By Kelly Morgan,Staff Writer

Kristan Hilchey stepped out of her Jeep Cherokee in the parking lot of a methadone clinic, her red metal lockbox in hand.

Eighteen months ago she lived without electricity or a phone, almost losing her home to foreclosure as she spent as much as $1,500 a week on drugs, including illegal painkillers.

Now Hilchey, a 32-year-old medical technologist, makes weekly trips to a southern Maine clinic. She takes a dose of methadone in front of a nurse before carting home six days’ worth of tablets in her metal case.

“It has given me a new life,” she said. “I got to a point where I could wake up in the morning and it was like,‘What can I do today?’ not, ‘How can I get high today?'”

In the past year, communities across the state have reacted with fear to news that more methadone clinics are looking for sites. Auburn, Lewiston and towns in western Maine’s Oxford Hills have enacted temporary bans on the facilities, alleging they could attract drug users, drug dealers and crime.

“I can understand the need for treatment,” Norway Town Manager David Holt said, “but on the other hand, I don’t know that Oxford Hills has that many opiate addicts.”

Lewiston City Administrator Jim Bennett’s concern is that inviting a clinic would be like rolling out the red carpet to heroin and prescription drug dealers.

“I’m afraid that somebody will say, ‘Huh, there’s a market here,’ and introduce the product,” he said. “We just have not seen any kind of indication that we have that kind of a problem in the Lewiston area.”

Treatment advocates argue otherwise, and studies show methadone actually reduces crime by getting drug users off the streets.

In a 1994 study of drug treatment in California, researchers found that rates of illegal drug use, criminal activity and hospitalization were lower for methadone patients than for addicts in any other type of drug treatment program.

Stigma

Deputy Chief Peter Arno of the Bangor Police Department is well aware of the stigma attached to methadone clinics. There was “a bit of a fervor” when Acadia Hospital first proposed offering treatment on its campus there.

It’s now been more than four years since the hospital’s methadone clinic opened, and Arno had no horror stories to share. He couldn’t say for certain whether crime had gone up or down in relation to the clinic’s opening, but the opiate problem was in evidence before methadone came to town, he said.

“Really, that’s what brings a methadone clinic, especially a for-profit one,” he said.

Westbrook Police Chief Paul McCarthy also said opiates were a problem in his city before the CAP Quality Care clinic opened. He couldn’t link any crime or increased drug use to it.

“Most of the people involved with the clinic tend to do quite well,” he said. “We’ve had the occasional call to the facility for a patient or client that isn’t behaving properly, but those issues seem to be few and far between.”

With opiate addiction on the rise and so few people getting help, even methadone opponents agree something needs to be done.

“There is a need for treatment. I just don’t agree with the way they do it,” said Cpl. Chancey Libby of the Oxford County Sheriff’s Office, who feels methadone is making its way onto the streets through clinic patients.

But, he added, “I’d rather someone was using methadone than heroin.”

Opiates in Maine

Contrary to popular belief, methadone clinics are generally quiet places. On a Friday afternoon in November, there were no lines of strung-out junkies in the parking lots of either the Discovery House clinic in South Portland or CAP Quality Care in Westbrook.

Most methadone patients go early in the morning so they can dose before work, Hilchey said.

That is what she does. She’s allowed to take home six days’ worth of methadone tablets each week, but still has to rise at 3 a.m. most Mondays to travel south for a dose and to pick up her take-homes before work.

The Maine Office of Substance Abuse estimated anywhere between 12,000 and 30,000 Mainers are addicted to or dependent on opiates such as heroin and its synthetic cousins, including OxyContin, Percocet and morphine.

Bill Lowenstein, associate director of the Office of Substance Abuse, said only about 2,200 people are in treatment for opiate addiction today, while abuse of opiates continues to rise.

In June, 115 of those enrolled in treatment were from Androscoggin County and 53 were from Oxford County. Those in treatment represent only 8 to 12 percent of the opiate-using population, Lowenstein said.

“The drugs of choice in Maine have certainly switched over the years,” he added, noting a trend toward prescription painkillers.

Roy McKinney, director of the Maine Drug Enforcement Agency, agreed. “The prescription narcotics are just everywhere, they’re everywhere – heroin, a little less so.”

OxyContin, often involved in drug arrests and pharmacy break-ins, was Hilchey’s drug of choice.

She was 27 when she started abusing Vicoden and Percocet. Before long she had learned to snort OxyContin. Then, she said, “I couldn’t do anything without having something in my system.”

Hilchey got drugs through local dealers in her mid-coast community, going so far as to sell weaker prescription medications to get her hands on the stronger stuff.

She finished college and started working in a hospital, but soon began ignoring her young daughter, her own appearance – and the bills. She paid for drugs instead of electricity.

“I had tried a million and one times to get and stay clean by myself,” Hilchey said. “And I had tried counseling, but stopped going because I couldn’t even manage to go to the meeting straight.”

She didn’t turn to methadone until she was arrested for possession. After her name appeared in local papers, people stopped selling to her and her daughter started coming home from school with questions. Suddenly, she had nowhere to turn.

Hilchey decided to try methadone, although in the beginning she didn’t think she would stick with it.

“Funny,” she said. “I kept thinking, ‘I have a career, am an upstanding young woman in the community – I can’t show my face in a methadone clinic.'”

Lifetime treatment

Methadone is a synthetic opiate that replaces cravings for other drugs while making a patient feel normal. It is not a cure, and can be a lifetime treatment.

Even Hilchey noted the irony of methadone treatment. “Let’s face it,” she said, “you’re giving narcotics to a drug addict – it doesn’t sound right.”

Still, methadone is widely accepted as the most effective treatment for opiate addiction. It is a disease that is difficult to cure because it creates extreme psychological and physical dependency, and the symptoms of withdrawal are severe and long lasting.

“Not everyone’s going to make it,” even with the help of methadone, said Lowenstein, of the Maine Office of Substance Abuse.

Treatment advocates acknowledge that many methadone patients relapse to illegal drug use, but argue that keeping people off the streets – even if only for the short term – is better than allowing opiate addiction to run wild.

“It is definitely harm reduction,” Hilchey said, adding that she knows of fellow patients who abuse their doses, mixing methadone with other drugs to get high.

Hilchey is grateful for the opportunity to be in treatment, even with the weekly three-hour drive to the clinic and back.

Like other successful methadone patients, she doesn’t feel high when she doses. She feels normal.

She may be on the medication indefinitely, because it is likely that her old craving for opiates and the symptoms of withdrawal will come back if she stops.

“My life is better on methadone than it ever was off it,” she said. “When my mom or someone else asks me when am I going to ‘get off,’ now I say, ‘When are you going to stop taking your anti-depressant, blood pressure, thyroid meds?'”

There are much worse things, Hilchey said, than taking a medication with her coffee every morning.

“Millions of people do it every day.”