ELLSWORTH — The Downeast Treatment Center (DTC), a center for substance abuse disorder treatment that opened last year on State Street, is expanding its services to offer treatment at no cost for those who are underinsured or have no insurance.
“We’re all about ease of access,” said Richard Shute, outpatient site coordinator. “We’ve tried to lower the barrier for clients. When they’re ready you need to jump on it.”
The money is coming from a three-year grant administered by the U.S. Substance Abuse and Mental Health Services Administration to Healthy Acadia.
“We’re thrilled to remove cost as a barrier to treatment,” says Elsie Flemings, executive director of Healthy Acadia.
“This funding, alongside the strong, collaborative partnerships between providers in this region, has opened up treatment to a greater number of people than ever before.”
Ryan Miller is one of those clients. Miller is wiry and quiet, with freckles and bright blue eyes and star tattoos spiraling up his fingers. He speaks like someone who has spent a lot of time discussing difficult topics and telling hard truths, probably because he has. Miller has spent the past year in addiction treatment, attending hundreds of hours of group sessions and therapy.
“I wanted to quit, but it was a vicious cycle,” he said on Tuesday morning. “The claws were so deep in me.”
Miller got into drugs young, before high school. He grew up in Bar Harbor, where one of his parents abused substances and says he saw drug abuse frequently in the home.
“It was something I lived with my whole life,” Miller said. But after awhile, doing drugs wasn’t fun anymore. It required “maintenance,” as Ryan puts it. “I got away with it for years. Then it just started catching up with me.”
In August of last year, Miller was arrested on charges of operating a methamphetamine laboratory out of a home on the Bucksport Road. The charge carried a potential sentence of up to 10 years in prison.
But there was another option: the Hancock County Drug Court Program. The program is intensive, requiring frequent drug screenings and a minimum of two and a half years of involvement.
Not everyone is eligible, but Miller qualified and began treatment. He started attending group sessions, meeting with a recovery coach and receiving a 16-milligram prescription for Suboxone.
“In the beginning it was pretty crazy,” Miller said. “You have to learn how to live life over again.”
He’s been sober for 11 months now, the longest stretch of time in decades, an accomplishment he credits to the Hancock County Drug Court Program, Downeast Treatment Center and its network of providers.
“If it wasn’t for this place I probably would’ve gone back to jail,” he said. “It’s important to get people started even if they don’t have the money.”
The center is a collaboration involving several groups. The Aroostook Mental Health Center is the licensed service provider for the facility, while prescribers come from Mount Desert Island Hospital (there are no medications kept on site, clients fill prescriptions elsewhere). Healthy Acadia coordinates the networking efforts among the organizations.
The treatment center is the “hub” of a model of care known as “hub and spoke,” which has been gaining traction nationwide as a way to treat opioid addiction. The State Street facility provides intensive care during the beginning phases of treatment, including group sessions, helping clients find housing and jobs, as well as a prescription for Suboxone, which helps to manage withdrawal symptoms and cravings.
Patients eventually transition to weekly and then monthly sessions and finally graduate to the “spoke” of the system — a primary care provider and a substance use counselor of their choice.
Using medication-assisted treatment helps clients get a foot in the door in the face of addiction, said physician Julian Kuffler.
“It’s that whole idea of harm reduction,” said Kuffler, who is part of the center’s clinical advisory group. “Nobody ever dies when they’re on Suboxone, so you’ve just accomplished the biggest thing that you want. When they’re ready [to come to treatment] they’re alive.”
But Kuffler is quick to point out that while medication can help with physical cravings and withdrawal symptoms, “It’s not a panacea. But I’ve certainly had plenty of folks who start on these medications and they can get their life back.”
“There are other tools that you need,” he continued.
“The Suboxone helps with the physical part,” said Miller, while the group sessions provide essential structure. Nearly a year in, Miller has cut his Suboxone intake in half, to 8 milligrams, and attends group sessions once every two weeks. He has a job, cutting wood, painting and roofing, “mostly cutting wood right now,” and his own apartment.
But the center is never far away, Miller said.
“They keep a close eye on you,” he said. “I have a network of people I can call.”