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.