Methadone Clinics: Why Location Matters

Location, Location, Location.

There's been an uproar in the Lower West Side community recently regarding a planned methadone clinic on Virginia Street. The organization responsible for introducing the proposed clinic to the community is Hispanics United of Buffalo, an organization that has been serving the community for decades.

The issue is the proposed location. I cannot stress this enough. HUB wants the clinic on the second floor of its Virginia Street building.  Directly across the street is a school bus pickup/drop-off spot.  One block over is the Herman Badillo Bilingual Academy for grades pre-k to 8. The HUB facility is the current recreational home for seniors living in the surrounding community. The building is entirely surrounded by residential homes and apartments. And not a word about plans to open the clinic was communicated to any of its neighbors until two weeks ago — and only after being pressured to do so by concerned 10th street resident Vanessa Pomales, who reached out to me for support.

HUB has invested significant resources to upgrade its second floor to suit the needs of the planned methadone clinic. The organization’s New York City based parent, Acacia, has reportedly invested upwards of $700,000 in upgrades to outfit the proposed clinic. At a Buffalo Common Council meeting held Tuesday, July 1st it was revealed by one of the speakers that HUB has already installed 26 security cameras, while plans to hire two security staff are underway. Additionally, the facility has been upgraded to conform to safety standards we are more familiar with when we interact with a bank teller. This conflicts with HUB representatives’ claims that residents’ concerns with respect to safety are unfounded.  If so, then why go through such extreme measures to keep the inside of the facility safe for its employees, while telling those outside there’s nothing to worry about?

Thus far, no one I've spoken to about this issue is opposed to a methadone clinic. Not one person. The need for the clinic is not what is being argued. The location is.

Furthermore, individuals in need of the services provided by a methadone clinic come from every socio-economic class, gender and race. It is not an issue exclusive to neighborhoods in despair.  The profile of someone addicted to heroin fits more of the working-type suburban professional, not the downtrodden person living in a low income neighborhood we are often led to believe.  And therein falls apart the argument that the clinic should be placed in a neighborhood where individuals seeking its services are more likely to live, such as the proposed Virginia Street location as some have suggested.  

Why not, as some have suggested, put the clinics alongside other medical establishments, such as the medical corridor or other healthcare facilities?

For many businesses, being in the right location can be  the difference between success and failure. In the business of life, too, location matters. It’s probably why you chose to live where you do.

Money, Money, Money

So what’s at the heart of this undertaking? And why did HUB go out of its way to keep its plans hidden from the public?

Considering that a convenience store must get approval from the Common Council before opening its doors, it's unnerving to see that a methadone clinic opening in a residential neighborhood could circumvent that process and go undetected while slipping under the legislative radar.

Just weeks before its planned opening, residents were caught unaware of HUB's plans and so were local elected officials. So what's driving this aggressive and underhanded push by HUB to bring a methadone clinic to its facility? Why proceed with the plans without informing anyone in the impacted community or anyone in local government?

Well, no one really knows. But that shouldn't stop us from doing some thinking. A few additional tidbits of information was revealed at the Buffalo Common Council meeting this past Tuesday, which was conspicuously absent of HUB representation. HUB is due to collect $8,000 a month in rent to host the clinic. That's not including the presumed $4,000 per patient.  For an organization that has been struggling financially and was saved from extinction by a New York City organization called Acacia (HUB now belongs to the Acacia network), this became a business proposition that is difficult to ignore.

Not So Fast

Although HUB representatives have maintained that they plan to open the clinic by the beginning of July, those plans may be forestalled by the Buffalo Common Council — who unanimously passed a resolution to put forth a moratorium on the clinic to prevent it from opening while further investigation on the matter awaits.

The Common Council also informed the public that HUB is in violation of federal guidelines which require the organization to host public forums prior to any planned opening.

Additionally, the Council also informed attendees that the clinic must get approval from the Erie County Health Commissioner before it can operate.  Plans are already on the way to use these tools as a measure to prevent the clinic's opening.

