AUGUSTA, Maine - The Maine Department of Corrections is expanding its program for medication-assisted treatment of opioid addiction to any person in jail or prison who medically qualifies.

In 2019, the department launched a pilot program with 100 participants, and has been slowly phasing it into more facilities. Research has shown that medication-assisted treatment can reduce cravings, which allows people to engage in counseling and treatment more effectively.

Corrections Commissioner Randall Liberty said they expect to treat up to 600 people once the program is fully implemented.

"Substance-use disorder is a disease," he said, "and the gold standard - to treat that and really provide the best care we can for the citizens of the state of Maine - is to provide medication-assisted treatment, and that means on the outside and on the inside."

More Mainers died of overdoses in January than in any month last year. Advocates of the program have called it a step in the right direction, but emphasized the need to get people into treatment rather than into jail or prison in the first place. Oregon recently became the first U.S. state to decriminalize possession of small amounts of illegal drugs; it's now a civil violation, with a fine and court-ordered therapy.

People who've returned to their communities after being incarcerated are far more likely to die of an opioid overdose than the general population. Liberty noted that the harm caused by addiction can be multigenerational, as whole families often are affected. He said those are some of the factors that have pushed the treatment program forward.

"Those individuals that have been in our care during the pilot phase of our program have had reduced cravings, reducing anxiety, increased interest in recovery," he said.

Liberty said rolling out the program also marks a culture shift in corrections because of misconceptions about using medication in recovery. However, he added, continuing discussions and education with staff and partners have made him optimistic about the program's future.


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More than 4,000 people in North Carolina died of overdoses in 2021, the highest number of overdose deaths in a single year on record in the state, according to recently released data.

Dr. Susan Kansagra, assistant secretary for public health with the North Carolina Department of Health and Human Services, said before the pandemic, the state's opioid overdose deaths had been leveling off, but now, she said they are on the rise, and communities have spent the past few years grappling with the loss of loved ones.

"We're seeing an increase in poly substance use as well," Kansaghra said. "Not just deaths caused from opioid overdose, but really we're seeing multiple substances have been used. "

She said the manufactured opioid called fentanyl is driving fatalities. In 2021, more than 77% of overdose deaths in the state likely involved fentanyl. The state's 988 Suicide and Crisis Lifeline offers 24/7 access to trained crisis counselors who can help people experiencing distress. Since the launch of 988 last summer, the call center has seen an 85% increase in people identifying substance use as their primary reason for calling.

Kansagra added health insurance is a major component of addressing the opioid epidemic. Lawmakers recently reached a bipartisan agreement that puts the state on a path to allow access to health care for an additional 600, 000 North Carolinians.

"One of the things we know in North Carolina is that we we are working on Medicaid expansion. And that's really important so that people have the ability to get high-quality care," Kansagra said.

She said the state has also expanded its mobile crisis care resources, where a person experiencing a behavioral-health or substance-use crisis can receive an assessment on the spot, whether at home, school, work or other location.


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Another Minnesota House committee has endorsed a bill that would allow sports betting within the state, but there are calls to add some provisions as the measure advances.

If approved, licenses would be provided to tribal nations around Minnesota to create sportsbooks at casinos, and Minnesotans age 21 and older could also place wagers through their phones, using online apps.

Bill sponsors have said revenue would go toward regulations and consumer protections, with another 40% used to address problem gambling. Susan Sheridan Tucker, executive director of the Minnesota Alliance on Problem Gambling, said that language is appreciated, but she asked lawmakers if information-sharing can be included, too.

"Operators and their licensees will be collecting quite a bit of data that can help answer many questions that researchers have concerning gambling behaviors," she said, "and can provide insights into whether more individuals are becoming addicted to gambling."

Tucker, whose organization is neutral on legalizing sports betting, stressed that no personal information, including a bettor's identity, would be shared. She said at least two other states have these provisions in their laws. The Minnesota Indian Gaming Association has said it needs more information before commenting on that recommendation.

Key supporters of the plan have said that with more than 30 other states already allowing sports betting, it's time for Minnesota to take something already being done on the black market and put it under the state's purview.

David Prestwood, government affairs manager for the online betting firm DraftKings, echoed that sentiment in his testimony.

"An estimated 1.17 million people in the state are making a combined total of more than $2.5 billion in illegal wagers annually," he said. "Nearly all of these wagers are placed online in the robust illegal market, where sophisticated illegal operators capitalize on the popularity of this form of entertainment."

As for the sharing of aggregated data, the bill's sponsor expressed a willingness to have more discussions about it. More broadly, the current version excludes horse tracks, potentially complicating final passage in the Legislature.

The federal government said it is clamping down on the use of telehealth for drugs with a high risk of abuse.

Under the proposed rules, doctors will be required to see patients in person for a prescription at least once for drugs such as Adderall and Ritalin. Nearly four million people reported misusing prescription stimulants in 2021, according to data from the National Institutes of Health.

Michelle Lydenberg, senior manager of data and learning at Cincinnati-based Interact for Health, said both prescription and nonprescription drug use have had devastating effects on Ohio communities.

"So we're talking about HIV, hepatitis C. Those are extremely costly, unfortunate diseases to have to deal with," Lydenberg pointed out. "There are many ripple effects that go along with an increased rate of substance-use disorder, overdose, and overdose death in a community."

In a news release, U.S. Drug Enforcement Administration administrator Anne Milgram said the agency is committed to the expansion of telemedicine with guardrails to prevent the online overprescribing of controlled medications which can cause harm. The new rules will likely go into effect this spring.

Lydenberg noted counties could begin thinking about how to improve access to substance-use resources in rural counties, especially as opioid settlement money flows in.

"The stigma of addiction makes it harder to expand and access those services," Lydenberg acknowledged.

In Ohio, more than 5,200 people died of a drug overdose in 2020, according to the Centers for Disease Control and Prevention.

According to a new Axios-Ipsos poll, around one in four Americans said opioids and fentanyl are the nation's top public-health threat.

Reporting by Ohio News Connection in association with Media in the Public Interest and funded in part by the George Gund Foundation.