

Danielle Blair of Farmington is co-chair of the Policy Committee at the National Association of Social Workers, Maine Chapter.

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