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V O L . X X V N O. X X S E P T E M B E R 1 6 , 2 0 1 9 26 H E A LT H C A R E Access is turning tide on opioid crisis While Maine's opioid addiction crisis may seem insurmountable — nearly 1,700 residents have died of overdoses in the past five years, according to state officials — those who treat addiction say more access to care may be turning the tide. "We are in the midst of the most devastating health crisis we've ever seen," says Peter Leighton, a pri- mary care physician with Central Maine Healthcare's Bridgton Primary Care. "Mainers are dying every day. "Access is the biggest barrier," Leighton adds. "But it's turning around." When Gov. Janet Mills signed an order Jan. 3 allowing Medicare expansion in the state, giving access to health care for 70,000 more Mainers, for a total of more than 250,000, that was a big start, says Leighton, a primary care physician who solely treats those with addiction. "We're trying to get patients with opioid use disorders on MaineCare. at's the golden ticket." e next step — access to buprenorphine, the synthetic drug used to treat opioid use disorder — is tougher. Federal law requires physicians to get a waiver to prescribe the drug for out-patient use. It can also be administered in a three-day dose in an emergency room as well as in in-patient treatment. Physicians are required to attend an eight-hour program to get the waiver. Of Maine's nearly 4,200 practicing physicians, 788 are certified to prescribe buprenorphine, according to the Substance Abuse and Mental Health Services Administration. It's saving lives While counseling and other measures are important in treating addiction, Leighton says, "Buprenorphine is what is saving lives. Getting rid of that waiver is the biggest thing in improving access to treatment." e Pew Research Center reported in February that rural areas are hit harder by opioid-related deaths, largely because of lack of access to treatment. Between 1999 and 2015, overdose deaths increased 325 percent in rural counties in the U.S., and in 2015, rural deaths surpassed the death rate in urban areas. Office-based treatment with medication like buprenorphine is limited — 29.8% of rural Americans live in a county without a buprenorphine provider, compared with 2.2% of urban Americans, Pew found. While some are working on the federal level to eliminate the waiver, health care systems in Maine are finding ways to work with it and increase access. » C O N T I N U E D F RO M PA G E 2 4 Dr. Peter Leighton, of Bridgton Primary Care, has a practice focused on treating patients with addiction. He says renewed access to care is helping turn the tide on the opioid crisis P H O T O / M A U R E E N M I L L I K E N F O C U S

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