The closure of one of Bangor’s largest service providers for people grappling with addiction, mental health disorders and homelessness is having effects well beyond the city, months after the nonprofit shuttered.
The Health Equity Alliance, known as HEAL, had provided health testing, clean syringes for drug injection to prevent the spread of disease and a community resource center, among other services.
It shut down in March after 37 years, its last few months marked by financial issues and disruption that led the state to suspend and ultimately revoke its license to provide syringes.
That had ripple effects across eastern Maine, because HEAL also had contracts with another health care organization, the Medical Center at Lubec, to offer services in additional communities including Ellsworth, Machias and Presque Isle.
The closures left both Aroostook and Hancock counties without any state-certified syringe programs. Access to clean needles prevents the spread of blood-borne diseases from shared injection needles, according to advocates, and five other Maine counties also lack those programs.
Penobscot County is facing an outbreak of HIV cases that began in late 2023, according to the state, and all 22 of those who tested positive said they had injected drugs within the last year.
There are now efforts to restore some of the services that were lost when HEAL closed, although they will be more limited.
In Hancock County, a Deer Isle-Stonington group that once operated a syringe exchange under HEAL’s license is working to resume offering those services independently, according to its leadership.
While the Opiate-Free Island Partnership’s application to the Maine Center for Disease Control and Prevention is processed, the state agency has allowed it to continue operating an exchange once a month, according to the partnership’s executive director, Ashley Pesek. That’s down from once a week previously.
The group has historically provided roughly 2,500 needles annually, according to Pesek.
“The closure of HEAL is definitely going to have an impact on the Hancock County community in terms of syringe exchange,” she said.
As a location on a bridged island at the end of a peninsula, she said her organization’s services likely can’t meet all of Hancock County’s demand. Ellsworth was a more accessible “hub” near the center of the county, according to Pesek.
The partnership’s application is the only pending proposal for such a service in the county, according to Maine CDC spokesperson Lindsay Hammes.
When HEAL closed, Wabanaki Public Health and Wellness expanded quickly in Bangor to fill the gap. The organization has had success working collaboratively with other groups in the city to offer multiple services in one location, according to its co-CEO Lisa Sockabasin, and she believes such local partnerships would be effective anywhere in Maine.
But there are few such organizations, if any, to begin with in more rural areas of the state. That’s a challenge on top of ongoing underfunding for harm reduction resources, which are often misunderstood and therefore vulnerable to further cuts, according to Sockabasin.
“Substance use disorder has never received the level of funding it’s going to take to address the crisis that we know is happening in every corner of this state,” she said.
In her experience, harm reduction services such as syringe exchanges connect people with resources when they are struggling and lead them to build relationships with recovery organizations, which are “essential” to healing from substance use disorder.
Pesek doesn’t know of any other efforts to bring a new syringe service to Hancock County. Neither do officials from Healthy Acadia, an Ellsworth-based nonprofit that runs a number of community programs, including an addiction recovery center.
“We know that this type of service is of critical importance to reducing illness and death related to substance use, and it is important for these programs to be accessible across the region,” said Paige Johnston, the recovery center’s community health and supports director.
Healthy Acadia doesn’t plan to add syringe services, according to Johnston.
But the organization offers hepatitis C and HIV testing in partnership with Regional Medical Center of Lubec, services previously overseen by HEAL.
The Ellsworth center also continues to offer harm reduction supplies including the overdose-reversal medicine Naloxone, strips that test whether drugs have been mixed with potentially deadly fentanyl or xylazine, and bags for safe drug disposal along with its prevention and recovery resources, according to Johnston.