Focus Area 2023-2025: Treatment

  • Prevalence of substance-use disorder in Maine
  • Medicaid claims for substance-use disorder treatment
  • Number of individuals enrolled in opioid treatment programs
  • Medication prescribed for opioid-use disorder
  • Department of Corrections substance-use disorder education, prevention, and treatment programs
  • Substance exposed/affected infants born in Maine

The National Survey on Drug Use and Health (NSDUH) estimates that 8.64% of Mainers suffer from substance-use disorder.

To ensure the availability of treatment that is local, immediate, affordable and best fit it is important to identify the number of Mainers in need of substance-use disorder treatment as well as where they are located within the State. NSDUH estimates that 8.64% of Mainers above age twelve suffer from substance-use disorder. (Priority F, G)

The following table is generated from NSDUH and provides estimates of substance-use disorder in the non-institutionalized, civilian population of Maine. The data are annual averages based on 2016, 2017, and 2018 NSDUHs. For full data visit the National Survey on Drug Use and Health website. Substance-use disorder is defined as meeting criteria for illicit drug or alcohol dependence or misuse. It is based on definitions found in the DSM-IV.

State/Substate RegionEstimated %95% Confidence
Interval (lower)
95% Confidence
Interval (upper)
Maine8.64%7.50%9.94%
Aroostook (Aroostook)7.53%5.59%10.07%
Central (Kennebec, Somerset)8.22%6.37%10.55%
Cumberland (Cumberland)8.71%6.90%10.94%
Downeast (Washington, Hancock)8.08%5.99%10.81%
Midcoast (Lincoln, Knox, Sagadahoc, Waldo)8.43%6.50%10.87%
Penquis (Penobscot, Piscataquis)8.39%6.51%10.75%
Western (Androscoggin, Franklin, Oxford)9.79%7.77%12.26%
York (York)8.82%6.88%11.23%
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2016, 2017, and 2018.

The number of Mainers receiving treatment for substance-use disorder has been steadily increasing.

Since 2015, the number of MaineCare claims submitted for substance-use disorder treatment has increased. Opioids and alcohol represent a preponderance of the primary reason that individuals seek treatment. In 2019, cocaine and other stimulants emerged as a third major cause for individuals to seek treatment.

This metric tracks MaineCare claims for substance-use disorder treatment in the State of Maine by substance. This metric is an indicator of individuals linked to care as well as the substances involved in treatment claims. The data is provided by the Office of Behavioral Health (OBH) The data is updated annually. The data also includes substance-use disorder treatment funded through OBH grant programs. It does not include treatment claims for private insurance or private-paid treatment.

20152016201720182019
Alcohol1,7352,0481,7741,9042,805
Amphetamines353000
Cannibas427679539517488
Cocaine194174250252412
Drug-Induced Mental Disorders616000
Hallucinogens9231039
Inhalants14880
Nicotine289518821
Opioids8,18111,84511,11811,20815,704
Other Drugs/Unknown41162000
Other Stimulants156774117348
Psychoactive Substances/Multiple120358200152206
Sedatives/hypnotics/anxiolytics/tranquilizers/barbituates4753777268
Total13,27917,43316,08516,25922,080
Source: Office of Behavioral Health, Substance use disorder treatment trends.

Despite an increase in treatment claims, many Mainers with substance-use disorder do not receive needed treatment.

This metric tracks the estimated percentage of Mainers with substance-use disorder that did not receive treatment but met the criteria for prescription or non-prescription drug dependence as identified in the DSM-IV. Individuals may not receive treatment due to a lack of personal or State resources or because they did not seek treatment. This metric tracks the additional need for substance-use treatment access. The following table, generated from the National Survey on Drug Use and Health (NSDUH), provides estimates of individuals needing treatment for substance-use disorder but who did not receive it in the non-institutionalized, civilian population of Maine over the age twelve. The data are annual averages based on 2016, 2017, and 2018 NSDUHs. For full data visit the National Survey on Drug Use and Health website.

State/Substate RegionEstimated %95% Confidence
Interval (lower)
95% Confidence
Interval (upper)
Maine8.04%7.00%9.22%
Aroostook (Aroostook)6.98%5.19%9.32%
Central (Kennebec, Somerset)7.83%5.95%10.24%
Cumberland (Cumberland)8.30%6.58%10.41%
Downeast (Washington, Hancock)7.35%5.49%9.78%
Midcoast (Lincoln, Knox, Sagadahoc, Waldo)7.76%5.91%10.11%
Penquis (Penobscot, Piscataquis)8.04%6.25%10.28%
Western (Androscoggin, Franklin, Oxford)8.78%6.88%11.15%
York (York)8.02%6.12%10.43%
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2016, 2017, and 2018.

The State is dedicating staff and funding to support the screening, treatment, and recovery of pregnant Mainers with substance use disorder by expanding integrated models of care through the Maine MOM (Maternal Opioid Model) initiative, Opioid Health Home, and the Rural Maternity and Obstetrics Management System (R-MOMS) program (Strategy 23.a).

