[from the Maine Hospital Association's Friday Report]

A program that that has reduced patient dependence on opioids and benzodiazepines in the Bangor area is being expanded statewide through a partnership between the Maine Office of Substance Abuse and Mental Health Services (SAHMS) and the Schmidt Institute, a joint venture of St. Joseph Healthcare and Penobscot Community Health Care (PCHC).

Since 2013, the Institute’s Controlled Substance Stewardship (CSS) Program has been implemented at PCHC, a Federally Qualified Health Center that serves 65,000 patients.  This effort has resulted in a 77 percent reduction in overall opioid and benzodiazepine prescribing at PCHC’s practice sites, a key effort given that opioids put patients at great risk for unintentional overdose and have not been proven effective as a long-term treatment for chronic pain.

CSS provides support and consultation to prescribing clinicians with a goal of promoting compassionate, coordinated care for patients whose prescriptions are being tapered.  It also offers tools for clinicians and practice staff, such as informed consent and patient-provider agreements that provide clear descriptions of risks and expectations of treatment, and prompt referral and access to experts in alternative pain management and other relevant services (e.g., medication-assisted treatment for Opioid Use Disorder).

The program supports front-line providers who are caring for patients with chronic pain, substance use disorders, mental illness and other complex conditions.  CSS disseminates to providers clear and practical policies around evidence-based prescribing and management of opioids, benzodiazepines, hypnotics and stimulants.

SAMHS, an office of the Maine Department of Health and Human Services, is sponsoring a statewide expansion of the model, with the goal of promoting safer, evidence-based treatment options for chronic pain, while supporting providers in alleviating opioid prescribing issues and concerns.

The partnership will include establishing statewide prescribing guidelines that providers and organizations can use to inform their opioid prescribing and tapering practices, and clinical case reviews by the Institute’s CSS Committee, an interdisciplinary team with expertise in pharmacy, pain management, family medicine, psychiatry and care management.

Case reviews will be offered at no cost to providers in Maine, thanks in part to financial support from the state of Maine through Overdose Data to Action, a federal Centers for Disease Control and Prevention grant recently awarded to the state.