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As Overdose Deaths Climb in Albany County, Towns Rail Against Opioid Treatment Clinics

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As Overdose Deaths Climb in Albany County, Towns Rail Against Opioid Treatment Clinics

Aug 21, 2023 | 8:49 am ET
By Spencer Norris/New York Focus
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Fusion Recovery in Menands opened in an old Price Chopper building in June. | Dakota Pace
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Fusion Recovery in Menands opened in an old Price Chopper building in June. | Dakota Pace

The room was packed with heavy-hitters. There was John Coppola, the executive director of New York’s trade association for addiction service providers; Joelle Foskett, a director at the state addiction agency; and Christopher Assini, the policy director at statewide advocacy group Friends of Recovery. Concerned Menands citizens filled the rest of the room, many with prepared remarks, lists of studies, and hundreds of pages of documents obtained through public records requests.

They’d come, depending on whom you asked, to discuss a modest local zoning proposal or a pernicious, discriminatory attempt to kneecap the state’s response to the ongoing opioid epidemic.

Menands, population 4,500, covers around three square miles in Albany County, just north of the capital. The village lost a Rite Aid and a Price Chopper from the same shopping plaza over the past six years; and while the buildings sat vacant, many hoped for something new. They got a gym, a beauty parlor, and an opioid treatment clinic.

The clinic, Fusion Recovery, has sparked a massive backlash in the Capital Region, leading to finger-pointing and widespread suspicion from both sides. It has also opened an unlikely new front in the state’s fight against the opioid epidemic: local policies that undermine New York’s drug treatment strategy.

While residents fight, the Capital Region is spiraling deeper into the opioid crisis. Overdose death rates in Albany County tripled from 2014 to 2021, the most recent year with data available, outpacing the statewide death rate when New York City is excluded. Albany and neighboring Schenectady are both in the top quarter of counties with the highest so-called “opioid burden,” an aggregate measure of opioid-related deaths, EMS calls, and emergency room visits.

The state’s strategy to combat the epidemic relies on medications for treating opioid use disorder. While some medications can be prescribed and taken home, methadone, often used for the most severe cases, generally needs to be distributed at licensed brick and mortar locations.

Despite the severity of the crisis in their area, local residents often don’t want such centers in their backyards. In Menands, the zoning law would require new opioid treatment programs to obtain a special use permit, a process that can take months and allows the village to impose additional requirements. While unlikely to impact Fusion Recovery, the law would affect anyone else trying to run such services in the Menands business district. The city of Albany has a similar law that limits where and when a methadone clinic can operate — and now faces a fraught local debate over additional regulation.

The zoning laws are minute on paper, but massively consequential for the hundreds of thousands of people who live in the Capital Region, many of whom commute to Albany County for treatment. Taken together, the laws create what Office of Addiction Services and Supports (OASAS) general counsel Trisha Allen called an “inconsistent patchwork” across New York, undermining state policy and barring access to lifesaving medications.

“This proposal will exacerbate increasing rates [of overdose] while simultaneously worsening health disparities in communities of color,” Allen wrote of the Menands proposal in an August 7 letter. “We strongly caution against attempts to circumvent access to treatment at the peril of people in dire need of services and supports.”

And because it targets services for people with opioid use disorder, she argued, the law could violate the Americans with Disabilities Act, which classifies most substance use disorders as disabilities.

But locals aren’t backing down. Community members have turned out for village meetings and circulated a petition taking aim at Fusion Recovery.

With so much opposition, the state is fighting a war on two fronts: against the opioid epidemic, and against local governments.

“It’s the hyperlocal that sets the trend for what you’re going to see in terms of backlash to progressive reforms for five years down the line,” said Megan French-Marcelin, director for New York state policy at Legal Action Center. “This is that moment in drug policy, where we’re seeing this unbelievable gearing up for that backlash to just make a wave across the state.”

The room was still half full around 9 pm, when the village came to a decision. Most of the people left were policy advocates, the village council, and the law’s most vocal proponents.

