CLINICS FORESEE LEGAL BATTLES

By passing a zoning law, the Baltimore County Council has tried again to
restrict where private methadone clinics can operate and sidestep the
community uproar that often accompanies such facilities. But as the owners
of two clinics prepare to challenge the law in court, it appears that the
longstanding fight is far from over.

Baltimore County has long maintained that it has no unmet need for methadone
treatment. Private companies, however, continue to bet that the demand for
the drug, which is used to control withdrawal symptoms of heroin, remains
strong.

Two clinics recently applied for licenses to dispense methadone within a
half-mile of one another on Reisterstown Road in Pikesville, north of the
Baltimore line. They are the latest in a string of proposals that would have
placed facilities throughout the county, from Catonsville on the west side
to Dundalk on the east.

No one denies that drug addicts live in the county and that a need for
treatment exists. James P. O'Neill, the county jail administrator, estimates
that 80 percent of the inmates have a substance abuse problem. Although he
hasn't conducted a study, he said, heroin addiction seems particularly
prevalent.

"We are not naive in Baltimore County," said Michael M. Gimbel, director of
the county's bureau of substance abuse. "There's a drug problem here. We
know that."

But residential neighborhoods consistently have rejected methadone clinics,
and the county has been reluctant to allow private, for-profit clinics to
open.

According to the Maryland Department of Health and Mental Hygiene, 14
methadone clinics operate in Baltimore City, four in Anne Arundel County and
one each in Howard, Carroll, Harford and Baltimore counties.

The Baltimore County clinic, a public-private hybrid, is in an industrial
zone off York Road in Timonium, south of the Maryland State Fairgrounds. It
can serve 647 people and at last count had 534 clients, Gimbel said.

Supply, Demand

"I very rarely ever get phone calls from citizens or addicts who need
methadone and can't find it," he said. "There doesn't seem to be a crying
need for additional methadone. The issue of building more methadone clinics
seems to be one of convenience rather than need."

Dr. Peter L. Beilenson, the city's health commissioner, said he cannot
believe only 534 people in Baltimore County could benefit from methadone
treatment. The 11 city-run clinics have 4,451 slots, and not a day goes by
that they aren't all full, he said.

Official statistics show that 13 percent of the clients are from outside the
city, but Beilenson said he suspects that many people give the address of a
relative who lives in the city instead of their own.

When Mayor Martin O'Malley told police Commissioner Edward T. Norris to
clean up a handful of the worst drug corners in the city, 50 percent to 75
percent of the people caught trying to buy drugs came from the suburbs, the
bulk of them from Baltimore County, Beilenson said.

"Baltimore takes a bad enough rap for drugs as it is," he said. "I think
it's unfair to place the entire burden of the region's drug problem on the
city."

The 11 city-run clinics are augmented by three privately operated programs.
But Gimbel said he's wary of private, for-profit centers because they are
not required to treat people who can't pay. Private methadone treatment
costs $70 a week or more. Publicly funded programs charge on a sliding scale
based on income and cannot refuse treatment.

James Prell, president and program director of Helping Hand Inc., which
recently opened a clinic in Pikesville, said the state prevents private,
for-profit clinics from kicking out clients who don't pay without putting
them through a detoxification program. As for the need for more clinics,
people need to look at the problem regionally, he said.

"It's not like ... addicts stop when they get to the city line," he said.
"Pikesville should put up a sign that says, 'Please leave your drugs and
your crime at the city line.' That's what they want to believe, but it's not
that way."

The owners of both clinics have promised to take the new law to court.

The county tried to use zoning to restrict methadone clinics once before,
but that effort was struck down in federal court as a violation of the
Americans with Disabilities Act. This time, to pass legal muster, the County
Council has broadened the restrictions to other types of medical facilities,
such as centers for outpatient surgery and dialysis, saying they often cause
traffic problems and operate at unusual hours.

Manufacturing Zones

Under the law, passed by the County Council last week, methadone clinics
would be permitted as a matter of right in manufacturing zones and as an
exception in office and commercial zones, as long as they are at least 750
feet from residential property and have adequate parking.

But treatment advocates contend that the law violates the federal court
order. Mid-Atlantic Realty Trust, which rents 100,000 square feet of space
in the county to medical facilities, some of which would be subject to the
restrictions, also has objected to the law.

"We'll go to court with it," said Chip Silverman, a consultant for START
Inc. (Success Through Acceptable Rehabilitation Treatment), which wants to
open a clinic in Pikesville. "We think it is definitely in violation of the
Americans with Disabilities Act. We don't really see much difference between
what the county has done here and what they did in the case several years
ago."

Must Be 'Sensitivity'

Helping Hand is open. The law passed the evening of April 15 and took effect
at 8 a.m. the next day. Helping Hand got its license from the state and
opened the day of passage, Prell said. The law exempts facilities that were
operating before April 1 and gives facilities licensed and operating between
April 1 and 15 six months to find a new location.

Councilman Kevin Kamenetz, a Pikesville-Randallstown Democrat who was
primary sponsor of the legislation, said he expects the county would
investigate whether the clinic was operating the morning of April 15.

Kamenetz said he isn't opposed to methadone clinics but thinks their
locations should be regulated. He says he took the same approach with
legislation on pawnshops and kennels.

"There has to be some sensitivity," he said. "The operators of these
businesses have to put themselves in the shoes of the people who live next
to these businesses. Would they want to live there?"