Governor Mills Signs Executive Order Directing Immediate Action to Combat Opioid Epidemic

Mills announces she will sign Financial Order to purchase and distribute lifesaving, anti-overdose medication and train hundreds more Recovery Coaches

Augusta, MAINE – Governor Janet Mills today signed an Executive Order directing her Administration to take immediate steps to combat the opioid crisis. The Order outlines the initial actions that will be taken by the Administration, as overseen by Gordon Smith, the Director of Opioid Response, to prevent overdose deaths, increase treatment and recovery efforts, and bolster prevention efforts – all of which will be done in a manner to reduce the stigma associated with substance use disorders. The Order will supplement the vigorous efforts of law enforcement at all levels to stem the tide of drug trafficking into Maine.

In support of the Executive Order, Governor Mills announced that she will also sign a financial order directing the Office of Substance Abuse and Mental Health Services (SAMHS) to purchase 35,000 units of the life-saving, anti-overdose medication naloxone using available federal and state funds and distribute it to health entities across the state. The order also directs the use of SAMHS funds to train 250 Recovery Coaches and to fund a full-time recovery coach in 10 emergency departments across the state to facilitate the movement of more people into treatment programs. Both actions can immediately help save lives.

“I will not stand by while every day in Maine someone needlessly dies of a drug overdose and three children are born drug-affected. It is time to marshal state government to finally confront this crisis,” said Governor Mills. “I have directed my Administration to work immediately to prevent overdose deaths, increase treatment and recovery efforts, build out prevention strategies, and complement ongoing law enforcement work. As part of this effort, my Administration will distribute more life-saving, anti-overdose medication and train more Recovery Coaches who will be made available to help transition Maine people struggling with substance use disorder into treatment. These actions can help save lives and represent the start of long-awaited action to fight this terrible epidemic.”

In addition to the actions taken above, the order formalizes the creation of the Prevention and Recovery Cabinet announced by Governor Mills two weeks ago and directs action:

To Prevent Overdose Deaths:

  • Make Naloxone more widely and readily available, affordable and accessible. The Director of Opioid Response must work to make Naloxone available without prescriptions in pharmacies, through health care providers and emergency rooms - especially in geographic areas deemed to be high-risk for overdose deaths. The Order also directs the additional purchase, through available funds at the Office of Substance Abuse and Mental Health Services (SAMHS), of 35,000 doses of intra-nasal and inter-muscular Naloxone for distribution to locations determined by SAMHS.
  • Develop a training for family or friends of those who are at risk of an overdose which includes information about how to administer Naloxone.
  • Encourage prescribers writing prescriptions for more than 100 morphine milligram equivalents (MME) or other potentially dangerous drugs to co-prescribe Naloxone and work with professional associations and employers of prescribers to educate them on this standard.
  • Develop an Overdose Map, to the extent practicable, with geomapping technology to locate overdose related hotspots and provide real-time data sharing.
  • Evaluate the efficacy of providing Naloxone distribution boxes in state owned or occupied facilities, similar to how the state currently provides automated external defibrillators.
  • Evaluate the efficacy of widely training state employees in Naloxone distribution, focusing first and foremost on state employees who interact directly and regularly with the public.

To Prevent Substance Use Disorder:

  • Target prevention programs to high-risk areas and school-age children. The Director of Opioid Response must work to target prevention programs to high-risk areas, establish a working group to evaluate the effectiveness of existing prevention programs in Maine and other states for school-age children, and identify funds and approaches to expand or improve prevention programs in Maine.
  • Improve training and awareness for health care professionals. The Director of Opioid Response must work to re-establish the Prescription Monitoring Program (PMP) Advisory Council to assist the PMP staff with analyzing prescribing trends and communicating those trends to prescribers, improve the training of healthcare professionals to prevent over prescribing, and work with the Office of the Chief Medical Examiner and the Margaret Chase Smith Center to establish a system whereby prescribers are notified of patients who overdose fatally or are revived.

To Expand Access to Treatment:

  • Ensure Mainers can access affordable, timely care. The Director of Opioid Response shall connect individuals to timely supports and services through active communication with health care providers and community organizations and work to identify whether a one-stop referral system to help provide direct referrals to treatment would be effective for Maine.
  • Identify effective ways to integrate Medication Assisted Treatment (MAT) in the criminal justice system, emergency rooms, and recovery efforts across Maine. The Director of Opioid Response will identify ways to integrate MAT into the criminal justice system with the hope of diverting people from entering the system and work to design an MAT plan of a larger system of a “hub” of clinical care and “spoke” of supportive services that include Recovery Coaches.
  • Work with the Bureau of Insurance to review any current limits on MAT applied by commercial health insurance plans in the state, and encourage their voluntary removal unless legislation to end discriminatory practices is found to be necessary.

To Bolster Recovery:

  • Increase the number of Recovery Coaches located in emergency rooms statewide. The Director of Opioid Response will direct existing funds to be used to train 250 Recovery Coaches and make a Recovery Coach available in up to ten emergency departments statewide.
  • Work with emergency medicine physicians and hospitals to expand the number of emergency departments offering rapid access induction of Suboxone.
  • Help incarcerated Mainers access MAT services during and after incarceration. The Director will also encourage every county jail to have MAT services available for incarcerated Mainers suffering from substance use disorder and help individuals receive similar services after their release. The Director will also assist the Department of Corrections pilot program to provide MAT to inmates.

Full text of Executive Order 2 (PDF)