METHADONE TREATMENT OF LAST RESORT

Low-cost, high-purity heroin has come to northern Maine. Within the past 18
months, the law enforcement community has seen a dramatic increase in
heroin use in Penobscot and Hancock counties. Abuse of prescription drugs,
such as Oxycodone-Oxycontin, which are used for a "heroin-like high," has
also dramatically increased.

Since October 1998, there have been four heroin-related deaths in Bangor.
In Penobscot County there was a 176 percent increase in admissions
reporting heroin as a substance used-abused from 1998 to 1999. The Bangor
Police Department has reported a significant increase in the number of
thefts and burglaries committed by heroin users seeking money to sustain
their habits. Kids - high school-aged and younger - are known to be using
heroin in the Greater Bangor area.

In November 1999, the law enforcement community within Penobscot and
Hancock counties, particularly troubled by the speed with which heroin had
taken hold, developed and began implementing a comprehensive plan to drive
heroin out of northern Maine.

In February of this year, just as the heroin initiative was getting under
way, the Bangor Daily News reported that the Maine Office of Substance
Abuse (OSA) and Acadia Hospital planned to open a methadone clinic in
Bangor. Neither OSA nor Acadia had bothered to consult with the city of
Bangor or the law enforcement community about the advisability of a
methadone clinic.

Dr. Thornton Merriam from Acadia Hospital estimated that "within a year as
many as 200 addicts may be seeking meth-adone treatment at the clinic."
Acadia planned to locate its methadone clinic near a child care center in
the city of Bangor's business park. They intended to be fully operational
by March of this year. Acadia also indicated its desire to open additional
clinics in Somerset and Washington counties in the near future.

Methadone maintenance as a treatment for narcotic addiction has been
controversial since its inception in the early 1970s, and it remains
controversial today. Methadone is a Schedule II narcotic that provides
effects similar to morphine and heroin. One former methadone user
de-scribed methadone treatment as the medical equivalent of "giving an
alcoholic wine to keep them from drinking whiskey."

In addition to very high failure rates (one study concluded that up to 47
percent of its patients continued to use heroin), methadone maintenance
programs create other problems for law enforcement. Methadone diversion,
which includes the sale by patients of take-home doses and theft of
methadone from clinics, is a serious problem. One study reported "13
percent of narcotics users not in treatment were methadone addicts whose
primary drug of abuse was methadone." Annually, a significant number of
methadone-related overdose deaths are reported.

Most experts agree that methadone, to the extent it has any validity as a
treatment, is a last-resort option for people who have not been able to
kick their narcotics addiction by any other treatment method. According to
Joanne Ogden, of the OSA, once individuals begin methadone treatment they
can expect to keep on taking methadone until they die.

Both New Hampshire and Vermont prohibit long-term methadone maintenance and
encourage alternative treatments. Gov. Howard Dean of Vermont, who is also
a physician, responded to an attempt to introduce long-term methadone
maintenance in Vermont: "I don't have enough bad things to say about it."
Dr. Robert Dana, senior associate dean of students at the University of
Maine and former chief research consultant to the state of Maine for issues
of risk and protection regarding drug use, who once ran a methadone
treatment program in Tennessee, has opposed the proposed methadone clinic
in Bangor.

The issue is not whether methadone is ever an appropriate treatment in
places like New York City where there are thousands upon thousands of
long-term addicts. The issue is whether it is appropriate at this stage of
Bangor's heroin problem, when it is, by all accounts, a treatment of last
resort.

There is a better way to address northern Maine's new but rapidly growing
heroin problem. It will require coordinated participation from several
segments of our community. In addition to an aggressive interdiction
strategy, a public awareness campaign and an educational program must
begin. The Maine Office of Substance Abuse's mission includes education,
prevention and demand-reduction as well as treatment, yet we have heard
nothing about their efforts in these areas. It is my hope that OSA will
assist northern Maine in implementing a coordinated prevention and
demand-reduction program.

I am not ready to concede defeat to a permanent opiate population in Bangor
and surrounding communities that will only grow over time. But the
development of a community-based heroin reduction program is going to take
more than a few months. I call upon both OSA and Acadia to agree to a
moratorium on methadone clinics in northern Maine for at least two years,
to give our community a chance to eliminate the availability of and the
demand for heroin.