Methadone, the addictive substance used to treat heroin dependency, could become more widely available in Baltimore County after a judge's ruling that the county violated federal anti-discrimination laws for years by blocking for-profit treatment centers.
U.S. District Judge Catherine C. Blake has ruled that Baltimore County's zoning laws violate the Americans with Disabilities Act because they treat private methadone clinics more strictly than other treatment facilities, such as weight-loss centers and laser eye-treatment offices.
While last week's decision should mean more treatment options for heroin addicts in Baltimore County, it also could affect how local governments regulate such clinics throughout the country.
"This is the first case in the country that found it was a violation of the ADA to single out methadone treatment centers. That is a major precedent that has not only local and statewide but national impact," said Paul N. Samuels, director of the Legal Action Center, a New York-based advocacy firm that brought the federal lawsuit on behalf of a clinic seeking to open near White Marsh.
"What the judge is saying goes right to the heart of what the ADA is all about, that people with disabilities and the agencies that provide them services deserve a level playing field," Samuels said.
Unlike neighboring counties and Baltimore City, the county has no private methadone clinics, keeping out potential operators over the years by pressuring state officials to withhold permits, and by interpreting its zoning laws restrictively. The county operates a single publicly funded methadone clinic, on York Road in Timonium.
Baltimore County Executive C.A. Dutch Ruppersberger said yesterday that while he has problems with how for-profit centers operate, he will not challenge the decision.
"We litigated it, the federal court ruled against us and we will abide by the decision," Ruppersberger said.
In the immediate aftermath of the ruling, none of the private treatment providers has announced plans to set up operations, including Smith-Berch Inc., which attempted to open the White Marsh Institute treatment center in 1997.
The court decision clarifies an emerging legal area: how drug addicts are treated under the Americans with Disabilities Act.
Communities throughout the country are monitoring such cases. In the Cincinnati suburb of Covington, Ky., local officials are embroiled in a federal lawsuit after removing methadone clinics from the city's zoning code. The Maryland Port Administration faces a similar case involving the Sanctuary, a ship that is seeking a permanent berth to treat recovering drug addicts.
In White Marsh, Smith-Berch co-owner Walter Smith, a former Dundalk resident who supervised drug treatment in Prince George's County, saw an opportunity to fill a need for methadone. He invested thousands of dollars in the proposed center in the 11400 block of Pulaski Highway, near the Harford County border.
The company rented space that was zoned for medical offices. But county officials said that the center couldn't open without getting special permission, a rigorous process that involved a public hearing.
Smith and his business partner responded by filing the suit in U.S. District Court in Baltimore, seeking $6.1 million in damages.
The county has agreed to pay Smith-Berch $275,000, county officials confirmed yesterday.
No other medical offices are subject to the same public hearing requirement, Blake wrote in her decision. Also, the county's publicly funded methadone center never went through a hearing.
Ruppersberger said he fought the lawsuit because he is uncomfortable with the profit motive behind private clinics. Because they seek to make money, such clinics might keep providing the drug to patients who have returned to heroin, fueling a secondary market for the treatment drug, administration officials said.
Methadone users frequently stay on the medication for 10 years or longer.
Smith, who also operates the Frederick Institute - a for-profit center in Frederick - rejected Ruppersberger's criticism.
"All public and private centers operate the same way," Smith said. "You have a code of professional ethics you subscribe to. You follow the basic medical model of `You do no harm.'"
Larry Lee, president of the neighborhood association closest to the proposed White Marsh center, said his community would quickly resurrect its fight if Smith returns with new plans.
"I don't think they are looking at it through the eyes of the individuals who live in the communities who are being forced to tolerate this," said Lee, a retired Bethlehem Steel worker. "Everybody realizes drugs are a problem. They are an illness. But when you listen to some of the stories - people on [methadone] for 10, 15 years - you wonder if it's working or if it's just shifting the burden. It's legalizing the sale of drugs, as far as I'm concerned."