Pubdate: Sat, 29 Apr 2000
Source: Bangor Daily News (ME)
Copyright: 2000, Bangor Daily News Inc.
Author: Claude P.M. OíDonnell is chairman of the board of directors at
Acadia Hospital.


The op-ed commentary by U. S. Attorney Jay McCloskey about the metha-done
clinic proposed for Bangor (BDN, April 13) causes me to respond. First, it
is important to acknowledge that we are fortunate to have law enforcement
officials in our community who are vigilant and concerned about the
ever-increasing problems of illegal drug use.

Acadia Hospital has always been supportive of efforts by law enforcement to
reduce illegal drug use in our community.

As U.S. Attorney McCloskey re-minded us recently, four heroin-related deaths
in Bangor have occurred since 1998. What is important to know is that there
are many more people being routinely treated for drug overdose in the
emergency rooms of our local hospitals.

He is correct in asserting that illegal drug use and addiction are thriving
in our city. For that reason it is constructive to consider methadone as a
treatment option for those who desperately seek recovery from the
life-threatening effects of opiate drug addiction.

The state of Maine has asked Acadia Hospital to be the clinical service
provider of the proposed methadone maintenance treatment program for this

>From the early development stages of this program, Acadia planned to
participate in a broader community discussion about the use of methadone.

Its intention is to achieve consensus for multiple responses to opiate

Several months ago, the Bangor Daily News ran a feature story on the growing
problem of opiate addiction in northern Maine, with particular emphasis on
the increasing use of heroin.

The article served as an important wakeup call for northern and eastern
Maine. Law enforcement, medical clinicians, educators, clergy and state and
city public officials must collectively respond to this multidimensional

People addicted to drugs are often those we would not necessarily imagine.
We tend to have a picture of the "typical addict" in our mindís eye and for
most of us it is a very limited view. We take some comfort in knowing that
we, or our children, wonít come in contact with drug addiction because we
think we know which people to avoid. Unfortunately, it is not that easy.
Illegal drug use includes people from all segments of our society. "They"
live with and among us. Their addiction may be the result of legal or
illegal use of drugs, and that distinction is important to remember.

Addiction, illegal or otherwise, is still a debilitating disease for the
person afflicted.

It is expensive, too. Available research estimates the cost of heroin for a
user at $80,000 to $100,000 a year. To support this habit, users typically
engage in criminal activity, committing thefts or engaging in various forms
of sexual prostitution in exchange for cash or drugs. Criminal behavior
motivated by addiction results in significant direct and indirect costs to
victims and communities. The availability of a methadone treatment service
in Bangor will not, by itself, curb the illegal use of drugs.

It does, however, provide the recovering person with an alternative
lifestyle, free of addiction and crime.

Many communities have seen a de-crease in crime when this service is

Economically speaking, when methadone is provided to patients on a daily
basis, the average cost is approximately $80 a week. This results is an
annual cost of approximately $4,200, including detoxification,
rehabilitation therapy and family support programs. Patients in a methadone
treatment program can and often do return to normal lives, fulfilling their
parenting roles and contributing as productive members of the community.

It is true that this form of treatment, just like law enforcement
interdiction, is not always 100 percent effective.

But the combination of all appropriate resources will likely produce the
best result.

The broad acceptance of methadone treatment for opiate addiction is
supported by the national experience. The White House Office of National
Drug Control Policy estimates that there are 810,000 heroin addicts in the
United States. Only 138,000 to 170,000 people currently receive methadone as
part of an addiction treatment program.

There are approximately 900 meth-adone treatment programs in the United

The prospect of locating a methadone treatment service in Bangor is much
like getting a medical diagnosis for an operation we didnít expect, much
less wanted, but need. Touching up the X-ray to avoid the operation may be
less painful, but it surely isnít a cure. Bangor is the most strategic
regional center in northern and eastern Maine. One cannot fault the Maine
Department of Mental Health for selecting Bangor as a potential site.

Mayor Michael Aube demonstrated wise civic leadership by recommending that a
community task force examine ways of doing what is best for all concerned.
Personal or political agendas have no place in this dialogue. Acadia
Hospital encourages citizens of this community to take an active interest in
these public sessions.

Attend if you can, and become educated about this important subject.

While you are doing so, you might consider the closing thought of a Joint
Statement issued July 22, 1999 by Health and Human Services Secretary Donna
E. Shalala, General Barry R. McCaffrey, director of the Office of National
Drug Control Policy, and U.S. Attorney General Janet Reno, regarding a
regulatory proposal that requires the accreditation of substance abuse
treatment programs that use methadone to treat heroin and other opiate

"Improving access and availability to substance abuse treatment is an
essential part of our national strategy to reduce drug addiction and its
consequences. These proposed regulatory changes will bring the full force of
our medical and clinical knowledge to bear on treating heroin addiction.

The result will be a strengthened treatment system that will be good for
patients, practitioners, providers, communities and our nation."

I take comfort in the collective wisdom, caring and dedication of the Acadia
family as decisions about treatment for all patients are considered in human
terms with the primary objective of returning people who are ill to healthy
and purposeful lives.

Certainly, all concerned citizens would probably agree with that objective,
now letís work together on how best to attain it.
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