Maine Maternal Opioid Model (MOM) Dashboard

The Maine Maternal Opioid Model (MaineMOM) aims to improve care for pregnant and postpartum people with opioid-use disorder, and their infants, by integrating maternal and substance use treatment services. MaineMOM offers a team based approach to care that includes a prenatal provider, substance use counselor, patient navigator, nurse care manager, recovery coach, and perinatal provider. More information can be found at MaineMOM.org. (Strategy 23.a)

The Overdose Prevention Through Intensive Outreach, Naloxone, and Safety Initiative (OPTIONS) refers their pregnant and postpartum clients to the MaineMom program. The following chart shows referrals to the MaineMOM program by OPTIONS Liaisons. This data is reported and updated monthly.

Source: University of Maine, Margaret Chase Smith Policy Center.

The State is promoting evidence-based approaches to supporting substance exposed-affected infants during newborn hospitalization as well as ensuring that all substance-exposed infants have a Plan of Safe Care. Further Maine is supporting the development of systems to ensure substance-exposed infants get appropriate preventative services, developments screening, and appropriate medical screenings (Strategy 23.d; 23.e; 23.j; 23.k; 23.l).

Since 2016, the number of substance exposed/affected infants born in Maine decreased 32%

In addition to addressing maternal opioid misuse, Maine is also dedicated to supporting infants that are born substance exposed or affected. The State of Maine promotes the use of evidence-based approaches to support substance exposed/affected infants (SEI) including the use of Eat, Sleep, Console; Public Health Nursing, Home Visiting, WIC, developing a Plan of Safe Care; and Snuggle ME guidelines. Additionally, Maine is supporting the development of systems to ensure that SEI get appropriate preventative services, developmental screenings, and other appropriate medical screenings (Strategy 23.d; 23.e; 23.j; 23.k; 23.l)..

The following metric provides the incidences of substance exposed or affected infants (SEI) born in Maine. It is important to not that not all Maine hospitals diagnose SEI the same way, that some hospitals include marijuana exposure while others exclude it, and that some people seek care in counties where they do not reside when pregnant or giving birth. Since reaching its peak in 2016, incidences of SEI have dropped 32% over the past several years.

Babies born in Maine exposed/affected to substances, 2022

Source: Office of Child and Family Services.

Medication for opioid use disorder (MOUD) is an essential component of the State’s public health strategy to combat the overdose crisis

The prescribing of MOUD has dramatically increased over the past six years. From 2017 through 2021 total MOUD dispensation has increased 133%, buprenorphine prescribing has increased 303% and methadone prescribing has decreased 48%.

The following chart shows the dispensation trends in MOUD in Maine from 2017 to 2021. This data is reported annually. It is important to note that the Prescription Drug Monitoring program collects data on dispensed prescriptions at retail pharmacies and does not track controlled substances dispensed at hospitals, carceral settings, or in stand-alone opioid treatment programs like methadone clinics which have been increasing dispensation. (Strategy 24)

Buprenorphine is a medication approved by the Food and Drug Administration to treat opioid use disorder as a medication assisted treatment. It was the most frequently dispensed controlled substance in 2021, with 19,440 unique patients filling 360,455 prescriptions.

This metric is an indicator of linkages to treatment for individuals with opioid use disorder. This data is provided by the Office of Behavioral Health. It is updated monthly.

Source: Maine Prescription Drug Monitoring Program. Please note data for most recent month is provisional and will be finalized as more complete data becomes available. Only prescriptions for buprenorphine that are filled at a retail pharmacy are entered into Maine’s Prescription Drug Monitoring Program. Prescriptions dispensed at hospital clinics are not required to be reported to the Prescription Drug Monitoring Program.

Source: Maine Prescription Drug Monitoring Program. Please note data for most recent month is provisional and will be finalized as more complete data becomes available. Only prescriptions for buprenorphine that are filled at a retail pharmacy are entered into Maine’s Prescription Drug Monitoring Program. Prescriptions dispensed at hospital clinics are not required to be reported to the Prescription Drug Monitoring Program.

Methadone provided to patients in Maine through Opioid Treatment Programs is increasing. Methadone is a synthetic opioid agonist that eliminates withdrawal symptoms and relieves substance cravings by acting on opioid receptors in the brain. Although it occupies and activates these receptors, it does so more slowly that other opioids and, in an opioid-dependent person, treatment does not produce euphoric effects.

Source: Office of Behavioral Health, Substance use disorder treatment trends.

