Pubdate: Tue, 20 Jun 2000
Source: Bangor Daily News (ME)
Copyright: 2000, Bangor Daily News Inc.
Author: Renee Ordway


BANGOR -- In another attempt by the city to avoid the state's proposal to
open a methadone treatment clinic in Bangor, officials teamed up Monday with
staff from the Northeast Occupational Exchange Inc. to announce a new
"drug-free" opiate treatment program.

Monday's press conference, called by the U.S. Attorney's Office Communities
Against Heroin task force, was a new wrinkle in the ongoing, contentious
debate about whether the city would benefit from a methadone program
designed to treat heroin and opiate addicts.

Also on Monday, Bangor Mayor Michael Aube said he would meet with city
officials all day making plans for what he called a "significant press
announcement" that would be made at 10 a.m. today at City Hall.

He suggested that announcement would be in response to the decision last
Friday to withdraw plans for a state and communitywide task force to study
the need for a methadone clinic. Instead, state Office of Substance Abuse
officials said they would hold one public forum in July to take public
opinions on the issue and to educate residents about methadone, which is a
synthetic narcotic used to help opiate addicts withdraw from those drugs.

Though the city has argued vehemently against the placement of the clinic
here, the state ultimately has the final say and can open the clinic despite
intense city objection.

Heading up Monday's press conference was Dr. Robert Dana of Bangor, who is
considered an expert in the field of substance-abuse research and treatment
and who routinely puts out statewide reports outlining the current status of
substance abuse among teen-agers.

Dana has joined forces with the city and the U.S. Attorney's Office in
opposing the methadone clinic, saying there are other more reliable and less
addictive ways to treat addicts.

Dana said Monday that a "killer is loose" in the city and that treatment was
a crucial part of the city's attempt to deal with the influx of heroin and
other diverted, prescription opiates.

"We, as a city, cannot run away from it and bury our heads in the sand,"
Dana said. "Nor can we accept the simple solution that a methadone clinic
offers by simply exchanging one addiction for another.

"Drug addiction is a complex issue that requires complex treatment plans,"
Dana said.

That kind of treatment can be offered for the area's opiate addicts by
Northeast Occupational Exchange Inc. of Bangor, according to Dana.

NOE is a private, nonprofit agency that provides mental health and substance
abuse services in Bangor, Newport and Lincoln. It is licensed by the Bureau
of Mental Health and Retardation and Substance Abuse Services. That is the
same department that has proposed the clinic in Bangor, which would most
likely be run by Acadia Hospital in Bangor. NOE is not publically funded and
operates on a fee-for-service schedule.

Charles Tingley, NOE director, said the program will be offered to anyone
and treatment is not gauged on an addict's ability to pay.

"Cost is on a sliding scale dictated by the client's ability to pay,"
Tingley said. "No one will be turned away for an inability to pay."

Tingley also promised a "no-wait" policy, meaning that addicts can begin
treatment immediately.

The new program is based on the philosophies that no two drug users are the
same, that no one treatment is universally effective and that opiate addicts
are usually abusing other drugs as well.

Addicts seeking treatment will undergo a comprehensive assessment and
evaluation and counseling that includes "motivational enhancement, coping
skills training, behavioral therapy, community reinforcement training,
aversion therapy, medical support and self-help groups," according to a new
brochure on the program.

Experts supporting methadone, however, have argued that some opiate addicts
do not sufficiently benefit from traditional substance-abuse treatment
methods and need methadone in order to kick the habit.

NOE has no inpatient treatment, and clients would be served in various day
programs of up to 20 hours a week, Tingley said.

Tingley acknowledged that detoxification of opiate addicts is a very
painful, physical event and said that detox, which can last up to 72 hours,
may be done in one of the city's two hospitals if necessary.

NOE has been working with opiate addicts for some time and is currently
involved in the treatment of about 10 clients with opiate addictions,
according to Tingley. He said that about 50 percent of all those who start
any substance-abuse treatment at NOE drop out. Of those who remain, about 75
percent successfully complete a year's worth of goals and objectives set
forth in their treatment plans.

Statistics put forth by Maine officials state that nationally, about 50
percent of those who begin methadone treatment drop out.

Dr. Ali Elhaj, president of Acadia Hospital, which would most likely operate
the proposed methadone clinic, said he was pleased NOE was offering opiate

"No one person or agency can do this alone," he said Monday. "There is no
one answer to this problem. It is multifaceted and the more avenues
available to everyone, the better."

Acadia offers similar treatment, already treating hundreds of opiate addicts
each year. The problem, according to Elhaj, is that a percentage of those
patients are in serious need of a methadone treatment plan that is currently
unavailable to them.

"We are not saying that all of our people with opiate addictions are going
to go on methadone, but this is the right answer and the only answer for a
percentage, and that's who we are talking about," he said. "Right now, it's
that percentage that need help, and we don't have the resources to help

Dr. Jeffrey Barkin, a Bangor psychiatrist and member of the Communities
Against Heroin task force, said he worked with opiate addicts in
Massachusetts who were on a methadone treatment program. Barkin said
methadone should only be used as an "end-stage" treatment option.

"Trust me when I tell you that I had patients begging to get off methadone,"
Barkin said. "It was more difficult for them to break the methadone
addiction then the heroin addiction."

Numerous studies claim that methadone is the most effective treatment
available and clinics operate throughout the country.

Katie Fullum Harris, assistant to the Commissioner of the DMHSAS,
acknowledged that methadone treatment was not right for every opiate addict,
but was an effective treatment for many, including many in the Bangor area.

"Our position and the position of countless experts across the country is
that methadone should be available, and we strongly believe it should be an
option available to those people in Bangor," said Fullum Harris.

Kim Johnson, director for OSA, said what NOE was doing was good, but all of
the things NOE is doing should be included as part of any good methadone
treatment program.

"What they are doing is not a bad thing," said Johnson, "but it doesn't at
all change my mind that we need methadone treatment in Bangor.

"Please understand the National Institute of Health and the National
Institute of Drug Abuse all agree that methadone is the most effective
treatment available," she said.

U.S. Attorney Jay McCloskey has noted that researchers are working on new
anti-addictive drugs that could receive FDA approval as soon as September.
It is hoped the new drugs would be dispensed by physicians, thereby making
methadone clinics obsolete.

Meanwhile, Elhaj said, many opiate addicts in the Bangor area need help now.
Noting that it may be quite sometime before newly approved drugs are readily
available, Elhaj said the situation would be like saying a breast cancer
patient should not undergo current treatment because a better treatment
might be available a year from now.

Any drugs used in NOE's program would provide only symptomatic relief, such
as anti-anxiety drugs or drugs to help with nausea or sleeplessness, Dana

Anyone who wants more information about NOE's program can call 942-386 or
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