I am a grateful reader of your publication and always look forward to Village Soup’s editorials.  However, I am more than perplexed to find that once again the Rockland City Council is being asked to amend zoning to permit a methadone maintenance clinic on Route 1, without your editorial board, or really any Midcoast medical professionals, questioning a much thornier problem.

Why are these treatment centers for-profit enterprises? Why aren’t these treatment facilities sponsored by Maine nonprofits that actually care about their own communities? What part of “for profit” don’t we all understand?  Profit for the owners, profit for the shareholders. Where do the patients, actually consumers, figure in this equation? At the bottom, obviously.  There is money to be made here and out-of-state corporations will be the first in line to reap the money-tree harvest. The profit motive often is in conflict with quality.

Other states license treatment centers. In New York City, Beth Israel and Albert Einstein hospitals, among others, treat drug addicts with methadone maintenance. Addiction is treated as a medical problem and therefore is administered by medical professionals.  Daytop Village, Phoenix House, Odyssey House, just to name a few, are all nonprofits, which only offer drug-free programs. However, there are actually hundreds of individual nonprofits that offer both treatment options. Obviously, New York is a wealthy state and Maine is not, but the cost-per-patient is actually lower in New York for methadone maintenance treatment.  Why?

I worked as fundraiser for a drug treatment agency that embraced a multi-modality model, both drug-free and methadone maintenance treatment. Our agency had medical doctors, psychiatrists, Ph.D. psychologists, registered nurses, practical nurses, social workers, counselors, acupuncturists – you name it – and the cost per patient was lower than Turning Tide’s in Rockland. We treated some of the most difficult clients: Homeless Vietnam War veterans with post-traumatic stress disorder, dually-diagnosed addicts (addicts with severe mental health disorders) and clients with multiple addictions (at that time mainly alcohol and cocaine). Our programs also treated the children of addicts with a developmental disabilities grant. Two-thirds of these children required special education remediation when they entered elementary school. Special education is expensive and dollars for prevention saved more money later.

Penobscot Bay Medical Center and its ancillary mental health clinic is in perennial financial trouble. Why don’t they increase their funding stream and access Medicaid, Medicare, private insurance and fee-for-service revenue to care for drug abusers with methadone maintenance in their own community? How many for-profit failures will it take before we recognize the need for professional caring alternatives? If Midcoast medical professionals do not have the clinical training and expertise to offer methadone to the large number of opiate addicts in our area, they could co-partner with other out-of-state professionals and utilize them on a consultancy basis.

Currently, Maine has two growth industries: Energy alternatives (wind, ocean, thermal and solar) and addiction treatment. Prescription drug abuse tops the charts here. And this problem will not heal itself. There will never be enough jail space for users, and incarceration can actually make the problem worse. Jail is like USC — University of the Street Corner — for addicts. They learn ever more sophisticated ways to play with their own private chemistry sets. And let us not delude ourselves: Not all addicts are welfare cheats and losers. There are plenty of professionals and productive citizens who abuse substances of all kinds and many of them were patients at the Turning Tide facility.

Turning Tide in Rockland was ultimately shut down by the DEA, a federal agency; our own state regulators would have permitted it to continue operating. I think this speaks volumes about our tolerance for mediocre and even inferior providers. Patients should never receive take-home doses unless they can truly be trusted to “follow the program.”  How long did it take for Turning Tide clients to earn this “trust”? I have been told by a knowledgeable attorney that two months was not unusual. Medically supervised facilities require much more: One or two years is more like it, and for some clients the time frame is “never.” When inadequately treated addicts have more take-home methadone than they can responsibly handle, it becomes “diverted” to other individuals.  Sadly, diversion can produce death, and it has.

Daytop Village wanted to locate a drug-free treatment residence in the Bar Harbor area. This project was shot down by the community. Bar Harbor, obviously, may not have been the best choice. What about the empty and isolated military base in Aroostook County? There is land, there are deteriorating facilities and it is far away from everyone. Perhaps Governor LePage will change his mind about social services when he looks at the true bottom line: Jobs, reclaimed facilities, and a rejuvenated economy. Why let Plum Creek develop the Moosehead Lake area, which may destroy one of the most beautiful assets in Maine, but not investigate the possibility of renewal for a deserted outback?

I lived through a period in New York when the addicts controlled the streets. There were shoplifters, purse snatchings, break-ins, street assaults, and eventually even murders.  The most vulnerable among us will always be targeted first. A frail older woman has already suffered multiple times in Rockland. We may all hope otherwise, but the coast of Maine, and really the entire state, is headed in the same direction, only 50 years later than urban America. There is a new sign when you enter out State:  “Maine — Open for Business”.  Unfortunately, it’s the drug business.

Ann Ryan lives in Vinalhaven.