To ensure the availability of treatment that is local, immediate, and affordable the State is supporting emergency departments in adding rapid induction medication for opioid use disorder

Rapid induction of buprenorphine allows for individuals with opioid use disorder who present to the emergency department with the ability to achieve therapeutic levels of medication for opioid use disorder (MOUD) in approximately 3 hours rather than the typical 2-3 days. Studies show that rapid induction has been shown to be safe and precipitated withdrawal due to the treatment to occur in less than 1% of cases. (Strategy 24.a)

In addition to offering individuals who present at the emergency department with nonfatal opioid overdoses or who have opioid use disorder, OPTIONS Liaisons (Overdose Prevention Through Intensive Outreach, Naloxone, and Safety) refer individuals during co-response, post-overdose follow-up, and other outreach work to EDs for rapid induction of MOUD. The following chart shows referrals to emergency department rapid induction by OPTIONS Liaisons. This data is reported and updated monthly.

Source: University of Maine, Margaret Chase Smith Policy Center.

In July 2019, the Maine Department of Corrections (DOC) began treating opioid-use disorder with Medication-for Opioid Use Disorder (MOUD).

Identifying that substance-use disorder was common among Maine Department of Corrections (DOC) clients and understanding that people incarcerated have a greater risk of fatal and nonfatal overdoses after release, are more likely to be re-incarcerated, and, if they are injection drug users, are at a higher risk of acquiring or transmitting bloodborne diseases such as HIV or Hepatitis C, Maine DOC launched a pilot medication-assisted treatment program in July 2019. (Strategy 24.b)

This metric tracks the number of incarcerated individuals in Maine Department of Corrections prisons that completed MOUD, the percent of Maine DOC clients that attended their first community treatment program appoint after they were released from prison, and the percent of clients who were enrolled in the Maine DOC MOUD programs that received naloxone upon release.

This metric is an indicator of individuals linked to treatment and to naloxone who are at a high-risk of opioid overdose. This data is provided by the Maine Department of Corrections. The data is updated annually. For detailed annual reports visit the Maine Department of Corrections’ Reports & Statistics website.

Residents receiving Substance use disorder services2019202020212022
Active at Year End64186600768
Waitlisted at Year End1341975335
Transitioned to the Community113418407468
Source: Maine Department of Corrections, Medication-Assisted Treatment Pilot. Evaluation Report, 2022.
Clients served by MDOC’s MOUD program 2019202020212022
Male81361 358408
Female36574860
Total117418406468
Source: Maine Department of Corrections, Year End MDOC Adult Data Report, 2022.

Maine Department of Corrections has increased the amount of substance-use education and prevention programs completed by clients.

Since 2015, enrollment and successful completion of substance-use programming has increased by men and women who are incarcerated. Examples of these programs include relapse prevention, living in balance, and medication-assisted treatment among others. (Priority G)

This metric tracks the number of substance-use programs that are completed by Maine Department of Corrections clients. This metric is an indicator of linkages to substance-use treatment and substance-use education for individuals at high-risk of overdose. This data is provided by the Maine Department of Corrections. The data is updated annually. For detailed annual reports visit the Maine Department of Corrections’ Reports & Statistics website.

Source: Maine Department of Corrections, Adult Data Report, 2022

The University of Maine created the following Residential Treatment Facilities Dashboard which includes hospital and non-hospital medically supervised withdrawal residential treatment locations. Users of the dashboard can also filter by facility name, county, city, number of beds, services provided, and the length of stay. (24.h)

Residential Treatment Facilities Dashboard

The State of Maine is using GIS to identify gaps in the treatment service continuum.

The State of Maine is implementing the Map % Match initiative to identify gaps in the treatment service continuum and geographic access shortages with real time capacity data. When the Open Beds tool is completed, clinicians, patients, and others will be able to identify provider capacity across the State to identify treatment that is local, immediate, affordable, and best fit. By eliminating several barriers to care, this tool will increase the proportion of persons with substance use disorder who seek and are in treatment.

Until Open Beds is implemented, the following dashboard on the Maine Drug Data Hub has been created to identify where various substance use disorder services are located as well as where gaps exist in the treatment, harm reduction, and recovery service continuum. (Strategy 27.a.)

Maine Drug Data Hub: SUD Related Services in Maine

The OPTIONS initiative provides active outreach to persons with substance use disorder and affected others which increases referrals to treatment and patient activations with providers.

Through the OPTIONS initiative (website: https://www.knowyouroptions.me) behavioral health mobile response teams are deployed in each of Maine’s 16 counties. These licensed behavioral health clinicians, who are embedded in a law enforcement department within the county they serve, educate and engage individuals at high risk for overdose in harm reduction strategies including the distribution and use of naloxone. They also offer referrals to treatment and recovery services. Visit the above website to find your local OPTIONS liaisons and know your options today. (Priority G)

The OPTIONS Liaisons have been especially effective meeting people with substance use disorder where they are at, and when appropriate, identifying treatment programs that seem to be the best fit for their clients. The following metrics track the number of treatment referrals OPTIONS Liaisons have made on behalf of their clients as well as the percentage of people who engaged with the treatment provider for their first appointment. This metric is updated monthly.

Source: University of Maine, Margaret Chase Smith Policy Center.