The Methadone Maze

A damning portrait of a methadone program in Maine:

For many people, the methadone program at Acadia Hospital has been a lifesaver, substituting a safe, monitored dose of liquid methadone for the dangerous and illegal street opiates abused by addicted clients.

In the best cases, these clients are able to resume their productive lives — finish their schooling, keep their jobs, care for their children. About 700 people are enrolled.

But attending the methadone clinic can be a daily exercise in frustration, anger and resentment. Brawling, harassment, intimidation and drug dealing are regular occurrences, some clients say, and the clinic staff rarely intervenes. This chaotic atmosphere at Acadia is a threat to their recovery, these clients allege — and it challenges public assumptions about the largely Medicaid-funded program.

But administrators at the hospital say that their clients’ antisocial and illegal activities are symptoms of the disease of drug addiction. Taking a hard line against such behavior would force too many clients out of treatment, they argue, undermining the goals of the program.

Speaking out

Danielle Eames-Powe, 22, has been a client at Acadia’s methadone clinic for two years. A drug user since she was 12, it was the birth of her daughter, Mabel, that made her seek treatment. She has been clean and sober for 2½ years now, she said, and works as a secretary for Bangor lawyer Joseph Baldacci.

Eames-Powe and her boyfriend, Bruce Raymond, also a client, told the Bangor Daily News that money and illicit drugs of all kinds change hands in the clinic’s waiting areas and parking lot. The staff looks the other way as these deals are made, they said, despite a largely unenforced rule that prohibits congregating, whispering or socializing on hospital property.

"A lot of them just make up their drug histories, so the clinic thinks they have a really big problem and gives them high doses of methadone," Eames-Powe said. Some clients — many, according to Raymond — who are entrusted with take-home doses sell their methadone to buy more potent drugs for their own use.

In the long hallway where dozens of clients may wait 45 minutes or longer to get their daily dose, they said, fistfights and shouting matches often break out. The language is often extremely offensive. Many clients bring their young children with them, and those children watch and listen as their parents and other clients take part in these violent encounters.

Mandatory counseling sessions are pointless, Raymond said. Some clinicians are apathetic and negative; others are overwhelmed by the number of clients they must see.

Clients can choose between individual therapy or group counseling; Eames-Powe said she always chooses individual sessions.

"I attended one of the groups and it was despicable," she said. "The people were nodding off, drooling, glorifying drugs, talking about how much they love getting high. I’ll never go to group again."

Individual sessions aren’t much more valuable, she said.

"I’ve had nine different counselors in two years," she said. "I just tell them the same story, my history. It doesn’t accomplish anything, but at least it’s confidential and you don’t have to sit next to a bunch of filthy people who are still using drugs."

Eames-Powe said she is "desperate" to get out of the Acadia program. But clinicians insist on weaning her so slowly that she fears she’ll never be free of the demoralizing daily visits.

Ironically, she said, despite her good behavior, consistently negative drug tests and evident commitment to recovery, she’s ineligible for take-home doses — she’s considered "unstable" because she is weaning.

Read the rest here.