PORTLAND, Maine -- Maine's providers of substance-abuse treatment and some other behavioral-health services are seeing a major increase in reimbursement rates going into effect this month.

But advocates for mental-health support say many agencies are facing major workforce shortages and other crises that prevent them from billing at all with the new rates.

Oliver Bradeen is executive director of Milestone Recovery, a nonprofit helping people facing homelessness and addiction. It's one of the few medically monitored withdrawal centers in Maine, often known as detox centers.

"Even with the increased rates, we're still struggling with workforce, and I know that's a common theme with the added level of COVID being a challenge," Bradeen explained. "There's just such a nursing shortage that it's hard to attract new talent from the nursing field."

He said their detox is currently closed because of those staffing shortages. He added while the improved rates are a step in the right direction, it could take time for providers who've been struggling to use them.

Malory Shaughnessy, executive director of the Alliance for Addiction and Mental Health Services, said the increase in demand during the pandemic, combined with the severe impacts on the workforce, are putting a huge strain on providers, and waitlists for services are growing daily.

She emphasized it is important the Department of Health and Human Services invest more of the federal relief funding into these services now, as well as begin the proposed regular review of MaineCare's reimbursement rates.

"It's all going to be really good for the system of care," Shaughnessy projected. "But the current reality of many agencies is the situation is pretty raw. And it needs some direct infusion of resources and support right now."

Jeff Tiner, chief program officer for clinical services at Catholic Charities Maine, said putting more funds toward substance-abuse treatment is the right thing to do to support Mainers, and saves taxpayer money on emergency services and the criminal-justice system.

Data shows nationally, more than 85% of the prison population either has a substance-use disorder or were incarcerated for something involving drugs or drug use.

"We see the overdose rates that have increased exponentially," Tiner observed. "I don't think there's anyone in my world that has not been affected pretty close to home for those losses. Investment in prevention and support and recovery is really well worth it, and is a smart as well as compassionate."

CORRECTION: The number of traffic fatalities in 2024 in Tennessee represents all traffic deaths, not just those that were alcohol-related. (8:18 a.m. MDT, Apr. 10, 2025)

Lebanon, Tenn., is one of more than 90 cities across the country taking part in Saturday's "Walk Like MADD," a five-kilometer event to help prevent impaired driving.

In 2022, alcohol-impaired driving claimed 364 lives in Tennessee.

Norris Skelley, chairman of the public policy committee for Mothers Against Drunk Driving-Tennessee, said his family became victims of impaired driving three decades ago. He noted 364 lives lost is fewer than in some years, but still indicates a crisis.

"The last two years before that, where both of those years in Tennessee, there were over 400 fatalities in alcohol-related traffic crashes," Skelley reported. "From 2019 to 2023, fatalities rose over 36% in Tennessee and 35% nationwide."

Last year saw more than 1,200 traffic fatalities in Tennessee.

State law imposes harsh penalties for driving under the influence, with first-time offenders facing jail, fines, and license suspension and repeat offenders facing longer jail sentences.

Skelley pointed out they are seeking volunteers for their outreach programs to speak in schools and to other groups about the risks associated with alcohol and drug use. He added raising public awareness is a key strategy for reducing DUIs in the state.

"It happens every day, every 78 seconds, somewhere in this country, someone is injured or killed in an alcohol-related traffic crash," Skelley emphasized. "I think education and public awareness is one of the best things we can do."

He noted volunteers have a chance to share their powerful personal stories of loss, survival and resilience.

Tracia Jungkurth volunteers with the group. Her eight-year-old son, Christopher and his father, Joseph, lost their lives in a drunken driving crash in 1996. Tracia and another son were injured but survived. She will be part of Saturday's walk.

"We will not forget, because there are generations coming behind us that we've got to stand up," Jungkurth stressed. "Because if we don't keep the roads safe, history is going to repeat itself. So that's our goal, is to educate. And prevention and safety."

