Methadone demand tops availability More addicts than openings spur possible Bangor expansion

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BANGOR – It’s 10:30 a.m. and Scott Farnum already has fielded two calls from people looking to enter his methadone treatment center at Acadia Hospital.

But Farnum, the program’s director, is still poring over the three requests that landed on his desk the day before, a relatively slow day for the clinic, which receives between five and 10 requests for the treatment every day.

“It’s clear that, particularly Bangor north, we’re vastly underserving people who would need methadone treatment,” said Farnum, who has run the center since its controversial opening just over a year ago at the hospital’s Stillwater Avenue campus.

The high demand is causing treatment providers, including Acadia, to ponder expansions of their methadone programs. Discovery House, a for-profit methadone clinic with branches in Winslow and South Portland, applied late last week for a state license to open a Bangor-area clinic.

“If we could do it tomorrow, we would do that,” said Discovery House project director Steve Gumbley from the company’s Providence, R.I., headquarters. “There is clearly a need.”

The application states that the Penobscot County clinic would serve up to 250 people.

The Acadia program serves about 140 people, just 10 shy of its limit.

Although Discovery House has applied for a state license, Gumbley said the company is still involved in the sometimes difficult task of finding someone to lease the company space, preferably within the city. Federal agencies require a specific site before granting a license, and state licensing depends on federal approval.

On the prospect of expanding the Acadia program, Farnum said, “It’s a constant conversation we have here, but that’s something we’d want to talk to the city about … before we made any applications.”

Any mention of methadone widens the eyes of city leaders, their ears still ringing with the echoes of heated public meetings in which opponents of the Acadia clinic labeled it a magnet for crime-prone drug addicts from throughout eastern Maine.

Contrary to the fears, and because of the clinic’s location at the busy hospital, police say few problems have been linked to the program, 80 percent of whose patients are from the immediate area with the rest driving from Hancock, Waldo and Washington counties.

City Councilor Nichi Farnham, chairwoman of the program’s advisory group, greeted the Discovery House application with surprise and, later, some trepidation.

“We’ve grown to have a comfort level with … Acadia, and from my standpoint I’d be more comfortable with a known entity than trying to introduce a new location with an entirely new entity administering it,” Farnham said.

“I don’t know that we need to have another clinic in Bangor, but, doggone it, we do know there’s a need outside of Bangor,” she said, referring to the high rate of abuse in Down East Maine.

Methadone is a synthetic narcotic used to treat those addicted to opiates – drugs including heroin and the powerful prescription painkiller OxyContin, the abuse of which has plagued eastern Maine and rural areas elsewhere in the country.

The drug, touted by proponents as an effective long-term treatment for opiate addiction, has made headlines in southern Maine in recent weeks with a rash of methadone-related overdoses in Portland.

While so far this year that city has seen a record 20 fatal overdoses, several of which were said to involve methadone, Penobscot County has seen only one confirmed fatal overdose involving the drug.

In May, a 24-year-old Brewer woman died after taking a fatal dose of methadone, which she had been prescribed for back pain, according to the state medical examiner’s report. Ruled an accident, the death also involved the anti-anxiety drug Lorazepam – a lethal combination, drug experts said.

“That’s a recipe for an overdose,” Farnum said.

While the Brewer case marks one of the county’s two confirmed fatal overdoses so far this year, Bangor police believe opiates were involved in the January overdose of a 33-year-old Indian Island man. Toxicology tests are pending in that case.

The Penobscot County Sheriff’s Department also is investigating a near-fatal June overdose of a 20-year-old man, who is still recovering at a local hospital after reportedly taking methadone.

In the aftermath of the Portland overdoses, the two area methadone clinics – including Discovery House – expanded their weekend hours and limited patients’ take-home prescriptions at the request of state officials.

Acadia Hospital’s program is already open seven days a week, Farnum said, and about 60 of the program’s patients have take-home privileges with most receiving just a few days’ supply.

Of the three potential patients whose applications sit on Farnum’s desk, all are “methadone appropriate,” he said, adding that about half of those who seek entry are suitable for the program.

But none of the three – two young men with long drug histories and a 40-something man addicted to prescription painkillers for years after a back injury – will be admitted.

With the few remaining spaces reserved for pregnant women, HIV-positive addicts or other high-risk groups, the three applicants – like the others who are turned away – will instead be offered an alternative outpatient program from the hospital.

But the reality is that not all will take advantage of the offer, Farnum said.

“Some say they’ll just wait until something in the methadone program opens up,” Farnum said, noting that the clinic no longer uses a waiting list because it “would be hundreds of people long.”

“In the meantime they’re using,” he said. “That’s the reality.”