Bayview closes its drug detox center

Hospital to expand methadone program, reflecting shift in city policy


Johns Hopkins Bayview Medical Center has closed its well-regarded drug detoxification center and is expanding its methadone treatment program, a move that reflects a shift in the city's drug treatment policy.

Hundreds of addicts were weaned off of drugs during stays of 10 days to two weeks at the detox center. But city drug treatment officials say the unit did not adequately meet the needs of the city's hardcore addicts, many of whom require more support than detoxification.

They also say public dollars would be better spent on long-term drug treatment, which can last up to a year and includes services such as methadone maintenance, counseling, job training and the use of buprenorphine, a prescription drug that cuts clients' craving for heroin.

Detox "was not an effective strategy to get people into recovery," said Adam B. Brickner, president and chief executive officer of Baltimore Substance Abuse Systems Inc., a city-run nonprofit that oversees publicly funded drug treatment programs.

"As we get people into the system, we want to retain them for longer so they can reach recovery," he added.

City Health Commissioner Dr. Joshua Sharfstein said he agrees with Brickner and the shift in focus to long-term treatment.

"We need to be paying for recovery," he said. "And if you are trying to get more people in recovery there has to be more than detox."

Dr. Robert K. Brooner, director of addiction treatment services at Bayview, said city drug treatment officials told him in May that they were going to cut funding for the detox unit's $1.5 million budget by about $900,000. Brooner said that rather than keep the unit open with a scaled-back staff and services, hospital officials decided to shift remaining funds to the methadone treatment program.

The decision to cut funding at Bayview was not a reflection of the services provided, Sharfstein said.

"It's always stressful when any kind of treatment program shuts down, but these tough decisions have to be made in order to move the system forward," he said. "There are going to be many ways that the facility and talent at Bayview will help people in Baltimore."

Brooner said he expects hundreds of clients a year from other methadone treatment programs in the city to benefit from psychiatric and pain management services at the hospital. He said clients will stay at Bayview for up to 12 weeks, long enough to receive psychiatric counseling and medication, then return to their original programs.

Methadone is an addictive synthetic opiate administered to addicts as a substitute for heroin.

"We want to target poor-responders in other drug treatment programs," Brooner said.

He said the addition of psychiatric and chronic pain care to the hospital's methadone treatment program could become a model for other programs in Baltimore and across the nation. Brooner said that he and his colleagues have reviewed the cases of hundreds of recovering addicts and that between 40 percent and 80 percent of them also suffered from some form of mental illness.

Brooner and city treatment officials said they are hopeful that most of the clients from the detox unit will be absorbed by other programs. The city has other detox units and is about to celebrate the opening of a 120-bed long-term treatment center in Northwest Baltimore.

The new center, which received major funding from the Harry and Jeanette Weinberg Foundation and will be named in memory of the couple, represents the biggest influx of new treatment slots in about 30 years, said Michael Douglas, chief of program operations at Baltimore Substance Abuse Systems.

Situated at Reisterstown Road and Woodland Avenue in Northwest Baltimore, the new center started accepting clients this month, Douglas said. The city will spend about $2.5 million in annual operating costs, but the center will be operated by Gaudenzia, a local nonprofit that provides drug treatment services.

"We are very excited," Douglas said. "This is our biggest boost in years."

He said many addicts in the city who will benefit from the new services at Bayview.

In the past, staff at the city's 14 publicly funded methadone treatment programs have done the best they could to help clients with mental disorders, including offering them counseling and referrals to specialists, Douglas said. But in some cases it was not enough, and those with severe psychiatric problems dropped out of treatment because they could not control their actions or moods, or were incarcerated.

"Now, instead of losing people, we will be able to stabilize them" Douglas said.

Frank Satterfield, an official at the Glenwood Life Counseling Center, a methadone treatment program in the Northeast Baltimore neighborhood of Govans, said he will welcome the new services offered at Bayview.

He recalled a female client who a year ago climbed a utility pole, touched a wire and suffered severe burns on her arm. The woman had exhibited signs of mental distress before the incident, Satterfield said, but when his staff tried to get her into a treatment program at a local hospital where she might also receive psychiatric aid, they were rebuffed.

"We could treat her addiction but there was nothing we could do for her otherwise," Satterfield said. "Having a program like this could mean the difference between life and death for some people."

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