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Methadone Bruhaha
By Jean Hay
August 2000
Jay McClosky, U.S. District Attorney for Maine, rose to address a packed house in Bangor last month with his concerns about the inclusion of the drug methadone in Acadia Hospital's drug addiction treatment program.
This is a man of no small stature in the community. I had long known the name, heard the reputation, but I had not seen him in action before that night. I knew he was not in favor of methadone treatment of addicts coming to Bangor and I wanted to hear his rationale for that position. I was expecting to be impressed.
Didn't happen.
He began by refuting the statement by Mental Health and Human Services Commissioner Lynn Duby that the use of methadone for treatment of addiction was a medical decision.
"It's a policy decision!" he stated pointedly in her direction. Clearly, this man, with admittedly no medical credentials, nonetheless felt he had a right as a matter of public policy to say whether this drug was appropriate for a given individual in a given location.
McClosky also did not like the statistics presented by Acadia Hospital officials, which showed that people using methadone to treat their addictions to heroin or other opiates such as the prescription drug oxycontin were less likely to commit crimes of burglary or petty theft to support their habits since their cravings were under control.
"Ask the people at the Maine Mall in South Portland if that's true," McClosky said. The mall has been reporting a significant increase in shop-lifting in recent years, he said. McClosky noted that Portland has a methadone clinic, one of only two in the state (the other is in Winslow).
"I'm not saying that the rise in shop-lifting is due to the methadone clinic," he then added.
A murmur arose in the crowd. Sure, Mr. Prosecutor, put a suspicion in a jury's mind and then ask them to disregard it because you have no actual proof of the connection. Is this the way our highest ranking attorney in the state of Maine conducts himself before the bench?
Noting that the statistics presented by Acadia Hospital on the drop in crime and illegal drug use by methadone users were based in large part on the self-reporting of admitted addicts, McClosky proclaimed, over and over again, that "addicts never tell the truth," and that drug users never accurately report their illegal activities.
While that concept may in fact be true, in the process of expounding it, McClosky was repeatedly discrediting the life's work of one Dr. Robert Dana, who is considered by some to be a local expert on drug use and abuse. Dana has conducted several statewide student drug surveys in Maine, all based on the self-reporting of illegal drug use and criminal behavior by students in grades 6-12.
The irony of all this is that McClosky is a friend of Dana's, and the U.S. Attorney had been trying to get the researcher included on a task force being set up to investigate the rising use of drugs, including heroin, in the Bangor area. It appeared that McClosky did not have a clue how badly he was publicly bashing the professional reputation of one of his most ardent supporters.
But that may well be why, speaking shortly after McClosky at the hearing, Dana gave a very muted disavowal of methadone, saying simply that "while I have supported its use in the past," he had lately come to view it as counterproductive, or even harmful to the addict in treatment. He did not elaborate on what had changed his mind. Dana also did not refute McClosky's statement that drug users could not be trusted to tell the truth about their drug use and/or other illegal activities.
Commissioner Duby and Acadia Hospital officials had reiterated early in the presentation that the depiction in the media of a "methadone clinic" was inaccurate, since Acadia Hospital would simply be adding methadone to the diverse treatment for drug addiction already being offered at Acadia Hospital.
McClosky, sitting in a front row at the public hearing, must have missed those often-repeated remarks. I say that because one of his most fervently espoused concerns was that heroin pushers would flock to a methadone clinic because there they have a ready clientele.
Since methadone satisfies the opiate craving of an addict without causing the high, since methadone is either no-cost or low-cost to the clients, and since all of these admitted addicts are working hard to stabilize their lives, I would not imagine that a methadone clinic would be the most lucrative location for a drug pusher to set up shop.
According to the medical testimony, methadone itself is addictive, and often has to be taken daily for years if not for life. That is why it is usually prescribed for addiction only after other treatments have not worked. So it would seem to me that addicts at a treatment center who do not have the option of graduating to methadone (as is the current situation at Acadia) would be more prone to revert back to heroin than those on methadone. Acadia Hospital has had an addiction treatment center on-site for years, but we heard no testimony from anyone, McClosky included, that drug dealers lurking just outside the doors of the clinic were a problem at Acadia.
Besides, if heroin dealers do tend to flock to such clinics, it would seem that they would then be easy picking for the police -- which would stop the problem in its tracks.
Most disturbing, however, was McClosky's characterization that the inclusion of methadone in Acadia Hospital's repertoire would be "an admission of defeat" for anti-heroin crusaders like him.
Why is it a defeat that a few dozen residents in the Bangor area who are addicted to heroin or other opiates want to get off those drugs and regain some control over their lives? I would think that a demand for better drug treatment coming from the addicts themselves would be a sign of success, not failure.
McClosky, who prosecutes drug cases at the federal level, called for a two-year moratorium on methadone in Bangor, giving him and those like him, he said, time to solve the heroin problem in the Bangor area. He called for prevention techniques, more police involvement, study commissions, and $100,00 from Commissioner Duby's budget "to run radio ads" and the like to stem the tide. As for Bangor-based addicts who need methadone, well, he said, they'll just have to travel to Winslow, about an hour southwest of Bangor, every day for the next two years.
As far as I could see, it was not an either-or situation. Every one of McClosky's suggestions could be put into practice concurrently with the use of methadone at Acadia Hospital. If McClosky's proposals turned out to be effective, then the demand for methadone at Acadia would diminish, despite an open authorization. I'm sure the folks at Acadia would be pleased at that development.
As for the radio ads, what would they possibly say that would be so compelling? And why couldn't they be run as public service announcements at no cost? I also can't figure out just how McClosky intends to determine which radio stations addicts or potential addicts listen to.
McClosky should have had the Bangor crowd eating out of his hand. The rationale for his position should have been irrefutable. Instead, McClosky's presentation was so lacking in logic and reality, and his "solutions" so lame and head-in-the-sand, that I was not the only one in that conference room wondering what was really going on. The question then became: What is it about this one form of drug treatment that was making this man go ballistic? Despite the earnestness with which he presented his case, McClosky didn't manage to answer that one.
Jean Hay of Dixmont is running for State Senate in District 10. She can be reached by e-mail at: jeanhay@brightberrypress.com.
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