Maine’s county jails have become one of the largest providers of addiction treatment in Maine, and the bill for it is now at the center of a statewide funding fight.
Counties spent about $9.1 million on medication for opioid use disorder last fiscal year and more than $3.5 million on mental health care, according to a January report from the Maine County Corrections Professional Standards Council.
The Maine Monitor examined those costs across the state’s 15 jails in a July investigation supported by the Pulitzer Center.
What the Numbers Show in Maine
Medical costs at Maine’s 15 jails grew nearly 40 percent between 2023 and 2025, the council report found. Personnel accounted for about 63 percent of all jail expenses last year, and prisoners’ medical costs made up 16 percent.
Spending varied widely by county. It ranged from just over $180,000 at the Washington County Jail to nearly $1.8 million at the Somerset County Jail.
The state’s contribution has not kept pace. A 2022 law set an annual $20.3 million County Jail Operations Fund across the 15 jails.
The council report estimated total jail expenditures would top $141 million this year, which would put the state share below 15 percent. Lawmakers added a one-time $4 million this year, down from a proposed $10 million annually.
Why Maine Jails Provide This Care
Maine’s jails have been required to provide medications for opioid use disorder for seven years. In 2019, federal appeals judges upheld a ruling that the Aroostook County Jail in Houlton would violate the Americans with Disabilities Act if it refused to let a prisoner continue medication-assisted treatment.
The ruling applied across the First Circuit. Maine codified the requirement in state law in 2022. Gordon Smith, the governor’s director of opioid response, told The Maine Monitor he has long objected to county officials calling the requirement an unfunded mandate.
He said the people in custody are county residents and that treating them for illness is a constitutional and ADA responsibility, and that you cannot discriminate because the illness happens to be mental illness or substance use.
Understanding Medication for Opioid Use Disorder
Buprenorphine combined with naloxone, sold under the brand name Suboxone, reduces withdrawal symptoms and cravings in people with opioid use disorder.
At the Piscataquis County Jail in Dover-Foxcroft, corrections officers watch crushed doses dissolve under the tongue to prevent diversion, a process that can take up to 15 minutes per person. On one day in early April, 7 of the 19 people in custody received a dose.
Signs that someone may need this level of care include using more of a drug than intended, withdrawal symptoms between doses, and continued use despite serious consequences at work, at home, or with the law.
Withdrawal from opioids brings nausea, muscle pain, sweating, and severe anxiety, and while it is rarely fatal on its own, it drives many people back to use.
The Scale of Need Behind Bars
Roughly 75 percent of people in Maine county jails have a substance use disorder and roughly 60 percent have a mental health disorder, according to testimony from the Maine County Commissioners Association.
Kyle Manahan, the Cumberland County Jail’s former health services administrator, estimated that for every 10 prisoners at least one is detoxing off opioids, alcohol, benzodiazepines, or methamphetamine on any given day.
The jail’s daily average population last year was nearly 400. He said the jail is probably the largest detox center in the state.
Nine jails reported that at least 3,446 prisoners received medication-assisted treatment last year. State corrections officials said their own data for the year is incomplete.
Diversion Programs Reach Far Fewer People
Maine runs 15 treatment and recovery courts, with the newest opening in Caribou in June. These let people who meet certain criteria avoid jail by completing programs that address underlying substance use or mental health issues.
Their reach is limited so far. Nearly 500 people took part in a treatment court last year. More than 25,000 people were booked into county jails.
Finding Addiction Treatment in Maine
You do not need to be arrested to get this care. If you or someone you love is using opioids in Maine, community treatment is available and does not depend on a court order.
Call 211 or text your ZIP code to 898-211 to reach 211 Maine, a free referral service that can identify treatment options and local recovery groups.
Every Maine county has an OPTIONS liaison who provides one-on-one help connecting to services. The SAMHSA National Helpline is free and confidential at 1-800-662-4357.
Search addiction treatment centers in Maine on Addictions.com to compare local programs by treatment type, insurance accepted, and level of care. Call
800-681-1058
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