title: Use and Misuse of Opioids in Maine: Results From Pharmacists, the Prescription Monitoring, and the Diversion Alert Programs.
abstract: Although opioids have substantial efficacy for acute pain management, escalation to opioid misuse and abuse is a persistent concern. This report assesses the current status of the opioid epidemic in Maine using three complementary data sets.
  
  
  
  A representative sample of pharmacists (N = 275) completed an online survey regarding the extent that opioids affected their practice. A county-level analysis of opioid prescriptions (N = 1.22 million) reported to the Maine Prescription Monitoring Program (M-PMP) in 2014 and the agents implicated in arrests as reported to the Maine Diversion Alert Program (DAP, N = 2,700) in 2014/15 also was completed.
  
  
  
  A significantly greater number of pharmacists agreed that opioid misuse (85.9%), rather than diversion (76.8%) or access (54.2%), was a concern. Only half (56.2%) reported use of the M-PMP. Opioids were dispensed to 22.4% of residents (37.7% of women in their 80s). This was enough to supply everyone in Maine with a 16.1-day supply. Buprenorphine accounted for almost half of opioid prescriptions to young adults (46.3% women, 49.3% men). Arrests increased by 13.3% from 2014 to 2015, and the proportion of arrests that involved prescription opioids decreased while those involving stimulants and heroin were elevated.
  
  
  
  Pharmacists are very aware of the potential for opioid misuse, but many do not consistently use the M-PMP. There continues to be substantial legitimate use, as well as criminal activity, involving oxycodone and other prescription opioids. Continued vigilance and use of tools like the PMP and DAP are necessary to minimize nonmedical use of opioids in Maine.
authors.affiliation: Department of Psychology, Bowdoin College, Brunswick, Maine.|Department of Molecular & Biomedical Sciences, University of Maine, Orono, Maine.|Husson University School of Pharmacy, Bangor, Maine.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Piper
authors.affiliation: Diversion Alert, Houlton, Maine.
authors.forename: Clare E
authors.initials: CE
authors.lastname: Desrosiers
authors.affiliation: Maine Office of Mental Health and Substance Abuse Services, Augusta, Maine.
authors.forename: John W
authors.initials: JW
authors.lastname: Lipovsky
authors.affiliation: Husson University School of Pharmacy, Bangor, Maine.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Rodney
authors.affiliation: Husson University School of Pharmacy, Bangor, Maine.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Baker
authors.affiliation: College of Pharmacy, University of New England, Portland, Maine.
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: McCall
authors.affiliation: Husson University School of Pharmacy, Bangor, Maine.|Maine Medical Center, Portland, Maine.
authors.forename: Stephanie D
authors.initials: SD
authors.lastname: Nichols
authors.affiliation: Husson University School of Pharmacy, Bangor, Maine.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Martin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000600:supply & distribution*; D002648:Child; D003157:Community Pharmacy Services / Q000706:statistics & numerical data; D057237:Criminals / Q000706:statistics & numerical data; D062313:Databases, Pharmaceutical; D005260:Female; D006801:Humans; D008281:Maine / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000517:prevention & control; D010595:Pharmacists; D063487:Prescription Drug Misuse / Q000517:prevention & control / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid