LEWISTON — Joey Masse began going to a methadone clinic last February after using heroin and OxyContin for seven years.
He had a wife and young girls to think about.
The 31-year-old meets a Community Concepts car every day at 4:30 a.m. for a ride to Portland’s Merrimack River Medical Services, a nondescript office-space-turned-methadone-clinic that serves 352 patients. Many travel from here for a shot of cherry-flavored drink that addicts say takes away the obsessive quest for heroin, OxyContin and other opiates.
In the past 11 months, Masse has put on weight, started eating three meals a day, and says he’s focused more on his daughters, 3 and 7.
“I’m getting back to the things I like in life,” he said.
He has Lewiston friends who can’t make the drive. They’re still using.
The Massachusetts company behind the Portland clinic is eyeing Lewiston for another site. It would be the state’s ninth methadone clinic after one closed in Rockland. There are three in Bangor, three in the Portland area. This is the first bound for this region of Maine.
It’s close enough that Masse could walk to the proposed location in the business park on Mollison Way.
Lewiston Police Chief Michael Bussiere says he’s not thrilled, but he’s keeping an open mind and asking lots of questions, like what’s to keep someone from overdosing? What makes a location a good fit? And, what about reckless drivers high on drugs?
The head of the state’s Office of Substance Abuse said there’s a lot that the public doesn’t understand about methadone clinics. For instance, doses are given in liquid form instead of pills; it’s tougher to cheek and resell, a common worry.
“The belief is that when something like that comes into your area, that crime is going to go up, drug use is going to go up and there’s going to be more problems,” said Office of Substance Abuse Director Guy Cousins.
But numbers show patients get jobs. They don’t see as much of the police and they reconnect with family. Police in Portland and Westbrook said this week they have few complaints about their local clinics.
However, not every experience is ideal. Waterville police recently found kids wandering a clinic parking lot, left behind while mom or dad went in to dose. They’ve responded to fights, parking complaints and increased accidents, and have caught people selling drugs.
“There are a number of social service agencies in the community that really challenge the police, and the methadone clinic is one of them,” said Waterville Chief Joe Massey.
Community Substance Abuse Centers, the company behind Merrimack River, has called a neighborhood meeting for 6 p.m. Wednesday at the Ramada Inn to field concerns about its Lewiston proposal.
Plans call for retrofitting 7,000 square feet of a former TD Bank, said Community Substance Abuse Centers Development Vice President Bob Potter. Many clients, he said, would be in and out at dawn.
He maintains that the clinic's presence wouldn’t draw addicts to the city. They’re already here.
“I think methadone clinics should be in every community,” Potter said. “If I open this clinic and I don’t have 250 people in there within two years, I’ve made a bad business decision.”
A long, daily commute
Chief Bussiere plans to tour the Community Substance Abuse Centers' Portland facility next week. From the outside, at its location on outer Congress Street, the low, brown building looks like it could house state office workers. It opened almost four years ago in former IDEXX lab space.
Jennifer Minthorn has been program director in Portland for three years.
Dosing starts at 5:30 a.m. A staffer monitors the parking lot for unfamiliar faces before opening the door. Once inside, patients — all there voluntarily — scan an ID card into a computer and get a color-coded message that directs them to a staffer or to the dosing line.
At one of two stations, nurses look for telltale signs of substance abuse — irregular pupils, tremors, the smell of alcohol — before dispensing a small, clear cup of pink methadone. (Signs of using drugs will trigger a referral to the medical director first, Minthorn said; a random urine sample that screens positive for drugs will be brought to the attention of a counselor.) Without a long line, or issues, it’s a quick process, over in 10 minutes.
How frequently a person visits the clinic and how high their dose is depends on the level of addiction, she said, something determined by the clinic doctor during a thorough intake exam.
Minthorn said 50 of her 352 patients have graduated to being able to take up to six doses home; they're people who’ve consistently stuck with their treatment plans over a long period.
She’d like to grow her patient base to 500. Clinics a few miles away — CAP Quality Care in Westbrook and Discovery House in South Portland — already see 500 each.
Minthorn has called police only once for a fight, between a man and a woman with history. She can recall two instances of people trying to divert methadone. In one case, a woman kept a cotton ball in her cheek, trying to save the dose for her boyfriend who’d left the clinic.
In 2009, 46 percent of her patients were employed at admission. After a year’s treatment, 60 percent had jobs — evidence, she said, of people getting their lives back.
Clinical Manager Tim McBrady said patients must spend time with counselors as part of treatment. One counselor teaches a class on things recovering addicts can do in their new, spare time, including hobbies such as scrapbooking.
Getting to Portland from the Lewiston area is an issue in bad weather, he said, when some car services like Community Concepts won’t go out on the roads. That, McBrady said, creates the potential for relapse.
One former Buckfield couple at the clinic Thursday said they moved to Auburn to shorten the trip. They’ve commuted every day for four years.
“Christmas morning, we came," the woman said. "I got up at 6 o’clock, and that wasn’t to put presents under the tree.”
He’s 32; she’s 28. Both are on disability. They declined to give their names, saying some family members don’t know they go. Both said their addictions began with legitimate prescriptions for painkillers whose use spiraled out of control.
Her methadone is covered by MaineCare, as is often the case statewide. He pays $90 a week out of pocket. They spend $8 on gas and $4.50 on tolls every day.
Before treatment, he would rip through a month’s worth of OxyContin, 120 pills, in five days.
“You’d have to buy more off the street,” he said. “You’re doing things you’d never think you’d do. You just can’t control it.” He credits the methadone clinic with saving his life.
Friends and family have complained that they can’t believe a clinic could move into Lewiston. “I sit right here; they’re complaining, they don’t even know. That’s how stigmatized it is,” he said.
State: Lewiston ‘a good choice’
In 1996, 200 people sought methadone treatment in Maine, according to the state. That number is now around 4,000. Those patients are coming off an addiction to prescription pain medicine more often than an addiction to heroin, said substance abuse expert Cousins.
“The whole idea of somebody taking a drug to get off drugs, there’s a percentage of people out there who 1) don’t understand it and 2) don’t agree with it,” he said.
Clinic location has typically been driven by NIMBY-ism (not in my backyard), Cousins said. “Oftentimes, the (reaction) is, we don’t want anything in our community, and the reality is the problem exists within the community. Bringing services closer to people makes the most sense.”
Many clinics have settled in business or commercial districts. One Bangor clinic is in a strip mall.
Based on need, Community Substance Abuse Center's Potter said the state told his company, “Lewiston would be a good choice.” It would be center’s 13th clinic in New England.
“I have letters from all of our abutters from all of our clinics that the methadone clinic (doesn’t) cause a problem," Potter said. "I’m sure there’s the fear that it will. The red flag goes up when you say methadone: ‘Addicts are going to be flooding into Mollison Way.’
"The bottom line is the people coming into Mollison Way are patients who need medical treatment for their addiction and we’ll be able to provide a safe, professional space with qualified masters-level clinicians and doctors to provide them the opportunity to become clean,” he said.
The for-profit facility would employ 15 to 18 people. He’d like to open in late spring.
The company has not approached another Maine town: “I will get serious about looking out by the seacoast once we get Lewiston up and operating,” Potter said.
Deputy Chief Peter Arno of the Bangor Police Department said he never envisioned his city would be home to three clinics. They see a total of 1,500 patients.
“I think more than anything else, it’s a sign of the significant opiate drug problem that we have in the region,” he said.
The first, opened 10 years ago, generated a lot of concern and led to the creation of a community advisory group with abutters, police and city officials, Arno said.
“I guess looking at it, I don’t see the types or number of times we respond (to be) out of the ordinary," Arno said, adding, "It has had an impact. They are dealing with an extremely difficult clientele.”
Lewiston City Administrator Ed Barrett spent 21 years at the helm of Bangor’s city government before coming here. He favors creating a similar community advisory group in Lewiston.
Once Community Substance Abuse Centers' business application is submitted to the city, it will have to face the Planning Board, then the City Council, which will hold at least two public meetings.
“It’ll be a long process, with plenty of opportunity for the public to ask questions, get information,” Barrett said.
Treatment, Westbrook Police Chief Bill Baker said, is part of dealing with addiction, along with prevention, education and law enforcement.
"It's clear that people attending the clinic have baggage, and that does manifest itself in some challenges from time to time," he said. "On balance, I think it's worth dealing with the down side in order to get the benefit treatment and rehabilitation they provide."
Portland Police Commander Vernon Malloch said his officers haven’t stepped up patrols around its clinic. “There hasn’t been reason to,” he said.
From her office next door at New England Title, Jan-Marie Prince has a clear view of Merrimack River Medical Services. It feels “sketchy,” she said, and can be strange to see people walking up with baby carriages, but the clinic hasn’t bothered business and it’s never given her trouble.
“I give them kudos for getting here,” Prince said. “Nobody wants a prison in their backyard; nobody wants a clinic in their backyard. They want them — but not in their backyard. Just give them a chance.”