The Quick Fix
Even to a casual eye, St. Paul's University Avenue sees a lot of action, with hot-rod cruisers and 18-wheelers rumbling past countless fast-food joints, bars, strip malls, and industrial sites. Amid the traffic and neon, the pair of asymmetrical brown-brick buildings on the corner of University and Aldine Street are easy to miss. A short stroll west from Snelling Avenue, the two modest structures house Twin Town Treatment Center, which has provided services to drug addicts there since 1974.
Three months ago Twin Town employees went to the surrounding Merriam Park and Iris Park neighborhoods to let residents know about a proposal to distribute methadone to what will eventually add up to 250 addicts trying to kick heroin. The neighbors were less than thrilled.
Many residents in the Twin Town area fear potential parking and traffic problems. "Two hundred and fifty extra cars a week would really impact the neighborhood," says Merriam Park resident Roger Meyer. "We already have so many social services in the neighborhood that this seemed like piling on."
Others aren't happy about having more drug addicts passing through. "I don't know when we cross the line from naiveté to knowledge, but I do know that there are occasions with methadone that you are going to have problems," says Merriam Park resident Jerry Striegel. "It's my understanding that the success rate for a maintenance program like that is about 80 percent. So the other 20 percent of those folks fail, and that's where you get into trouble."
Twin Town chief financial officer Michael Bundy says the neighbors' reactions aren't uncommon. "We wanted to be good neighbors and let people know this was a possibility," he says. "But I can also say we are not surprised to run into this kind of reaction for methadone." Indeed, Twin Town's parent company, Meridian Behavioral Health Network, and other rehab organizations are running into this kind of local tempest more and more often lately. Most clinics say the number of heroin addicts is rising in Minnesota, increasing the need for methadone programs.
Last month, acting on neighbors' opposition, the Merriam Park Community Council, the neighborhood group in Twin Town's part of St. Paul, voted 13 to 1 against the methadone proposal. A few days later, the St. Paul City Council went on record opposing the plan. Finally, on October 17, the Ramsey County Board of Commissioners voted unanimously against Twin Town's proposed expansion.
Opposition from the city and county didn't kill the proposal, however; in Minnesota, methadone clinics are licensed by the state. Nonetheless, Ramsey County scrutinizes all proposals for new or expanded clinics within its borders, passing its recommendations on to the Minnesota Department of Human Services, which makes the final decisions. "Ramsey County has historically advised against having methadone clinics," says Dave Haley, an administrator with the county's Department of Human Services. Because the county treats very few people with methadone, he explains, officials don't perceive much unmet need. "The state looks at population and larger trends, but for us, it's just the number of folks we are serving. We don't know much about the world outside of that."
In June the state granted a private company called St. Paul Metro Rehab a license to move from Maplewood to Roseville, where it will distribute methadone to roughly 400 clients per week, an increase of 50 patients over its previous caseload. As in the case of Twin Town, the county argued that there was no need for the Roseville clinic.
Ramsey County is processing treatment referrals for some 75 methadone patients at any given time. The county itself doesn't distribute methadone, however; instead it refers addicts to clinics affiliated with Hennepin County Department of Human Services, the University of Minnesota, or the Hennepin Faculty Associates.
Because many users live in isolation or are transient, it's difficult to estimate the amount of heroin use, explains Pat Harrison, researcher for the Minnesota Department of Human Services. She cites a report from the federal Drug Abuse Warning Network, which tracks heroin-related emergency-room visits in 21 metro areas, including Minneapolis and St. Paul. Although the Twin Cities have lower numbers than any other city in the survey, between 1994 and 2000 local emergency-room admissions rose from 78 to 207, in line with a national trend. Many treatment experts believe methadone is the best solution to heroin addiction, she adds. "Methadone reduces crime, health-care costs, and increases employment rates among addicts," she says. "There is no disputing the improvement in public health and safety, and in the health of
In the case of Twin Town, however, the debate may be moot. On October 18 the St. Paul City Council concluded that Twin Town can't operate a methadone clinic in a residential zone. (The treatment center had planned to run the program out of its building on 463 Aldine St., rather than in the adjacent structure at 1706 University Ave.) The state can't overturn the buildings' zoning designations; that's the purview of St. Paul's zoning commission.
Jay Benanav, the council member whose Fourth Ward includes the Twin Town site, says it's standard procedure for the council to look at zoning anytime a new use for a property is proposed. In order to change the property's zoning, Twin Town needs the approval of the city council and the signatures of 80 percent of neighboring property owners. Benanav won't speculate on the likelihood of a zoning change, but he does note that he has already received calls from several residents who don't want to live near a methadone clinic.
The controversy disappoints Bundy, who says there is no better place for methadone treatment than his clinic, where the right facilities are already in place. "Certainly there's a stigma with any kind of treatment, but we've gone through this type of thing before," he says, noting that the center has won approval from the state, the federal Drug Enforcement Agency, and the U.S. Food and Drug Administration to treat many kinds of chemical abuse. Twin Town, in addition to offering individual and family counseling, as well as regular physicals, can house up to 40 patients and currently serves 38 outpatient clients. "We feel that University is a good location, and, given our facilities, we felt we could treat the rise in heroin with full programs rather than just dispensing methadone."
Bundy says Twin Town will decide whether to press on and either revise the proposal or request a change in zoning of the building on Aldine, or simply abandon the idea in the next 30 to 60 days. "There's a need and there's a good chance we may go forward, but we don't want to stir the waters," he says. "Had we known about zoning issues to deal with, we probably wouldn't have applied."
Meyer insists that neighbors bear no ill will toward the clinic. "Twin Town was very gracious in dealing with the neighborhood, and I was impressed by the tone and the tenor of the meetings," says Meyer, who has lived in Merriam Park for six years. "But this was just a little much for the neighborhood. University just gets hammered with the park-and-rides and the cruising that goes on in the summer. It's hard to keep the neighborhood wholesome and clean."
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