An open hand

Opioid abuse: Maine DO treats all comers, insured or not

Merideth Norris, DO, is a one-woman hub-and-spoke system, educating patients about treatment and connecting them with recovery resources.

It took the patient two years to work up the nerve to tell his primary care doctor he’d been abusing his prescription pain medication. In response, the physician cancelled his prescription, gave him the phone number of a recovery center that was no longer open, and instructed him to return in six months to report on his progress.

Eventually, the man sought treatment from Merideth Norris, DO, an addiction medicine specialist in Kennebunk, Maine, who was horrified to hear his story. “This man had previously been diagnosed with colon cancer. When that happened, his doctor didn’t give him a nonfunctioning phone number and tell him he needed to figure out his own treatment plan,” she says. “Addiction is a medical condition, and as physicians, we need to treat it as such and guide patients toward appropriate treatment.”

Caring for the uninsured

Dr. Norris recently made headlines for announcing she will provide affordable care for uninsured patients who have opioid substance abuse disorders at her Kennebunk practice, Graceful Recovery. It’s a much-needed offer in Maine, where the nation’s opioid abuse epidemic has been especially acute. Between 2011 and 2014, the state saw a 530% increase in deaths involving heroin and morphine, according to Maine’s State Epidemiological Outcomes Workgroup.

Merideth Norris, DO, and her daughter pose at the Maine State House during the legislature's Doctor for a Day advocacy event. (Photo provided by Dr. Norris)

Dr. Norris’ uninsured patients must cover the cost of any medications, but they’re charged only $40 for appointments with her, which includes a new patient consult, followup calls, connections with support and resources and medication management. “I’ve had patients drive from 180 miles away because they couldn’t find treatment in their area,” she says. Because she also serves as medical director at a methadone clinic in Westbrook and a recovery center with sites in Lewiston and Portland, Dr. Norris is familiar with addiction resources throughout the state.

Treatment options for opioid abuse

Specific treatment plans are tailored to the patient’s situation and goals, Dr. Norris says. Some patients opt to detox without using medication, while others pursue medication-assisted treatment, which combines counseling with medications such as Suboxone or naltrexone that block opioids’ pleasurable effects.

Whatever the treatment plan, connecting patients with support is an essential element, Dr. Norris says. She requires patients to bring a support person to their appointment, and this person signs an agreement pledging to help the patient avoid using drugs and work toward recovery goals. Depending on the patient, further support may come in the form of counseling, a 12-step program or peers who are also in recovery.

“I had one patient who was a lobsterman, so he worked really irregular hours—seeing a therapist or going to 12-step meetings was going to be difficult for him,” Dr. Norris says. Instead, she reached out to colleagues in the area who also work with patients in recovery. “That same day, I was able to connect the patient with another sober fisherman who was in the same situation he was. My patients tend to be scared, isolated, and overwhelmed, so just giving them evidence-based information and getting them started with treatment is a huge first step.”

10 comments

  1. Congratulations on a truly Osteopathic approach to patients needing care and recovery. It was great to read about your compassion and commitment to your community. Your engagement with recovery services and medication assisted therapies has been enlightening.

  2. Doctor Norris I know you are saving lives and will surly inspire other doctors to reframe attitudes and service the victims of this plague. Years ago I was Medical Director of the 24hour club in Portland taking care of the Street Alcoholics and they were disenfranchised and needed services. The Board of the 24hrs organization who administered the grant money was spiritually driven by recovering alcoholics and some community leaders like judges and attorneys. You might need a halfway facility and look to some recovering addicts to spearhead its evolution. Keep up the quest and best wishes. Patrick Bentley, Ph.D., D.O.

  3. Congrats to Dr Norris for doing the right thing.

    I have a comment though about the title of the article and how, at least to me, it insinuates that docs don’t treat patient unless they are insured.

    Healthcare and Health insurance are not the same.
    Dr. Norris has proven that fully.

  4. I was treating addiction for several years in Wyoming. People drove up to 5 hr to see me, due to lack of resources! I called in my “bipolar practice” because some patients were so rewarding, while others were just the opposite. I drove to Rapid City in a blizzard to try to persuade the FP residency there to start a treatment program, but just ran into a wall. “We don’t want addicts in our practice”. Anyway, we need more treatment availability. Unfortunately, some doctors, including at least one on the WY board, think suboxone is just another drug of abuse and should not be used, so you can be persecuted for trying to do what is right for your patients.

  5. I personally refer patients to Dr. Norris. She is a credit to our community. We, as osteopathic physicians, should be proud of her. She has helped several of my patients beat their addiction. Many thanks Meredith.

  6. Dr. Norris is an inspiration to all those who became physicians to help people. All of our citizens deserve access to health care.

  7. Eddy, Good for you and your patients!
    Would love to speak with you and catch-up.

    Be Well, Lee Wisnioski, D.O.

  8. I do not meet any patients that want to detox without medication. If they could do that, wouldn’t they have done it before seeing a physician. Not to be critical, but, how do you get an opioid addict to stop without meds?? besides jail of course, but that is only temporary solution.
    Is there another way?

    1. The point of that statement is that it is up to the patient. Dr. Norris presents the options and the risks/benefits of each option, and than allows the patient to choose the treatment that they desire, based on what is being offered. It is about presenting the treatment options like we would in any medical disease treatment discussion. I personally do not recommend abstinence based treatment because of the unacceptable risk/benefit ratio but would not refuse to treat a patient who chose that course. It is about harm reduction. Just my 2 cents.

  9. This is hilarious!

    ALL ADDICTION DOCTORS IN MAINE TAKE UNINSURED PATIENTS–know why? Because they make a lot more money off the uninsured! She’s not doing some heroic thing by accepting patients without insurance and she’s not doing anything any different than any other Suboxone or Methadone doctor does! Mainecare reimbursement doesn’t even cover the costs to treat patients and insurance companies don’t pay much more! So guess who doctors really make the most from? You guessed it! THE SELF PAY PATIENT! And I promise you her self pay rate (that she claims is based on “income”) is still more than either Mainecare or Insurance reimburses her. I think it’s great to treat addicts-just don’t use us to pat yourself on the back. Especially for something you don’t even do!

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