Maryland Addiction Consultation Service (MACS)

A statewide service to help primary care and specialty providers better address patients with opioid use disorders and chronic pain

Opioid overdoses have been increasing in Maryland and a large minority of those with opioid use disorder (OUD) are not getting evidence-based treatment with medications. This may be from low provider capacity to treat these individuals. In response, the Maryland Addiction Consultation Service (MACS) was launched in 2017 by the University of Maryland in collaboration with the Maryland Department of Health to address the various provider barriers to medications for opioid use disorder (MOUD), some of which include: limited training, education, and skills related to managing OUD and prescribing opioids for pain, lack of institutional support, insufficient behavioral health treatment referral options, regulatory burden, and provider stigma towards OUD. 

Some of the types of services provided include:

  • Warmline consultation - providers can call into MACS to get support for a patient from a consultant with addiction treatment training, as soon as real-time and delayed no longer than one day
  • Outreach - statewide and regional outreach to increase awareness of MACS using presentations, presence at conferences, mail, email, telephone, and social media
  • Training - availability of training on topics such as MOUD, treating patients with substance use disorders, and chronic pain management
  • Resources and referrals - individualized resources and referrals for patients

An overview of the service and contact information can be found here. More detail on the statewide response to the opioid crisis in Maryland, which includes MACS, can be found in the presentations here and here. Preliminary evaluation data can be found here and here. Funding for this program is through the Maryland Department of Health. 

There is a similar statewide service that has been implemented in Massachusetts

This program has been shown to increase access to specialty addiction medicine consultation and training through use of technology.

Continuum of Care
Type of Evidence
Response Approach
Cautious Opioid Prescribing
Medications for Opioid Use Disorder
Peer-reviewed Article

Evidence of Program Effectiveness

"Initial implementation outcomes indicate service components are being adopted as intended and by the target audience; many prescribers who engaged with the service have their buprenorphine waiver (44%) but do not have any additional formal addiction training (57%). Also, statewide penetration is promising with prescriber engagement in 100% of counites, however only 33% of counties in engaged in all four types of MACS services. Most calls (61%) originated from urban counties...The MACS program increases access to specialty addiction medicine consultation and training through use of technology. MACS can serve as a model for other states looking to bridge the gap in access to addiction treatment." (Sweeney et al., 2020)