Menands Mayor Brian Marsh announced that they wouldn’t be passing the zoning law to avoid running afoul of the ADA. Instead, he said, the village board would redraft the law to get the same effect without targeting opioid treatment programs specifically.

People became indignant. Chuck Price, a local pushing for the law, pressed village attorney Stephen Rehfuss.

“I guess I’m surprised that these issues, Steve, weren’t caught in this version of it,” Price said. “Can we be sure that we aren’t going to bump into this with the new version of the proposed law?”

Locals pushing for new laws in Albany and Menands have gone to pains to frame the situation as a relatively innocuous zoning issue. Many have argued that the Fusion location was opened with little or no notice to the community.

“Our concerns aren’t targeted against the noble endeavors of [opioid treatment programs],” Price told New York Focus over email. “Our grievance lies in the way Fusion Recovery’s proposal has been handled — seemingly sidestepping pivotal community dialogues and considerations.”

On Change.org, a petition Price started offers a different perspective.

“The introduction of a methadone clinic in our residential area could pose potential safety risks to our families, children, and the general public,” the petition reads. “The establishment of a methadone clinic in our neighborhood may result in a decrease in property values, affecting the financial stability of homeowners and businesses.”

Advocates have accused local officials of fearmongering as well. Alison McLean Lane, an Albany County legislator and staffer for state Assemblymember Phil Steck, shared a video on Facebook of a distraught man near the Fusion Recovery location. Still images from the video show a man in loose-fitting clothing hunched over near the entrance to the plaza where Fusion opened on June 3.

“Recorded today in front of Fusion Recovery on Broadway in Menands. I called 911 to make sure this opioid impaired individual had emergency services,” McLean Lane wrote.

The post was dated May 20 — about two weeks before Fusion Recovery opened. It has since been deleted, but multiple sources shared screen captures with New York Focus.

In an interview, McLean Lane said that she wrote the post out of legitimate concern for the man, but deleted it out of respect for him and his family. Nevertheless, such messaging has fueled animosity with progressive drug policy advocates.

“It puts people in a difficult situation, because there needs to be a working relationship, and there’s concerns that maybe they would be alienated in the future,” Assini, the Friends of Recovery policy director, said.

The fear appears to have set in in Menands. At the village meeting, community members asked what would happen when people began overdosing near Fusion, why company ceo Mitch Baumann was opening here instead of another town, and whether the new law would impact the center.

Back when Fusion was still a grocery store, neighbor David Archambault dealt with industrial loading at 3 am, but has generally been able to negotiate any problems with the businesses across his property line. He’s lived behind the plaza for over 50 years, and he’s hands-off. “I just don’t want any problems back there,” he said.

When New York Focus visited Archambault this August, his daughter Sherry swung by. She lives a few blocks away and has been keyed into the Fusion controversy.

“I agree that people need help. This just isn’t the place for it,” she said. She opened her phone and read off a passage about the local zoning ordinances, arguing that it’s the wrong location for a treatment center. She said she was reading off of something Price sent.

For all the fervor, Fusion Recovery has had an uneventful first two months. The Archambaults didn’t report any issues. Businesses sharing the plaza say that the program’s clients haven’t caused any trouble. The most interesting incident so far: A man walked into the neighboring salon to ask where the clinic was.

Decades of research indicate that the spike in crime Price predicts is unlikely to materialize. Numerous studies have found that opioid treatment centers generally have no impact or actually reduce local crime and recidivism. The Journal of Studies on Alcohol and Drugs found that addiction treatment centers draw about the same level of violent crime as liquor stores — and less than convenience and corner stores.

So far, it seems unlikely that academic research will assuage anyone’s concerns.

Marsh, the mayor, entered office on July 3 and said his first 36 days were “baptism by fire.” He is trying to balance what he believes is good for the community against the comfort of his constituents. His father is board certified in addiction medicine, and Marsh said he recognizes that service access is essential to combatting the epidemic.

