URGENT NOTICE: Abrupt Service Disruption in Southern Maine

Oct 27, 2022

The Maine Prescription Monitoring Program (PMP) is notifying all health care providers and institutions of an abrupt service disruption affecting several hundred patients in southern Maine. A pain and addiction medicine clinic in this region has been affected by federal law enforcement action, leaving patients without access to their usual care. Many of these patients are prescribed controlled substances including opioids for chronic pain, buprenorphine for opiate use disorder, and benzodiazepines for anxiety. 

Abrupt loss of chronic prescribed opioids is associated with increased risk of suicide and overdose, and acute benzodiazepine withdrawal can be life-threatening.   

Providers are advised to take the following steps:   

1. Use the Prescription Monitoring Program to look up any patient presenting for care and requesting a controlled substance refill. Patients affected by this clinic closure will have a documented history of chronic prescriptions from a provider in Kennebunk prior to October 26, 2022.   

2. When checking the PMP, pay particular attention to the “date sold” and “days supply” data fields to calculate when refill doses would be needed.   

3. Though it is not usual practice for Acute/Urgent and Emergency care providers to prescribe opioids or benzodiazepines for patients in chronic management programs, please consider issuing prescriptions of up to 1-2 weeks should an affected patient present at your practice.  

4. Remember that any Emergency Medicine provider can administer buprenorphine to a patient to treat/prevent buprenorphine withdrawal.   

5. Know your in-house drug screens. Some synthetic opioids and benzodiazepines do not show up on standard tests, which could lead to an incorrect conclusion that a patient is not adherent to their prescription.   

6. In cases where multiple diagnostic criteria for opioid use disorder are met, initiate buprenorphine with proper education, or refer to a treatment clinic with verified immediate availability.   

7. The PMP and Licensing Boards are aware of this disruption in care and are taking all legally authorized action possible to assist patients to connect with medical providers. 

The following resources are available to assist providers and practices who are serving these displaced patients by assuming their care: 

1. MMA-CQI 2 online modules https://qclearninglab.org/all-courses/?items_page=1 

1. Maine Prescribing Laws, Limits and Compassionate Tapering 

2. Chronic Pain Diagnosis, Management and Alternative Treatment 

2. MICIS Private 1 hour CME (Academic Detailing) on Tapering 

1. https://micismaine.org/contact/  

3. ME SUC-LC Technical Assistance (procedures & work flows), Resource library (recorded webinars) 

1. https://mesudlearningcommunity.org/  

4. Schmidt Institute Comprehensive Controlled Substance Stewardship program 

1. https://theschmidtinstitute.org/contact-us/  

Questions? Please reach out to the Maine PMP Team: 

• (207)287-2595, Option 2 

• TTY: Maine Relay 711 

• Fax: 207-287-4334 

• Email: PMP@maine.gov