Methadone clinics are often seen as the bad neighbor nobody wants.
Residents concerned about crime and other quality-of-life issues often protest if they even hear word of a methadone clinic, which treats those addicted to heroin and other opiates, is considering moving into the area.
But drug-addiction specialists who say methadone is one of the most effective ways to treat opiate dependency are hoping a new study led by a University of Maryland School of Medicine assistant professor debunks concerns that the clinics breed crime and drag down neighborhoods.
The study is the first of its kind that takes a geographic look at crime around clinics, according to the National Institute on Drug Abuse. Previous research only has examined the link between crime and methadone users.
"The concern is that methadone treatment facilities are related to a higher crime rate in the area, but there is no evidence that this is what happens," said Antonello Bonci, scientific director of the institute. "We hope this study will alleviate this concern. I hope people will look at this data and realize it is not a problem."
The research, led by UM's Dr. Susan Boyd and others, found that crime doesn't increase because a methadone clinic opens.
The study used FBI Uniform Crime reports from the Baltimore Police Department to look at crime near 13 methadone clinics for a two-year period beginning in 1999. Researchers compared these reports to crime data for similar areas in Baltimore where there were no methadone clinics.
They also compared crime around methadone clinics to crime near hospitals and convenience stores in the city. Crime was more likely to occur around convenience stores, the researchers found.
"I think there is still a very bad perception of methadone clinics," Boyd said. "There are many more people out there who need treatment, but there are not enough slots and clinics available, and part of it is because of the community stereotypes they have about methadone clinics."
Methadone clinics in the state are tightly regulated by the Department of Health and Mental Hygiene.
Still, the clinics' locations have caused bitter, and sometimes politically charged battles, some of which have ended up in court. Zoning restrictions keep the clinics out of certain communities. Owners of the clinics said it is sometimes tough to get landlords to lease to them.
In many of these incidents, residents said that they believe crime increases and that methadone users, many of whom must come to the clinic daily, loiter after getting their dose of methadone to control their drug urges.
There also is debate about whether methadone users just trade one addiction for another and that the clinics continue to feed a drug culture. And even though methadone clinics have tight controls for distribution of the drug, there are cases of the drug's abuse and people dying from methadone overdoses.
Most recently, residents in Southwest Baltimore have protested a methadone clinic opened by the University of Maryland Medical Center, which runs that and other treatment services for the Baltimore City Office of Addiction Services. It was among several treatment programs that were relocated.
University officials said there was no connection between the study and its decision to move the Southwest Baltimore clinic.
The clinic, which serves more than 500 addicts, relocated in January to West Pratt Street after its former building on nearby West Fayette Street was torn down due to its poor condition, said a medical system spokeswoman, Mary Lynn Carver. The new location is accessible to public transportation and close to the university and medical center, she said.
Residents said they were caught by surprise when the clinic opened and said they believe there are too many substance-abuse treatment programs concentrated in their neighborhood. They say they are not against drug treatment.
But crime is a concern. The Southwest Partnership, a coalition of neighborhood groups in the area, posted a picture on its Facebook page of a man sleeping on the street in front of a bus stop. The caption next to the photo: "This should be the poster image for why more rehab services are not needed in the neighborhood."
Also on the page are charts with neighborhood crime data and promises to monitor crime levels because of the clinic.
"It's very frustrating that our community is the headquarters for drug addicts and mental health patients from all over," wrote one resident, Jane Buccheri, in an essay posted on the Facebook page.
In a phone interview, Buccheri, also a leader of the Southwest Partnership, said residents have no statistics to back up claims the clinic is causing increases crime. But residents know what they see, she said.
"After they have treatment they don't necessarily leave the neighborhood," she said. "It's hard to attract homeowners and quality businesses if there is a lot of loitering.
She added: "It has the potential to attract drug dealers. If you have this many potential clients why would you drive around?"
University of Maryland officials have met with residents to address their concerns, Carver said. She said that there were problems with loitering and security in the area before the clinic opened in January, but that she was not aware of issues because of any of the university's services.
A 73-year-old Baltimore man who uses the UM methadone clinic said that when he started using methadone to beat his heroin addiction he stopped committing crimes. The man, who didn't want to use his name because of the stigma attached to methadone users, said he used to pick pockets and rob people to support his habit.
Most methadone users are living good lives, he said. People oppose methadone clinics, he said, because of misperceptions.
"People don't know about methadone," he said. "A lot of people aren't aware of the good things that methadone does for patients."
A Pikesville methadone clinic operated by Joel Prell got caught up in a legal battle after Baltimore County Executive Kevin Kamenetz, then a county councilman, passed buffer legislation restricting the location of such clinics.
At the time, Kamenetz said he wasn't opposed to drug treatment programs but thought they should be located "in areas where they don't impact the surrounding areas." Prell's A Helping Hand clinic was located near a residential neighborhood.
The 2002 legislation required that methadone clinics and other state-licensed medical facilities that want to open less than 750 feet from homes in areas zoned for business and office use seek additional approval from the county.
Prell sued to challenge the law and to determine whether he should be forced to move. Residents picketed his house.
Prell eventually closed the facility and relocated to Woodlawn, where he hasn't had any opposition. For another center he runs in Westminster, he got council support before opening. That center is in a business park near an airport, not a residential neighborhood.
"It's fear of the unknown and stereotypes," he said. "What most people don't understand about drug treatment programs is that it works."
Prell said he works to keep order at his clinics, urging people to leave soon after taking the medication. He also said some may perceive patients as loitering when they just stop for a conversation on the way to their cars. But, he noted, not every clinic operates to the same standards as his.
Prell and others said methadone users come from all walks of life, especially as more people are becoming addicted to prescription pain killers after routine surgeries.
Boyd said she hopes her study opens the doors for more clinics to open and addicts treated.
"When they choose to go to treatment it shows they are willing to work to change," Bonci said. "We want to make sure people are not stigmatized because they seek treatment."