Bangor committee recommends approval of moratorium on new Suboxone facilities

By Nick McCrea, BDN Staff
Posted Oct. 22, 2013, at 8:54 p.m.

BANGOR, Maine — The city’s Government Operations Committee recommended during a meeting Tuesday night that the City Council adopt a temporary moratorium on new or expanding suboxone facilities in the city.

A proposed ordinance would place a 180-day ban on any new facility that would provide Suboxone to patients. Suboxone, like methadone, is used to treat opioid addiction. The moratorium would not affect the ways Bangor’s three substance abuse clinics — Penobscot County Metro, Discovery House and Acadia Hospital — currently operate. There are only nine such facilities in the state, and the only one north of Bangor is in Calais, which mean Bangor draws patients from as far north as Aroostook County.

Some councilors raised concerns after Penobscot Metro mentioned during a meeting last week that the facility would like to treat 200 new patients with Suboxone. That facility currently only uses methadone.

City officials have been working with legislators on a bill, titled An Act to Reduce Costs and Increase Access to Methadone Treatment, that would allow the Department of Health and Human Services to license federally qualified health centers, health care providers or medical practices as methadone treatment clinics. It garnered enthusiastic support from Bangor’s City Council and city officials back in March and April of this year.

Councilors passed a resolve in support of the bill, arguing that having more facilities in more communities would provide easier access for patients seeking addiction treatment while reducing the number of people from outside Bangor that facilities in Bangor would need to treat.

City Manager Cathy Conlow said city officials have a meeting with the state in November to discuss the bill.

“The state needs to realize that this is a state issue, not a local issue,” Councilor Joe Baldacci said Tuesday. “The City of Bangor shouldn’t be handling this all by itself.”

The city already has ordinances that regulate methadone treatment facilities under land use rules, but there are no such restrictions for Suboxone facilities, according to Assistant City Solicitor Paul Nicklas. The moratorium would give the council time to consider whether it needs to extend those rules to Suboxone.

Councilors have expressed concerns about the fact that Bangor has more treatment facilities than any other city in the state, as well as the fact that patients sometimes have to drive more than two hours to get to Bangor and receive their treatment.

Civiello said that if you’re treating addiction as you would another disease, for example, diabetes, then you wouldn’t make someone drive two hours to get their medication. The state also pays transportation costs to get to appointments for most of these patients. In 2010, that cost about $7 million.

Three people turned out to Tuesday’s committee meeting to oppose the moratorium and ask the council to allow the Suboxone service expansion proposed by Penobscot Metro.

Tracey Allen, a 30-year registered nurse in Bangor, said she thinks the bill to allow qualified health centers to administer methadone and Suboxone was a good idea, but that it shouldn’t mean keeping 200 people on a waiting list to receive Suboxone for longer.

Brent Miller, program director for Discovery House, was far more critical of the bill. He argued that if the state allowed other health centers to provide methadone and Suboxone, some practitioners might be lax in follow-ups with addicts or wouldn’t have the time or financial incentive to provide counseling that an addict needs to truly recover.

If they see less supervision at these facilities than they do at places like Discovery House, there’s also a chance the drugs could end up being distributed on the streets in communities that begin providing them.

“This is not going to do anything,” Miller said of the bill. “It’s going to send more people to the emergency room. The only way you get an addict to stop being an addict is treatment. There is no other answer.”

The other opponent of the moratorium was an addict who said he was receiving Suboxone treatment at Discovery House and that the city would be doing a “huge disservice” if it put a moratorium in place that would effectively delay Suboxone treatment for 200 people.

The council won’t make a final vote on the moratorium until after the Nov. 5 election, when it will have at least one new member and potentially as many as three who will need to be brought up to date on the issue.

http://bangordailynews.com/2013/10/22/news/bangor/bangor-committee-recommends-approval-of-moratorium-on-new-suboxone-facilities/ printed on November 26, 2014