Chronic Pain and Addiction Treatment in Maine

How is chronic pain treated when someone also has a substance use disorder?

When someone in Maine has chronic pain and a substance use disorder, treatment usually follows one coordinated plan in which pain clinicians and addiction clinicians agree on medicines, therapies and goals. Coordination can mean a shared care plan, regular contact between the pain prescriber and the addiction team, and one clinician tracking every prescription.

Long-term opioid use can cause physical dependence, an expected effect of steady use that differs from a use disorder, so clinicians assess the two separately. The choice of treatment sits with the person and their clinicians, and options can include buprenorphine, which treats opioid use disorder and also relieves pain, or methadone through an opioid treatment program.

Pain medicines should not be stopped or cut sharply without help. A sudden stop can bring withdrawal and a sharp rise in pain, and abruptly stopping benzodiazepines can also cause seizures, so any taper belongs in a plan made with the prescriber. Some people hold a steady dose or switch to buprenorphine instead.

Non-drug approaches often sit alongside medication, including physical therapy and psychological methods such as cognitive behavioral therapy. MaineCare covers telehealth visits for substance use disorder treatment, which helps people facing long drives, and intake staff can say whether a program will coordinate with your current pain prescriber.

Buprenorphine prescribers in Maine are listed under Suboxone clinics in Maine, and opioid treatment programs are listed under methadone clinics in Maine. A wider look at opioid care across the state is on the opioid rehab in Maine page.

Is it safe to stop or reduce pain medication on my own?

No. Long-term opioid or benzodiazepine prescriptions should not be stopped or cut sharply without help, and any taper should be planned with the prescriber. A sudden stop can bring on withdrawal and a sharp rise in pain. With benzodiazepines, stopping abruptly can also cause seizures.

Benzodiazepines taken together with opioids raise the risk of slowed breathing, which is one reason prescribers review the two together and do not treat benzodiazepines as pain medicine. For some people, a prescriber may suggest holding a steady dose or moving to buprenorphine instead of tapering. Programs that work with sedative medications are listed under benzo rehab in Maine.

Can I keep getting pain treatment while in addiction treatment in Maine?

Yes, pain care can usually continue during addiction treatment in Maine, as long as the pain prescriber and the program work from a shared plan. State rules govern how opioids are prescribed in Maine, and your prescriber can explain how those rules apply to your care.

MaineCare covers telehealth visits, including substance use disorder treatment, and phone-only visits can count when the provider allows them. That helps people in Aroostook, Washington and other northern and eastern counties, where travel distances are long. Remote options appear on the telehealth rehab in Maine page. For people who also have a mental health condition, see dual diagnosis care in Maine.

Maine’s Office of Behavioral Health requires recovery residences to be certified by the Maine Association of Recovery Residences and to accept people who take medication for opioid use disorder. Options are listed under sober living in Maine.

Naloxone in Maine

Naloxone nasal spray is sold over the counter in Maine without a prescription, and MaineCare covers a two-dose nasal spray kit at the pharmacy. Free naloxone is also available through the Maine DHHS OPTIONS program, which has a local liaison in each county.

How do I pay for pain and addiction treatment in Maine?

Pain and addiction treatment in Maine is usually paid for through MaineCare, private insurance, or state-funded treatment through the Office of Behavioral Health at Maine DHHS. MaineCare is run by the Office of MaineCare Services. Maine expanded the program to low-income adults, with newly eligible enrollees covered since January 2019, and the adult limit is listed at 133 percent of the federal poverty level. Ask intake staff whether the program bills MaineCare for medication for opioid use disorder and for the level of care you need. More on coverage is on the Medicaid rehab page.

With private insurance, federal parity rules generally limit how much tighter a plan can make its substance use benefits than its medical benefits. People without coverage can start with state-funded rehab in Maine.

What should I ask a Maine program before starting?

Before you start, ask three things:

• Does the program treat pain and substance use together?
• Can it continue or start medication for opioid use disorder?
• Will it coordinate with your current pain prescriber?

Listings for this service lean rural: 56 percent are in rural areas and 42 percent in towns, with Presque Isle, Ellsworth and Lewiston among the most common locations. Every listing sits within 25 miles of a river, at a median of 4.9 miles, most often the Little Androscoggin River. Portland International Jetport is the most common nearest airport, and the median distance to the closest airport is 12.4 miles. Each listing shows its levels of care, medication options, payment types, insurers, accreditation, languages and the populations it serves.

For free help finding care, dial 211 to reach 211 Maine, or call 1-877-463-6207 from out of state. The national treatment referral line is open around the clock, and 988 is there in a crisis. You can browse all services from the Maine rehab hub or read the national guide to pain and addiction care.