The dozen men, fidgeting at 785 Westchester Avenue on an early December morning, were in line for their daily fix. Their emaciated bony hands shook, their eyes were haggard and cavernous, and the wrinkles and spider veins on their worn faces told of substance abuse and poverty.
They are recovering drug addicts at the Carmen Iris Capeles Drug Treatment Program, one of six clinics administering methadone in the South Bronx. Many agree that the benefits of methadone clinics outweigh the costs for a neighborhood but some South Bronx residents fear the overwhelming number of such centers hinders their community.
“The community sees us a double edge sword – we help them but we hurt them in the same time,” said Yolanda Ramos, a clinical coordinator of this 35-year-old substance abuse program, a part of the nonprofit Hunt’s Point Multi-Service Center, Inc. (HPMSC). “There is such a high concentration of chemically dependents, and clinics need to be here to provide treatments. But too many clinics in one place may decrease the economic standing of a neighborhood and increase crime.”
Methadone is a synthetic opioid, which is a chemical non-addictive substance that has a morphine-like action in the body. Its use in programs to eliminate narcotic drug cravings started in New York City in 1964 in response to the dramatic and continuing increase of heroin abuse and addiction following World War II.
“This neighborhood, more than any other in the city, and even in the whole country, has a long and painful history of drug use and drug crime,” said Ramos, who has worked in the field for 16 years. “What we are deal with is the product of that. Things are better now, but because of that past drugs are still around.”
About 115,000 people receive methadone treatment nationwide today, of which 40,000 visit some 168 designated clinics in New York State, more than anywhere else in the U.S., according to the Committee of Methadone Program Administrators, Inc. of New York State. Medicaid, the state-run program covering medical care for low-income patients, pays for most methadone clients. Many of the city’s methadone treatment facilities are run by hospitals or non-profit clinics like the HPMSC but about 30 percent are for-profit companies.
While the city is safer than ever, according to NYPD statistics, drug-related offenses are still significant and account for most crimes in the South Bronx, local patrol officers said. Many drug activities occur around the corner from methadone clinics.
“Where are the drug dealers? Where the drug addicts are,” said Lincoln Allen, one of thee doctors at the Hunts Point methadone clinic, which has total staff of 45. “For us methadone is a medication, for them it’s something else – a drug they could combine with another drug to get high.”
Ramos agreed, adding that some clients pair methadone with Xanax, Valium or other anti-depressant pills, sold by dealers at a nearby corner. Routine urine tests helped detect any lapses by the patients, she said. Participants receive methadone and meet with a counselor during their required daily visits at the clinic Monday through Saturday. Some of patients would recover fully and qualify for jobs at the day care or family programs at HPMSC, which currently has 300 employees. But many are bound to slip up.
“People don’t do much around here. They get bored and there are many opportunities to relapse,” said Allen, while rummaging through cases, some stuffed in plastic crates, some piled up on the floor, others dumped on the examination table in his office.“Many have some mental condition and they self-medicate on drugs because mental care is not as readily available to them.”
The hospital odor of sanitizers and metal filled the hallway and treatment rooms on the first floor of the clinic. A prematurely aged woman, waiting for her treatment, broke into a crooked smile while battling the muscle spasms of her facial tic. A scrawny man in his early 30s fidgeted in the corridor; he was done for the day but had nothing else to do.
“I like that the clinic is right here, near my house,” said the man who gave his name as Richi. “Many of my friends go here so we hang out together around here, and time goes.”
Richi was in the program for a second time, he said. Some months back he relapsed because he hung out on the wrong corner, he said.“I have friends who use, and when they come around my house it is easy to take that path again,” he said.
About 80 percent of the clinic’s 750 patients are from the South Bronx and bordering neighborhoods, said Ramos, adding that the rest traveled from as far as Staten Island, Coney Island and Queens.
“They don’t want their neighbors to know that they are dependent,” she said. “We have professionals, people with families that prefer to make the trip than to be stigmatized in their community.
”While most South Bronx residents understand the nature of methadone clinics, they are fed up with the side affects of drug recovery.
“The loitering, the begging, the drug dealers around the corner. Something should be done. Enough is enough,” said Leticia Willis, 52, of Hunts Point. “Everybody here has relatives and friends who recovering, relapsing or using. The clinics help but I really want to see my neighborhood cleaned up.”
Willis waited for a hair wash at The Nueva Imagen beauty salon on Westchester Avenue. She looked outside the window, her eyes fixating on a group of four men coming from the direction of the clinic.
“You see them circling around, doing God knows what,” she said. “Nothing good can come out of that. I guess I’m used to it because I’ve been here a long time. But who’s going to stay here or move here. Everybody wants out of this neighborhood.”
Most of the business owners and shoppers around the nearby Prospect Avenue subway stop said that they did not consider the clinic a disturbance but they would prefer something else in its place.
“Methadone clinics are in neighborhoods where their services are needed, and South Bronx is such a neighborhood,” said Mario Bodden, who manages the community revitalization programs at the South Bronx Overall Economic Development Corporation (SoBRO). “People don’t want to live next to them but if they are not there, crime and drug use would be a lot worse.”
There are 14 methadone clinics in the borough, some housed in nondescript one-story buildings, few like HPMTP with plans to expand. The organization will build a new, improved facility funded by the state next year. Such initiatives for methadone centers are rare.
“Nobody wants these clinics,” said Allen. “They try to sneak them in a neighborhood through hospitals.”
The Fulton Division of Bronx Lebanon Hospital has a methadone facility, and nearby Lincoln Hospital also hosts methadone treatment. The state Office of Alcohol and Substance Abuse Services, which creates and monitors methadone treatment programs in New York, had to abandon plans to move an East Harlem clinic to Mott Haven in the summer of 2007 at the request of Bronx Borough President Adolfo Carrion and Community Board 1. The local officials insisted that another clinic in an already overwhelmed neighborhood with six methadone centers would not be economically, environmentally or socially viable.
“They are not buying from me ‘cause they don’t have money or a job. And I worry that some of them will snatch my bags,” said Malik Anafo, 26, who sells bags at the Hub, a commercial area at 149th Street and 3rd Avenue in the South Bronx.
Anafo disapproved of the loitering clients of the Narco Freedom Methadone Treatment Program on nearby Willis Avenue. While he agreed that the clinics helped many people recover, he wanted them out of this neighborhood. “We are doing business here, and these centers should make room for business,” he said.