Maine is in the throes of an addiction crisis. Treatment admissions for heroin use were 90 percent higher in 2014 than in 2010. Tens of thousands of Maine people are in need of treatment for substance use and aren’t getting help.
Methadone clinics in Maine receive some of the lowest Medicaid reimbursement in the nation, and the state’s chief executive said recently he’s trying to shut them down.
Given that backdrop of great need for medication-assisted treatment and limited capacity, a rare opportunity to help has essentially landed on the doorstep of the Bangor City Council. The Penobscot County Metro Treatment Center, a methadone clinic on Hogan Road, is seeking the city’s permission to treat 500 patients, up from its current licensed capacity of 300.
For a city council that has been receptive to the need for more substance use treatment capacity in eastern Maine, approving the clinic’s expansion request should be a no-brainer. The council is rarely faced with such meaningful decisions that are so easy to make.
Bangor councilors should be praising Penobscot County Metro for taking the initiative to add treatment slots that are clearly needed. But at a public hearing on Monday, the clinic operators met a steady and undeserved barrage of criticism from multiple councilors who suggested that the clinic expand in Aroostook County, or in Ellsworth — basically, anywhere but Bangor.
Yes, those suffering from an addiction should have the opportunity to receive treatment close to where they live and work. But that’s not the issue before the Bangor City Council.
Before the council is the simple question of whether Penobscot County Metro has satisfied the conditions for expansion: whether the clinic’s physical space is adequate; whether the clinic has sufficient staffing; whether it has demonstrated the need for added capacity; and whether the clinic is in compliance with local, state and federal rules and regulations.
But during nearly two hours of questioning Monday night, councilors spent virtually none of their time addressing those topics.
Councilors asserted, falsely, that Suboxone is a safer treatment alternative — and one that’s potentially available closer to home for the patients who would be seeking treatment at Penobscot County Metro. Fortunately, Dr. Judith Weisman, medical director at Rockland Metro Treatment Center, an affiliated clinic, addressed that claim.
“It is a great drug for certain populations. It is a great drug for what we call the lightweights — people who have only used for a short time,” Weisman said of Suboxone. “For the heavy hitters, particularly the IV users, they need methadone. It works better.”
Indeed, city ordinances allow councilors to also consider whether there’s sufficient demand to justify a treatment center elsewhere, in proximity to current and potential future patients’ homes. But councilors focused almost exclusively on that condition. And the focus isn’t even justified.
Of the clinic’s 300 patients, currently four are from Aroostook County, where there is no methadone clinic, and five are from Washington County, which is home to a methadone clinic in Calais. The vast majority are from Penobscot and surrounding counties.
What’s more important than where patients live is what happens to those patients whom the clinic can’t admit for treatment due to limited capacity. Penobscot County Metro says it has a waitlist of 173 people who have called the clinic seeking treatment. When the clinic recently followed up with those people, it could reach only 60.
“Many of our patients, once they hit bottom is when they recognize that it’s time to make a change in their lives,” James Harrison, regional director for Colonial Management Group, the Bangor clinic’s parent company, told councilors. “And if we aren’t able to capture them, as far as assist them at that moment in life, whatever it is that they’re experiencing, they might … continue on with their addiction.”
Which means there’s a good chance those people could end up dead.
Adding 200 treatment slots in Bangor won’t solve Maine’s opiate epidemic, and it won’t solve the problem of a lack of treatment capacity in rural Maine. But the clinic expansion is a simple step the Bangor City Council should take to help — and to save lives.
