Topeka Street Methadone Clinic Seeks to be Part of the Solution

By Seth Daniel

The Habit OpCo Methadone Clinic and therapy center on Topeka Street – just steps from the stately Worcester Square neighborhood and what has been called the Methadone Mile – is the oldest Methadone Clinic in the area and has been the subject of a great deal of scorn as the problem of homelessness and addiction has morphed into the statewide opiate crisis whereby Worcester Square has become ground zero for the negatives associated with that monumental problem.

However, there are many who believe it isn’t entirely a problem with the Methadone Clinic, and the clinic officials said during a tour of the facility last week that they want to be part of the solution – committing to having an open house and to regularly attending community meetings on public safety.

“We definitely want to be seen as part of the solution and not part of the problem,” said Jo-Ann Forson, a director with the clinic who has worked there for 22 years. “There are some things that might come back to us, probably around the BMC area. Mostly our patients are told to have appropriate behavior and not to to be hanging around and there are consequences if they do. If they hanging around and getting in trouble in the community, there are consequences…For me, I think it’s more of a homeless problem and people who don’t yet want to get better and those people don’t have anywhere to go or anything to do. It was horrible to hear what was happening at (the September Worcester Square Area Neighborhood Association) meeting. Where can those people go to? If our patients are getting treatment, they’re getting the info and know where they can go and where bathrooms are available. The people not in treatment struggle with where to go. In being in that meeting and hearing some of the things people are experiencing, you cannot help but sympathize. I don’t know what it’s like to have someone urinate on my steps. It hasn’t happened to me.”

Forson, Clinical Director Mamta Bhakta and Program Director Kate Brennan showed off the clinic to the Sun last Thursday. The clinic has two very distinct sides to it.

On one side is the medication area, where liquid Methadone dosing takes place daily. On another very separate side, there are areas where group counseling and individual counseling take place – as well as numerous other services such as parenting classes, Greater Boston Food Bank food services, mental health treatment, pregnancy appointments, Narcan trainings and even celebrations such as a recent Recovery Day fete.

Last Thursday, the clinic served 694 patients for dosing and counseling – and the number can go up or down by about five every week. There are eight full-time clinicians, one full-time supervisor, one full-time case manager, a physician and Nurse Practitioner – not to mention a low-key security staff and other support staff positions.

The clinic begins operations at 5 a.m. when a counseling group for working people starts. An early dosing takes place for working people from 5:30 a.m. to 6 a.m. The larger lines form in a queue for the regular dosing period from 6-11 a.m. daily. Many times, depending on their treatment regiment, patients will have mandatory group therapy or individual therapy afterward in the non-medical wing. No one can continue to get treatment without having counseling.

“Ultimately, they are discharged for missing counseling,” said Bhakta. “ We’re not going to continue giving medication to people who aren’t participating in the therapy part of the program. That is a mandate.”

After counseling, patients can schedule service appointments for food, mental health or other services too.

For the most part, though, those at the clinic say their patients aren’t sticking around.

“Most of the patients we surveyed said they dose here and leave right away,” said Bhakta. “If it’s a day to receive medication, they might have group afterward for an hour, but then they leave.”

Said Forson, “There’s probably a small percentage of people who get together after group and go to the McDonald’s to have coffee and breakfast. There are some that have medical appointments in the area and have an hour to kill before an appointment at BMC or Healthcare for the Homeless. Transportation, if they’re taking the bus, can be difficult so they’re not going home and coming back. There is some of that. A small percentage said they live in the area – some in shelters and some in apartments…Most want to get in here early and get back home so they can get to work or get home to watch children or a parent. I don’t think most people here want to linger around.”

Both added that their patients who need to wait for appointments have indicated they would like to have a designated place to wait that is safe and dedicated to recovery. They said it shouldn’t be lost in the discussion that patients at Habit OpCo want to get better, and the staff members want to help them get better.

“Many of our patients did say they would like a place to stay if it’s a positive place,” said Forson. “I don’t think people understand that generally at this point, these patients want to get better…We do a lot more here than have people come in and get Methadone and leave. I realize that’s the perception. That’s concerning because the people who work here are very dedicated to the patients. Nobody goes into becoming a therapist without wanting to help the people on their caseload. The staff is very dedicated and wants to help the people improve their quality of life.”

One other issue addressed during the tour was security, and Forson and Brennan said they have a security staff that makes low-key rounds to check for their patients. Though confidentiality prevents the security from confronting offending patients, the situation is always addressed the next treatment visit. Also, the security monitors the parking lot and immediate area for drug dealers who try to take advantage of the vulnerable population.

“That security person does go down to the end of the street to make sure patients aren’t lingering around,” said Forson. “They’ll go down our street, to the McDonald’s and Cumberland Farms to make sure that’s not happening…If we do see patients hanging around, we know that and can have them meet with Mamta or Kate. The security have checkpoints they go to every hour to make sure people aren’t hanging around and aren’t loitering.

“We do have issues though,” Forson continued. “We do have problems with people who target our patients coming here and they try to deal drugs. It is a problem.”

To that end, all three said they have been meeting proactively with the area police to make sure that situation is on the radar and their patients are protected and prevented from abusing Methadone and illegal drugs – which is a major problem in all Methadone recovery programs and commonly cited as something that’s seen on Methadone Mile.

As a pledge to the community in the South End, Forson said Habit OpCo and the other clinic, CSAC, have been planning a community open house some day this month so residents can see both properties and understand the program and treatment that is going on near their community.


So called Magic Buses don’t come from the Methadone Clinic

Part of the ongoing discussion of Methadone Mile at the neighborhood level has often included references to buses that appear to be dropping off patients for treatment – giving the indication that problematic people are being bussed into the neighborhood and left for hours at a time to linger and, likely, cause the troubles that are plaguing the neighborhood.

Jo-Ann Forson of Habit OpCo said there is no such “magic bus” that has been commonly talked about, and that her clinic doesn’t do any kinds of transportation at all.

“We don’t have buses,” she said. “There are no shuttle buses coming to the program. We do have and people may see buses operated by Medicaid that bring people to medical appointments and this being one of those medical appointments. They may have five or six patients and they drop them off here and they have to wait here for them to finish. When they’re done, they leave with them to take them home. They are not supposed to be dropping them off at a corner, even if the patient tells them to.”

Those buses are very restricted, she said, and are known at PT-1 buses. They are operated by Medicaid, and under contract with the state. They are outside the purview of the clinic, though the clinic knows of no pervasive problems associated with those buses.

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