Maine Addiction Expert Weighs In On Trump's Opioid Plan

Mar 20, 2018

President Trump, speaking in New Hampshire yesterday, detailed plans for confronting the country's opioid epidemic. In broad strokes, it calls for prevention and education advertising, improved funding for treatment and the death penalty for drug trafficking in certain instances. Dr. Mary Dowd is medical director at Milestone Recovery and has treated people suffering from opioid addiction for years. Dr. Dowd spoke with Maine Public Radio’s Morning Edition host Irwin Gratz.

GRATZ:  Dr. Dowd, welcome.

DOWD:  Thank you.

GRATZ:  What was your initial response to the ideas the president outlined yesterday?

DOWD:  Well, I think more funding for treatment is huge. That's what we really need - and prevention as well. As far as the war on drugs goes, we've been fighting that war since I was a kid and we’ve spent probably a trillion dollars. And our opioid epidemic is just getting worse.

GRATZ:  So you would not support a plan to use the death penalty against drug dealers?

DOWD:  Well, I would say a couple of things about that, Irwin. One is if you read anything about how drugs are distributed in a country, any investigative reports like Dreamland or Methland, you find that these people are completely expendable - the cartels will just send somebody else to take their place immediately. So, I don't think that's going to solve the problem. The other thing is many, many patients, in fact most heroin addicts, do some low-level dealing to support their habit. And I really don't think they should be getting stiff penalties and the death penalty.

GRATZ:  The president did promise increased funding for treatment if such funding became available. How would it help Milestone?

DOWD:  Well, we could expand our services - that would be huge. We only have 16 beds. Now we’re the only detox in the state of Maine and we only have three female beds, so there's a huge shortage of beds. Expanding money for treatment would mean many, many more people could be on methadone and Suboxone, which are really the gold standard for treatment for opiate addiction.

GRATZ:  Mr. Trump also did call for increased access to naloxone, which is the opioid overdose antidote. Now that's something that Gov. LePage opposes. I'm curious where you come down on this conflict.

DOWD: I am in favor of increased access to naloxone. I would like it if it were over-the-counter. One of my concerns with it is that it's now, like, three times more expensive than it used to be. So, buying it over the counter for many people is out of reach. It's about $150 for a naloxone kit.

GRATZ: What was missing from the president's remarks yesterday that might help in combating opioid abuse?

DOWD: I think that there wasn't enough emphasis on treatment. I think, Irwin, it all comes down to money, and we're going to be spending a lot of money. The treatment is very expensive because the drugs are very expensive. A month's worth of Suboxone is about $600. Vivitrol, which is a shot that you can get monthly, is now up to $2,000 dollars a month. So, the drugs are very costly. And I'd like to see some regulation of that.

GRATZ: Of course, a lot of folks start down the road to opioid addiction using opioid painkillers legitimately as prescribed by doctors. Do we need to do more on that front - simply limiting how we use these medications, period?

DOWD:  I think the Maine Medical Association is doing a good job with education and regulations on that. I think that's true - that we do need to do more.

GRATZ: Bottom line for the president's plan as he outlined it yesterday - do you think that would be a help to Maine communities that are struggling with opioid abuse?

DOWD: I think anything that gets more funding into the states for treatment would be a huge help.

GRATZ:  Anything else you want to mention that I haven't asked you about?

DOWD:  I would say that expanding Mainecare [Maine’s Medicaid program] and expanding Medicaid throughout the country would be helpful. I'm afraid that part of the federal budget is looking at decreasing Medicaid, also looking at dismantling the Affordable Care Act. So those would be huge blows to getting drug treatment to people.

GRATZ: Dr. Dowd, thank you very much for the time. We really appreciate it.

DOWD: Thank you.

Dr. Mary Dowd is medical director at Milestone Recovery. Dr. Dowd began administering the opioid addiction treatment drug Suboxone in 2005.  In 2008, she quit her primary care practice to focus on serving patients suffering from addiction.