15-Minute Methadone in Baltimore – Police and Public Health vs. the Regulators

Baltimore is on the verge of a showdown over methadone. It’s not the usual NIMBY battle – Baltimore has embraced medication-assisted treatment for opioid addiction since the days of the well-informed and visionary Mayor Kurt Schmoke. Instead, it’s about something called “open-access” methadone, in which someone can come in for a quick assessment and get the medication within 15 minutes.

Waiting lists for treatment in Baltimore, where heroin addiction is a long-time problem, mean that many people are turned away for treatment when they most need it and are most likely to benefit. What are they supposed to do for a month while they are waiting to be admitted? Most go back to their dealers.

Now, one program is vowing to tackle the regulatory apparatus preventing methadone treatment from expanding and is just going to do it – at least that’s what the operator says.  In late June, Rev. Milton Williams, pastor of the New Life Evangelical Baptist Church in Northeast Baltimore, who already operates a traditional opioid treatment program “Turning Point”, said he would start offering “open access” methadone – treatment within 15 minutes – on July 5.

No, it’s not endorsed by the Maryland Alcohol and Drug Abuse Administration or the state’s health department, which has not given approval for the scheme. But Williams said his church is going to go forward with it anyway, adding that he would be able to treat 100-150 more patients a day.

And Williams has a well-placed and powerful supporter: the Baltimore Police Department. Even the police department is in favor of Williams’ plan.

The Baltimore Sun published stark statements from the police department saying that arresting addicts was not going to happen anymore. Detective Donny Moses, spokesman for the department, said he “had a change of heart” about arresting addicts after five years in the narcotics division. “I must have arrested a million and one people addicted to heroin, and I thought there had to be a better way,” he said. “I was thinking this was someone’s daughter or son and someone was praying for you.” Moses added: “The Police Department is no longer interested in locking up all the addicts.”

And Lt. Col. Ross Buzzuro from the police commissioner’s office said: “We can’t arrest ourselves out of this problem.”

Some critics rightly point out that counseling and other services are important, as well as methadone, to treatment. But in the absence of any funding for extra treatment, giving out the medication will at least give patients a safe option to street use of heroin or other drugs.

Like so many people who are passionate about treatment, Williams has personal reasons for being involved. His daughter was shot in a drug deal in 2002. She left three children behind.

On one side a pastor who is a zealous advocate, a community which is infested with drug deals, a police department that knows what drugs are doing to the neighborhood, and a drug that has been the single most successful treatment for opioid addiction for more than half a decade – and on the other bureaucrats who may not step far outside their well-appointed offices and who see no problem with waiting lists lasting a month, not to mention rulemakings lasting years – and it’s not hard to decide which side has the moral imperative in this showdown.

Which will win is another story.