Officials from Bangor and Eastern Maine Healthcare have a limited time to make progress in their discussions about treating heroin and other opiate addictions before the state loses patience and moves ahead with its plans to include methadone as a treatment option in Bangor. For the good of the community — in this and many other areas — these officials must suspend their enmity and distrust, make extraordinarily certain that they are doing nothing to further provoke the other and begin what should have started six months ago: a broad discussion of the drug problem, the range of possibilities for addressing it and whether and how methadone fits within that range.
City officials believe, with some justification, that they have been treated badly throughout the process that began last year with the Department of Mental Health, Mental Retardation and Substance Abuse Services looking for a Bangor area provider for methadone treatment. They fear that a proposed task force to examine drug issues will be used merely as cover for EMH subsidiary Acadia Hospital to proceed with a methadone maintenance program as it had originally planned. Hospital officials, meanwhile, say, again with some justification, that some city officials and active residents are eager to use a task force to delay or confuse the question of treatment even as it becomes increasingly clear how badly needed that treatment is. Trust, it almost goes without saying, is nonexistent.
To both sides’ credit, they have recognized that this issue goes well beyond a single type of drug treatment. This is about the city facing an unpleasant reality about itself — a significant drug problem. It is about the city’s relationship with its largest employer, the role of the state in affecting local quality of life, the hospital’s responsibility to its patients and the city’s responsibility to its residents. Add to these the negative image created just by the words “methadone clinic,” and it is not hard to see why this issue has produced deep and angry rifts in the community.
One option for Acadia now is simply to proceed with its methadone application with the Mental Health Department, thus antagonizing the city and many residents. One option for the city is to file a lawsuit against the state, antagonizing state officials, the hospital and, in the likely event the city lost, removing itself from having any influence in the manner in which methadone is distributed. Both options badly serve the public and make relations between the city and hospital, which work together frequently on everything from federal and state policy to local charity, a lot more difficult. Far better is for both sides to put aside these options and move forward with a couple of points they already have discussed:
The city and the hospital should request that Mental Health Commissioner Lynn Duby not approve any application or issue a license for a methadone maintenance program in the Bangor region for the next six months, so long as the community makes progress on a process to address all aspects of opiate addiction.
The hospital should ask federal officials to place a hold on their application for the methadone program.
The two should begin a broad, public review of the drug problem and include treatment options, rehabilitation, education and law enforcement.
Commissioner Duby already has indicated should would support the first request, but her emphasis was clear: An actual dialogue, not more wheel-spinning and accusations of the sort that have occurred in the last few months, must take place. The time to get this together is limited, but so important.
Hospital officials, understandably, want to minimize the focus on methadone and look at the broad question of drug addiction. But the public needs and deserves a lengthy examination of the topic, in a context of all appropriate medical and clinical treatments, if only because of the divisiveness that the proposed program has generated. And it needs to hear about possible means of providing methadone — at a central site, a number of local clinics or in individual doctors’ offices. And the city and hospital should mutually explore the possibility of effective new drugs to fight heroin addiction.
The Bangor City Council properly has held off in offering an opinion about the appropriateness of a methadone program here, instead resolving to learn more about it. It now has a chance to do that by joining hospital officials in forming a community-wide task force that could deepen the region’s understanding of the issue and begin to close the divide that currently is hurting this city.
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