It’s been five months since the Scarborough Police Department launched a new program in response to the opioid epidemic in Maine. Operation Hope is intended to offer help to anyone ready to address their addiction.
It’s not a way for someone facing criminal charges to avoid jail. It’s a way for those ready to enter treatment to take the next step — but the definition of “treatment” is open to some debate.
In the first of two reports, a look at where Operation Hope is sending its clients, and why it’s raising red flags for some who work in addiction medicine.
Demand for treatment is so great in Maine that since Oct. 1, more than 200 people have arrived at the Scarborough Police Department seeking help for their addiction from Operation Hope. More than 120 have been placed in residential or outpatient rehabs and sober houses. About two-thirds of the placements are out of state.
Lee Ann, who asked that we not use her last name, is an exception. She says she was sick with withdrawal and desperate for help when she got a ride here on Oct. 28. A few hours later she was being detoxed from heroin and had a bed at a rehab in Portland known as Liberty Bay.
“I knew the illegal activities I was doing and the drug use, one way or another I was going to be arrested,” she says. “I was going to overdose. I was going to be killed by the lifestyle. Like, I was dying inside anyway. I was so miserable in my active addiction. It literally became like a life or death situation.”
Lee Ann says individual and group therapy rooted in Alcoholics Anonymous’ 12-step recovery program has helped her address an underlying trauma that fueled her initial drug use as a teenager. She says she became addicted to heroin at 19 years old. She’s now 24 and has been sober for four months.
“I tried literally, like, every method to try to stay clean off heroin,” she says. “I tried getting street drugs, like detox drugs off the street, but really it was the internal stuff that I needed to get through to be clean and OK with myself. That’s something I learned and I’m really grateful for being in treatment.”
“Treatment” in this case means “rehab.” And it’s expensive. According to the website rehabs.com, standard drug rehab costs between $10,000 and $20,000 per month. Add some bells and whistles like equine therapy or resort-style surroundings and it can run more than twice as much.
Lee Ann is fortunate. Unlike most of the people who arrive on the doorstep of the Scarborough Police Department, she has insurance. And while Scarborough Police Chief Robert Moulton says taxpayers are not footing the bill for Operation Hope, the program does depend on the goodwill of rehab providers to offer scholarship beds, meaning that they are free of charge.
“Obviously, one hand washes the other, so when we do have somebody who has the ability to pay or insurance or whatever we try to place those with the folks that have been good to us with the scholarship beds,” Moulton says.
The only cost for the police department is the cost of transportation one way, and so far that has been covered by grants and donations.
Clients are given a basic screening when they walk through the door. They’re asked about the type and quantity of drugs they’ve been using, for how long, and then a trained volunteer known as an angel starts working the phones to find them a placement. Angels are often people in recovery themselves.
This day, Steve Cotreau, planning manager for the Portland Recovery Community Center, discusses a possible placement with Jamie Higgins of the Scarborough Police Department. It’s the kind of conversation they have on a regular basis. The Recovery Center, which offers peer support services to people with substance use disorder, coordinates the angel volunteers for Operation Hope and helps find placements.
Cotreau says anyone without insurance is sent to an abstinence-based program or rehab.
“It’s a huge variety,” he says. Most of them are 60- to 90-day programs. A lot of them have connections to sober houses. There were two instances where we placed folks and the programs were not good. The patients called, there was no support, conditions were bad, they were left on their own.”
It’s hard to gauge how Operation Hope is actually working. Cotreau says once people are sent out of state they aren’t tracked, so it’s unclear whether they return home or how well they do in recovery. He says there simply isn’t the manpower to do that.
And Operation Hope does not place people in medicated assisted treatment. Those are programs that rely on maintenance medications such as methadone or Suboxone.
Research shows that these medications lower the risk of fatal overdoses. It also finds that people using medications are twice as likely to be successful in recovery for at least a year as those who don’t. But in the recovery community, there is resistance to this approach.
“You are substituting one drug for another,” says Marc Anthony Martinangelo, director of marketing and outreach for Royal Life Centers, an umbrella organization of drug and alcohol detox and rehab centers based in Florida and Washington that has taken at least three people from Operation Hope. “I feel the only way to live in recovery and live a sober life is complete abstinence.”
In recovery himself, Martinangelo says he has nothing against the use of maintenance medication but he doesn’t consider it to be “living clean.”
In part two of this series, some addiction specialists say that’s a misguided and potentially dangerous message.