Closing the city’s only public methadone clinic might sound like a cold-hearted move, but Mayor Walsh’s administration is acting responsibly by making plans to shutter the facility. As long as the city can ensure that the more than 400 patients who now rely on the clinic can make a smooth transition to other providers, redirecting the clinic’s $2.4 million budget to other addiction services makes sense. It will help to make sure that public-health dollars are used as effectively as possible to combat the recent rise in drug addiction and overdoses.
The city clinic, on Frontage Road in the South End, has operated for 40 years, since methadone first won approval as a treatment for heroin addiction. Methadone reduces cravings for heroin and helps stave off withdrawal symptoms. The drug was a giant leap forward in treating addiction, but clinics initially faced strong community resistance; when it opened, the Frontage Road facility was the only methadone clinic in the city.
But several trends have altered the addiction-treatment landscape. The Affordable Care Act mandated that private insurance cover many kinds of addiction treatment, improving access for millions. Buprenorphine — available in pill form — also offers a better treatment option than methadone for many patients, one that doesn’t require daily clinic visits for liquid dosing. Five other clinics in Boston now also offer methadone; the city expects one of them will assume responsibility for the patients at the city facility.
Walsh’s administration wants to shift the clinic’s budget to a new Office of Recovery Services, which will take a more holistic approach to treatment. That’s the right philosophy: The city shouldn’t favor any particular medical treatment, which is the practical effect of being in the methadone business. City government still has a vital role to play in responding to the addiction crisis, but its most effective role is the one Walsh, a forceful advocate for addiction services, has envisioned: coordinating services and connecting patients to the treatment they need, whatever it may be.