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W W W. M A I N E B I Z . B I Z F O C U S H E A L T H C A R E 27 New plan for access In February, Mills created a director of opioid response cabinet position, a position held by Gordon Smith. Training up to 250 recovery coaches, who would work with emergency rooms, as well as finding ways for emergency rooms in general to increase access to buprenorphine treatment, were among the goals listed in her executive order. Central Maine Healthcare this year instituted a bridge program, headed by Dr. Paul Vinsel, in which a patient who gets a three-day emergency room prescrip- tion can get an additional three-day one from a doctor with a waiver, giving the patient time to connect with Leighton or another CMH doctor who can begin a treatment plan. In Bridgton, the program works with the Lakes Region Recovery Center, created last year on the hospital's campus. Mid-Coast Hospital in Brunswick, last year, was the first to institute a program that began long-term treatment with buprenorphine in the ER. In announc- ing the program, the hospital cited a 2015 study by Yale University that found early intervention by a team of emergency department physicians and behavioral health providers can result in better outcomes for people with an opioid addiction. Leah Bauer, a physician with the Mid Coast Hospital Addiction Resource Center, said at the time, "Medications stop withdrawal and relieve cravings so patients can have the best chance of engaging in successful treatment." Several hospitals, including Portland's Mercy Hospital, now have emergency room access programs. In April, Penobscot Community Health Care, in Bangor, announced that it will offer walk-in access at its Union Street clinic to patients who need treatment, and then will connect with a treatment program for further care. Getting beyond the stigma Leighton, a Sebago native, graduated from residency in 2006, and in 2013 became a primary care doctor. He practices out of Bridgton Primary Care. He got a waiver to prescribe buprenorphine in 2013. "I built up a little side practice in addiction medicine," he says. He soon realized the need was overwhelming, and in 2016 he began treating addiction patients full-time. He says while action by the Mills administration is helping increase access to care, there is another big bar- rier to get past — the stigma associated with addiction. "We come from Puritan stock," he says. "Alcoholism and addiction in general are very, very taboo. e number one barrier to treatment is the stigma." He says that includes in emergency rooms and among the medical profession. He says that the focus on better access is beginning to turn that around, too. "ere's a realization that these are patients who need help," he says. He sees a day when addiction will be treated by a primary care physician, just like any other disease. "We're going to treat diabetes, hypertension, COPD, asthma and addiction the same," he says. "It's a chronic disease, so we need to use a chronic disease model, and that starts with access." M a u r e e n M i l l i k e n , M a i n e b i z s e n i o r e d i t o r, c a n b e r e a c h e d a t m m i l l i k e n @ m a i n e b i z . b i z

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