BY ANDY GARDNER
North Country This Week

CANTON -- County legislators discussed who may be the best candidate to run a methadone clinic here.

The debate among county legislators for who should provide methadone treatment here appears to be between St. Lawrence County and St. Lawrence Health System.

The Board of Legislators Finance Committee discussed the issue during their Monday, Sept. 28 meeting streamed live online via YouTube. They were talking about presentations from those two entities, plus St. Joseph’s Addiction Treatment Services, that they heard at last week’s Services Committee meeting.

Legislator John Burke, R-Norfolk, gave several reasons for backing St. Lawrence County’s proposal. Burke has been a vocal proponent of the county getting into offering methadone treatment.

“I thought all the presentations had their strengths, but … as an advocate for the taxpayers of St. Lawrence County, when we had the program that can offset some of our deficits and delivering services, I think that we should be advocates for our taxpayers,” Burke said. “The preparation the county did … with all the people who’ve been in the business, OASAS, state reps, the preparation was extensive. The reality of it is that level of preparation has not been matched by either of the other two presenters.”

Responding to some of the concerns raised by other legislators later in the meeting, Burke said the reason St. Lawrence County is even talking about a methadone program is because the state came to them.

“The efficacy of methadone treatment after seven or eight years is like 80%. It’s an amazing intervention for people who need that. It’s very well researched,” Burke said. “This is OASAS, our state agency for alcohol and substance abuse, is the one that pursued St. Lawrence County to start up the program. There is a solid base of support and knowledge far beyond mine, and in my opinion beyond anyone else on our board … saying this is needed. This is important. This can change lives. At some point we have to recognize that the experts in the field should be listened to.”

“I think St. Lawrence County’s proposal was the most viable,” said Legislator Margaret Haggard, D-Potsdam.

“I felt the county’s presentation was the best … I liked their location. I believe their startup cost beyond the grant was significantly cheaper than the other two,” said Legislator Tony Arquiett, D-Helena.

Legislator Joe Lightfoot, R-Ogdensburg, said he thinks the board needs to do more research into actual need and feasibility before making any decision.

"I think we need to know, is there really a need right now this is not being met for the people of St. Lawrence County,” he said.

“I think we have an obligation to take a look and see with some accurate means how many people potentially would this take to generate the necessary revenue?” Lightfoot said. “I think there’s a lot left to be learned. I was impressed by two out of the three presenters last week.”

Finance Committee Chairman Kevin Acres, R-Madrid, said he is convinced a methadone program would most likely be helpful with the county’s drug problem. But he thinks St. Lawrence Health System’s network of services, with a methadone program added in, would be better for people here who need treatment.

“The … idea of going about this is funding the best care, the best provider. I felt SLHS would be the best provider because of the wraparound services they have,” Acres said. He pointed to SLHS’s current detox, inpatient and outpatient rehab, and intensive outpatient substance abuse treatment services, along with others to help addicts manage their lives as they go through recovery.

Legislator Rita Curran, R-Massena, said she doesn’t think methadone would be a good addition to substance abuse services needed here.

“I think that addiction is horrible. I’d give anything for a quick way to solve this. I just don’t think methadone is the answer for this county,” she told the board. “What I’m seeing, people … go on methadone, have problems with daily dosing, gain a lot of weight on treatment, and move back to Suboxone.”

Suboxone is a non-opioid medication prescribed to manage opioid withdrawal symptoms.

Curran also said she thinks the county’s projections for the first year may not be enough to cover their expenses. The county’s presentation, based on 30 clients in the first year and increasing to about 100 by the second, showed a slim profit in year one and a greater profit in the second year.

“It seems like it’s lean,” Curran said. “When you talk to [people currently running methadone programs]… larger programs do better. They’re talking a couple hundred people is what it takes to keep the lights on,” Curran said. She also questioned how many people who now go to Clinton or Jefferson counties for methadone treatment would decide to come here instead.

“We don’t have a true number,” she said.

Community Services Director Jay Ulrich said they made their projections using a calculator provided by the state Office of Alcoholism and Substance Abuse Services (OASAS), entering into it what he called “very modest projections.”