“There’s a battle. There’s a responsibility as a leader in the village government to make sure that the residents feel that the village is advocating for them, and then there’s also a good side of me that understands that ultimately, I believe that this operation will be clean and sound and do a great deal of good for the public,” Marsh said.

Marsh is having a difficult time striking a balance in the current climate — and he isn’t the only local leader facing such challenges.

In nearby Albany, an opioid treatment program called Camino Nuevo turned into a local flashpoint. Originally slated for 100 clients, the program has swollen to more than 500, according to a June 28 letter from local officials. And although less than half of the program clients are from Albany County, the officials wrote, “100% of the cost associated with the externalities of serving this population has fallen on our local governments.”

The letter, signed by state legislators and Albany’s mayor, implored the commissioners of OASAS and the state Office of Mental Health to accelerate a planned move for Camino Nuevo, noting that some local businesses had closed or relocated because of the crush. Representatives from Camino Nuevo did not respond to a request for an interview.

Back in Menands, Sherry Archambault said that she was concerned Fusion would turn into another Camino Nuevo. As of August 9, Fusion was serving 34 people and planned to add 12 more clients, according to Baumann, the CEO. It doesn’t even dispense methadone yet: While waiting on certifications, the facility is focusing on therapy and other medications that don’t require daily visits, like suboxone and sublocade.

Spurred by the fight over Fusion, McLean Lane introduced what she thought was an innocuous proposal to the Albany County legislature. The law would require the Albany County Department of Mental Health to notify a number of stakeholders — including local and state legislators, city mayors and councilmembers, state Senate and Assembly representatives, and the principal of every school within a quarter mile — any time a new substance use treatment provider tries to open.

Advocates have eyed McLean Lane’s proposal with suspicion. The bill would give everyone notified two months to voice their opinions — which stakeholders interpret to different effects. Progressive policy advocates read a 60-day period as a delay tactic that would scare providers off, instead of as an opportunity for a community dialogue. According to Assini, the law is “clearly meant as a deterrent.”

Even some of the officials involved in overseeing Camino Nuevo’s relocation think that McLean Lane’s proposal goes too far. Assemblymember John McDonald, who is involved in orchestrating the provider’s move, wrote in a letter to the county legislature that “at face value, this purpose and the legislation make sense and efforts at transparency that allow public input should be applauded, but I am concerned about what the practical impacts will be.”

That’s because the law singles out substance use treatment from other disabilities, McDonald told New York Focus. “The message coming from that local law is, ‘Albany County is not welcoming to individuals who are in need of treatment and want to live a longer life in recovery.’”

The pushback has confounded McLean Lane. She said that her bill was designed as a straightforward good government measure. It was supposed to promote transparency and preempt concerns about community outreach, like the ones that have cropped up around Fusion.

Despite the differing interpretations, the county legislature is ushering the proposal along: The health committee, which includes McLean Lane, discussed the proposal for 45 seconds before advancing it.

McLean Lane is exasperated by the argument that has opened up around Fusion Recovery. She bristles at the term ‘nimby,’ which she said has been thrown around throughout the fight.

“These people are legitimately worried about the character of their community, their property values, their safety,” she said. “I grew up not too far from [Camino Nuevo], and I see it every day when I get to work. And so it is not unreasonable for residents who live adjacent and right near [Fusion Recovery] to have their concerns.”

Advocates pushing to expand services said that the controversy reflects a grim reality: Addiction is still stigmatized. And until that changes, programs will keep getting pushed out.

Tracie Gardner, a senior vice president at Legal Action Center, said she was unsettled by the “nerve and audacity” of local governments working to exclude addiction services.

Residents in towns like Menands are “having community meetings to limit the scope and purpose of a healthcare provider,” Gardner said. “Whether they’re providing methadone or suboxone is not the issue. It is healthcare. It is recognized as effective, as life-saving. It confers protection against overdose. It engages people in care. And they want to have it on the outskirts of town like it’s a porn shop.”