This July 23, 2018 file photo shows packets of buprenorphine, a drug which controls heroin and opioid cravings, in Greenfield, Mass. A proposed treatment center for those suffering from substance use disorder has Dover-Foxcroft residents wary of its impact on the town's image if a downtown facility is approved. Credit: Elise Amendola / AP

DOVER-FOXCROFT, Maine — Dover-Foxcroft residents are divided on whether an opioid addiction treatment office proposed for downtown is needed in the community.

Ahead of a Dover-Foxcroft Planning Board meeting to discuss the proposal this week, townspeople have been engaging online, many of them quickly shutting down the idea despite the prevalence of substance use in Piscataquis County and the lack of accessible treatment options in rural Maine. Locals have expressed concern about the proposed clinic’s location, worrying that it’s across the street from a bar downtown and its visibility could hurt businesses and future investment.

Contrary to what many residents want to believe, opioid use disorder is a serious problem in Piscataquis, said David McDermott, vice president of medical affairs and senior physician executive at Northern Light hospitals in Dover-Foxcroft and Greenville. Locally, there is a need for more evidence-based treatment options, he said.

“We have people who live in every one of our towns who are in various stages of recovery,” and not enough access to the medications that aid them, he said. “The other challenge is we have a number of able-bodied people of working age who have to spend so much time traveling out of the region to get their treatments.”

Medication for opioid use disorder, or MOUD, is treatment combined with counseling and behavioral therapy.

Chatter among townspeople began online last week, after a planning board agenda was shared, notifying the public about a site plan review for a professional office that would provide medication-assisted treatment at 123 East Main St.

Rosemary Boudreau of Provider Services, a Skowhegan-based office that provides medication for opioid use disorder, will present her proposal to open the downtown clinic when the Dover-Foxcroft’s Planning Board meets Thursday. The clinic provides urine drug screens and medications for opioid use disorder, according to a brochure. An advanced practice registered nurse and psychiatric mental health nurse practitioner prescribe the medications.

Boudreau was not available for comment Friday, but she answered questions and tried to dispel misinformation online when townspeople assumed the office for opioid use disorder medications was a supervised heroin-injection site or methadone clinic, among other ideas.

Boudreau, who wrote online that she has 30-plus years of work in mental health and substance use, manages the Skowhegan office and scheduling, while an advanced practice registered nurse completes assessments, monitors patients and handles drug screens and results, she said on Facebook.

Typically patients are prescribed Suboxone, the brand name of a medicine that contains buprenorphine and naloxone, she said. Buprenorphine is an FDA-approved medication to help those addicted to opioids get through withdrawal safely.

McDermott didn’t advocate for this particular proposal because he had only basic information about its services, but he welcomed more qualified professionals bringing life-saving medications like Suboxone to the area.

“Every single person that they keep alive to get into long-term recovery is a person still alive and contributing to our community,” he said.

Dover-Foxcroft resident Theresa Spelios was initially skeptical of the clinic, but she felt reassured after interacting with Boudreau. She supports more treatment services coming to town because she recognizes the need and has seen friends struggle with addiction, she said.

She prefers that the facility be located in a discreet location that would offer patients privacy. Spelios suggested inside the Union Square Mall, which is also located downtown but in a building with other small businesses. Patients could park behind the mall, she said.

Benjamin Cookson, who co-owns Shaw Road Farm and Little Organics Early Learning Center with his wife, Ashley Cookson, opposes the clinic because it could be economically detrimental to thriving businesses downtown, he said. He suspects real estate values would drop over time, and the public location would expose local children to people with substance use disorder.

“The reason is not because I’m insensitive to people who need addiction treatment,” he said. “We’re trying to attract new residents and businesses from outside of Maine. We’re trying to grow the area. There’s a stigma attached to the Suboxone clinics. Right, wrong or indifferent, there’s a stigma there.”

Cookson would prefer to see the office located closer to Mayo Hospital and other medical buildings in town, he said.

Northern Light Health offers treatment options for opioid use disorder in Piscataquis County, but it isn’t meeting current demand, McDermott said. Since about 2020, McDermott has noticed an increase in overdoses and demand and capacity for treatment.

Staff are working on expanding options at Mayo Hospital and C.A. Dean Hospital, and the primary care practice in Milo offers the most robust program, he said.

McDermott has prescribed Suboxone to patients for the last four to five years, and many of them are active people who contribute to their community and want to get better, he said. Area hospitals have started hospitalized and emergency room patients on buprenorphine, and pregnant patients taking the medication also routinely visit Mayo, he said.

“The barriers to prescribing it [medications for opioid use disorder] have gone down,” he said. “It is becoming more accepted as people begin to understand that this is a disease that could affect anybody, that does affect our neighbors.”