As a therapist, Jungkurth turned personal pain into purpose by writing a book and founding Christopher Ministries. As DUI crashes rise in Tennessee, she urged people to drive sober and take highway safety seriously.

"The walk is one avenue to show support for the people that are gone," Jungkurth observed. "But I want Tennesseans, as I want all people, to realize that this is preventable and that we, as human beings, need to be responsible for our actions."

She emphasizes MADD's commitment to educating young people in particular about how early drug or alcohol use can negatively affect brain development and judgment.


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The Kentucky Board of Medical Licensure recently proposed new changes to regulations around the prescribing and dispensing of buprenorphine, also known by its brand name Suboxone, a Food and Drug Administration approved medication used to treat opioid-use disorder.

Experts say the changes would increase barriers for people who rely on it to keep their lives stable.

Michelle Lofwall is a professor in the Departments of Behavioral Science and Psychiatry at the University of Kentucky. She said the stricter rules send a discouraging message to people in recovery.

"And we know," said Lofwall, "low-barrier care, where patients can really get access to the medication and they can add on what's needed when they're not doing well, is really important."

The new regulations would limit doses patients can receive, mandate participation in counseling services, and require frequent drug testing, among other changes.

Critics of expanding access to buprenorphine, classified as a schedule III substance, argue the drug itself is an opioid that people can become addicted to - and don't address the root causes of substance-use disorders.

The board did not respond to an email request for comment for this story.

Lofwall pointed to the numerous reasons why requiring regular counseling and drug testing can prevent people from being able to access the medication they need.

The new rules would require clinicians see patients using buprenorphine every ten days, or at two-week intervals, in the first few months - and then every few months after two years of treatment.

"A lot of people have jobs that don't let them take off from work to come every week," said Lofwall. "They can be discriminated against because, all of a sudden, they're late, or they just don't have the benefits of a job that allows sick days."

Lofwall said she's confused by the board's actions, given the research showing significant declines in overdose deaths among people taking buprenorphine.

"The Kentucky Board of Medical Licensure just really has had a lack of transparency, I think," said Lofwall, "about the rationale for some of these changes."

According to the Centers for Disease Control and Prevention, in 2023 Kentucky ranked among the top five states for buprenorphine dispensing rates nationwide, along with West Virginia, Vermont and Maine.

Support for this reporting was provided by The Pew Charitable Trusts.




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The incidence of drug overdose is decreasing in Indiana and one reason could be the efforts of an organization offering free training to anyone willing to help someone struggling with addiction.

Indianapolis-based Overdose Lifeline works to address the basic needs of families, individuals and communities, showing them how to administer the overdose reversal drug naloxone, or Narcan.

Justin Phillips, founder and CEO of the Overdose Lifeline, explained naloxone can reverse the effects of fentanyl, currently the most prevalent synthetic opioid in the drug supply.

"We want to make people understand opioids and the class and family of opioids," Phillips emphasized. "Then we talk about stigma and harm reduction, and we give people the signs and symptoms of an overdose, and then we provide them with free overdose reversal kits."

She pointed out with proper training, someone can be better suited to reverse an overdose than administer CPR. The training lasts about an hour. In the second quarter of last year, the Marion County Public Health Department reported 124 overdose deaths. It said 56 happened at a residence and 28 at a hospital, 25% fewer than the same time in the previous year.

Phillips noted anyone may know someone who is struggling with addiction. But conversations about drug use and overdoses can be uncomfortable, which she argued reinforces the need for training.

"Sometimes, we're not as willing to go to a pharmacy to acquire Naloxone or talk to our doctor," Phillips acknowledged. "Which is why we do these community events and we make it available, easily accessed in the community, so that you can avoid some of that stigma and judgment."

She added Overdose Lifeline also partners with CareSource for a free program to support Indiana school nurses to implement a naloxone Emergency Preparedness and Response Plan in schools. The program provides free naloxone, emergency medication boxes and staff training.


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