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."

COLUMBUS, Ohio - The holiday season has officially started, and one group is encouraging Ohio parents to make a special effort to check in with their teens to help them avoid risky behaviors.

With days off school, parties and distracted parents, experts say underage drinking tends to increase during the holidays. Rick Birt, president and chief executive of Students Against Destructive Decisions, said alcohol is the most widely used substance among teens, with 14 the average age for a first drink. He encouraged parents to set ground rules to manage expectations, and to not make discussions about risky behaviors as "one and done."

"We've talked with parents all across Ohio who try to have regular, routine check-in," he said. "Maybe when you're driving 'em to the bus stop, go beyond the 'How's school?' conversation; dig into the 'How are you feeling?' The more that you talk with your young person, the more able they are to have that ongoing conversation with you."

Because risk-taking is a typical part of teenage development, Birt recommended avoiding scare tactics. He said the best conversations focus on education about healthy choices and how to make smart decisions in the face of peer pressure.

Other important topics to touch on, Birt added, include the illegal use of prescription medications, tobacco and marijuana. With medical marijuana legal in Ohio as well as efforts to legalize recreational use, Birt said, teens may have misconceptions about its dangers.

"The marijuana of today is not the marijuana from the '60s and '70s," he said. "It's been genetically modified and is much stronger. It is different depending on how it's ingested - whether it's smoked or used as a dab, or used in an edible or in some other way."

Birt also noted that it's important to keep a check on a teenager's mood.

"While the holidays are full of lights and glamour and special moments, and while we're oftentimes more together during the holidays, we don't always feel that way," he said. "They can be lonely seasons for many young people. There's anxiety, and all sorts of other things that come into play."

Parents who are concerned about a teen's mental health can contact their primary-care physician. Online resources are available, too, at nami.org, ohiosadd.org and preventionactionalliance.org.


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SACRAMENTO, Calif. - Saturday is National Prescription Drug Take-Back Day, when the Drug Enforcement Administration encourages everyone to clean out their old prescriptions.

Flushing prescription pills can poison the local water supply, so instead, people can drop their bottles off at 200 police stations and government offices across California.

Susanna Marshland, Northern California regional vice president for the Fred Finch Youth and Family Services Center in Oakland, warned that unused medications are a danger to children, especially teens.

"There was an increase in parents relapsing during COVID, and a simultaneous increase in isolation and loneliness for their children," she said. "Kids whose needs are not being met may themselves turn to use."

According to the California Overdose Surveillance Dashboard, more than 5,300 people died from opioid overdoses in the state last year, a 120% increase from 2018. In 2020, Californians filled more than 14 million prescriptions for opioids. Find the closest drug drop-off sites online, at TakeBackDay.DEA.gov.

Nationally, said state Attorney General Rob Bonta, drug overdoses killed more than 93,000 Americans in 2020, and two-thirds of them involved a prescription or an illicit opioid.

"These aren't just statistics. These aren't just numbers. These are real people and these are real lives," he said. "We're talking about 93,000 moms, dads, teens, loved ones - each with a story."

Bonta added that at the last Take-Back Day in April, authorities collected 48,000 pounds of unused medications in California and 800,000 pounds across the nation.

MANCHESTER, N.H. - September is National Recovery Month, and New Hampshire groups are working to raise awareness about the many paths to recovery from alcohol or substance-use disorders.

This Saturday in Manchester, a "Rally 4 Recovery" will feature speakers sharing their own personal stories, as well as booths representing treatment centers, health agencies and various recovery tools - from 12-Step programs to SMART Recovery, Recovery Dharma and more.

"The rally really is a chance for people in recovery to demonstrate that no matter how low we may have fallen in our lives, we do recover, we do get better," said Keith Howard executive director of the group Hope for New Hampshire Recovery, which is leading the event.

Howard said there will be more than 40 booths, as well as juggling instructors, visual art and live musicians, all of whom are in recovery themselves. He said these stories are powerful for helping people who may be struggling with addiction as well as their friends, families and neighbors.

During this awareness month, advocates are working to reduce the stigma around addiction and mental illness; they say it often can prevent people from seeking the help they need. Howard said it's important to "show up, show pride and show the world we get better." He said his own story is an example of what hope - and help - can do.

"I was living on the streets - homeless, toothless and pretty much hopeless," he said, "and thanks to work that I did as directed by folks in recovery, today I'm able to be executive director of a large Recovery Center."

The Substance Abuse and Mental Health Services Administration has free, confidential and anonymous resources for people dealing with addiction - themselves, friends or family. The SAMHSA hotline can be reached at 1-800-662-HELP, and its Behavioral Health Treatment Services Locator can be found at findtreatment.samhsa.gov.