Here are some additional points provided by members of the VETTE Block Club

• No local or state officials endorse the clinic.
• Neither HUB nor Acacia fulfilled federal regulation of performing community outreach, which is a necessary part of obtaining a license.  Neighbors found out (Not notified) 2 weeks prior to planned opening date.
• According to the Federal Guidelines for Opioid treatment, community outreach, input and stigma reduction is “a necessary operation element”, and the Substance Abuse & Mental Health Services Administration’s approved Opioid Treatment Program accrediting organizations require that “Medication-assisted treatment for opioid addiction providers demonstrate effective community relations and stigma reduction efforts.
• No plans for security outside the clinic boundary has been made; inside, the cameras are to be monitored not by a security guard, but by administrative assistants with not training and many other duties.
• Common Council resolution against it. Going forward, clinics should have to go through the Buffalo Common Council the same way music permits and corner stores have to.
• HUB/Acacia Network has not yet received the necessary certification from OASAS (The NYS governing body responsible for issuing approval to distribute substances)
• HUB has completely ignored the neighborhood’s plea to move the clinic to a commercial zone, i.e, The Lakeshore Clinic location on Niagara Street which ran a methadone clinic until it recently closed.

My hope is that we can move forward with identifying a location that lends itself to being less disruptive to the quality of life of the surrounding neighborhood.  And, of course, plenty of notice and opportunity for input from those that would be affected by this decision is given.

As heroin use becomes more prevalent in our society, we’re not the only community debating this issue. And we’re certainly not the last.

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UPDATE: A lively discussion is taking place in the comments section of this Buffalo News article. 

Among some of the more interesting comments:

"I live a block away and I have struggled with the idea of NIMBY (Not In My Back Yard) in relation to this proposed clinic. But I think this comes down to the specific location of HUB. It is surrounded on all sides by residential homes. It is one block away from Herman Badillo elementary school. I drive by HUB every morning on my way to work and there are small kids waiting for the school bus on every corner around HUB.

I believe that Methadone clinics should be located in or near healthcare facilities, in a commercial area, close to public transit, and away from private homes and school bus stops. No one saying this clinic should be in someone else's neighborhood. I would find it just as inappropriate to open a clinic that is surrounded by residential homes and in proximity to an elementary school if it were in the fruit belt or black rock or parkside or any other neighborhood in Buffalo." - @LetsGoBuffalo

@CannibalKing writes: 

"Not a good plan. Too many empty lots, empty dwellings and back alleys. Methadone is a proven bridge drug to get clean, but many, many people fall off the wagon. As a past intern at a methadone clinic, you will definitely need a strong community watch plan and a much bigger police presence in order to just make sure the area doesn't grow into a flop area. Lots of users take methadone at the same time and lots of users sell their methadone. There is a huge need for these programs, but it's got to be tough to be living in that area knowing that you will now have a guaranteed flow of drug addicts in and out of the neighborhood. Oh, and you'll also need to have a hazmat needle plan once you start seeing the garbage that will undoubtedly grow."

Robert Biniszkiewicz:

"This program belongs in a hospital/health clinic setting only. It does not belong in any residential neighborhood, period. As others have noted, this kind of program is a magnet for problematic addicts and those addicts do impose a cost on the neighborhood (Main @ Northampton included).

Shame on HUB for its utter disregard of its neighbors. This development should be protested. I will happily join the picket line (fwiw: I served a half dozen years on HUB's board a decade ago; no beef with HUB generally, just this program)."

@bikerchick63 says: 

"one of the biggest problems with methadone is that it is more addictive than the heroin. i have seen, first hand, how these kids are put on it n after 3-4 years, they are still on it which is just trading 1 addiction for another. no effort is made to wean them down and off because these clinics get subsidized for each patient. some one close to me was a heroin addict for almost 3 years and decided to quit cold turkey rather than go the methadone route and, yes it was terribly difficult but she was strong and had family support and is almost 4 years clean, finished college and has a good life."

Susie writes:

"Good for these women stepping up to protect their community. I work on Main Street and pass the clinic there everyday. People loiter around for hours after leaving the clinic, screaming at each other, throwing their garbage on the street and sidewalks, asking people for money, you name it. These clinics can seriously have a negative affect on an entire neighborhood. I know, I see it five days a week. I hope Hispanics United can see that too and not move a clinic into a community that is working hard to make progress."