Pen Bay’s recent response regarding its plans for addiction services in Knox County (see Dr. Robert Stein’s column in last week’s Free Press) is just not enough, as the fact is that Pen Bay won’t really be offering anything new in Knox County for a year or longer.

The response and subsequent press release indicated Pen Bay would “partner in the establishment of the Lincoln-Knox County Integrated Treatment Continuum.” But that means that Pen Bay still expects disadvantaged patients to make the 50-mile round trip each weekday to Damariscotta (the Addiction Resource Center or “ARC”) for at least three consecutive weeks to start treatment. That burdens people with no reliable transportation and jeopardizes their jobs — most patients realize that they will fail so never make the attempt. This current Pen Bay, and Maine Behavioral Healthcare, approach already has failed.  

Pen Bay’s press release is also sparse on details and fails to address how they will hire the two to seven psychiatrists they would need in order to provide care in Knox County in 12 to 18 months to prescribe for the proposed target of 190 patients (DEA allows doctors to prescribe Suboxone to 30 patients in the first year of practice — after one year doctors can apply to treat up to 100 patients — one doctor cannot possibly treat 190 patients). Pen Bay has failed to recruit psychiatrists to handle this problem for the last 10 years, despite Waldo and Lincoln counties running successful programs over this same time period. What is different now?

The reality is that, right now for residents of Knox County, about three babies every month are born addicted to drugs. Patients discharged from the PARC unit after detox from drugs can’t find ongoing treatment needed to prevent relapse. In this community young adults die of overdoses every month and thousands more with addiction cannot find the treatment they seek.  

Treatment is needed now. When it comes to solutions, where there is a will, there is a way. This needs to be priority #1 for our community, and we need Pen Bay’s leadership to truly engage with the community it serves, conduct an enlightened and realistic reappraisal about how best to deal with this emergency facing us today and to seek ways to deal with the crisis as soon as possible, not next year.

Next Steps – Including Upcoming Knox County Addiction Workgroup Meeting in April

The good news is that, in early April, Rockland Mayor Louise MacLellan-Ruf and I are planning to convene all those involved in opiate use disorder treatment in Knox County. The goal of this meeting will be to prioritize all the unresolved issues regarding treatment in Knox County and to divide up into smaller workgroups to come up with realistic and actionable solutions. Pen Bay behavioral health and medical practitioners will be encouraged to attend. More importantly, Pen Bay leadership will be encouraged to attend. 

As described in my column last week, a private organization called “Recover Together” is ready to begin providing treatment in Rockland to people with opiate addiction at any time within six weeks — if only they can find three doctors willing to work with them. Each doctor would only need to devote as few as six hours per month in order for a combined 90 patients to receive treatment. The staff of Recover Together would manage every other aspect of treatment, freeing up the doctors to continue their present responsibilities. Recover Together will be invited to the Addiction Workgroup meeting as well.

Let’s do a little math. Pen Bay currently employs more than 100 physicians. Given a roughly 40-hour work week, these physicians devote 16,000 hours of work every month.  Given the public health crisis facing us now, if Pen Bay could somehow find 18 hours per month of physician time to help 90 people with substance use disorder, including pregnant mothers and their babies, that could help the most desperate individuals receive real help and start to slow the spread of addiction in Knox County. I know that the hospital’s leadership has the values, the integrity and the knowledge to figure this out, and it would be wonderful if the hospital’s Chief Operating Officer could take the lead on this issue for Pen Bay and work with this workgroup to find meaningful solutions. 

Those interested in joining the Knox County network to battle addiction can contact knox.recovery.network@gmail.com (or call or text 370-9881).

New - Plans for a Knox County Community Investors Initiative to Deal with “The Octopus”

People with addictive disorders become addicted because of a myriad of problems in their lives. All of them are related to poverty which, like an octopus, has many tentacles to defeat the strongest amongst us: History of early childhood physical, emotional and sexual abuse; behavioral health disorders (such as PTSD); very few good employment opportunities; lack of health insurance and access to medical, dental and behavioral health care; unstable living situations; lack of transportation; ongoing damaged personal and family relationships; social isolation; and entanglements with law enforcement — all of these lead to more disruptions of recovery and create almost insurmountable barriers to future employment. 

Many things need to be done by our community for those with substance use disorder and also those who are simply disadvantaged. I am working with many organizations and individuals to address all these issues.  

In the meantime, there is serious discussion about implementing a program which has had an amazing impact in Lewiston. The “Community Investors Initiative” unites local charitable organizations into a cohesive unit to respond to individual and family needs. Examples of this include help to disadvantaged people who need food, housing and/or transportation assistance, medical care expenses and much, much more. In essence, this program can help deal with the octopus. We hope that, by this summer, we will extend invitations to well-meaning neighbors to sign up as Community Investors to expand the charitable organization’s reach.  Investors would receive group-email requests to respond to the needs of individuals and families as they do in Lewiston. In less than one year, Lewiston’s Community Investors numbers have grown from 90 to 238.  

In their “Round 33” of requests, there is a good example: “an elderly woman with limited mobility is moving out of the homeless shelter. She finally has an apartment and a plan to stay stably housed. At the moment, she does not have a bed. This could pose many challenges for her, especially since she uses a scooter to get around. Getting on and off the floor would cause her great difficulty. We are asking for cash donations to help pay for a new mattress, which we will have delivered to her. The cost of a twin mattress, box spring, and frame is about $300. If you would like to make a contribution to help this woman sleep soundly at night, please consult the donation information.” If all of their investors gave but two dollars, this woman would be helped. In fact, in Lewiston, 100% of requests have been met since the program started. We can and we will do this in Knox County within the next six months. When we are ready to start, please consider becoming a Community Investor yourself.

In the meantime, please consider joining Neighbors Helping Neighbors: join.the.knox.cause@gmail.com (or call or text 370-9881). We will send you updates and keep you informed about opportunities and outcomes.