MADISON — Nearly two years of controversy over a proposed methadone clinic ended Monday as the Select Board approved its license, but only after two board members who initially refused to vote were swayed to vote in favor.

The decision at the end of the tense deliberations was 3-1 to allow Acadia Healthcare to operate a clinic at the Madison Business Gateway park.

Voters enacted the location-restrictive ordinance governing the application process in 2024 after pushing back on the company’s initial plans to open in the center of town. The original proposal sparked a petition to convince Acadia to shift its sights elsewhere.

Board Chair Sally Dwyer and members Kathy Estes and Shawn Bean ultimately were in favor of approving Acadia’s application, filed in August. John Martins was opposed. Mike Pike was absent.

The board voted Monday after holding two required public hearings earlier this year, which both at times turned contentious as residents peppered Acadia executives with questions. The board was set to vote at its last meeting Feb. 23 but tabled the matter as at least one member of the public raised a potential legal technicality.

Martin Berry had claimed that when measuring from property boundary to property boundary, the proposed site in the Madison Business Gateway industrial park is within 1,000 feet of Madison’s high school. The Madison resident claimed the high school is a designated safe zone and therefore Acadia’s clinic would not be allowed in that location.

In an opinion disseminated to the public Friday evening, town attorney Ken Lexier disagreed, saying the proposed location at the former veterinary clinic at 36 Business Park Drive complied with the ordinance voters adopted in 2024.

Lexier noted that although the town’s Outpatient Substance Use Disorder Treatment Programs Ordinance references a requirement that a clinic located in the eastern half of the business park must be outside a high school safe zone at the high school, neither the town nor its voters ever made that designation for the school. A separate ordinance on safe zones — aimed at protecting children using parks from drug dealers — does not list the high school.

Even assuming the safe zone existed, Lexier, of the Skowhegan law firm Mills, Shay, Lexier & Talbot, wrote that the 1,000-foot setback is only a factor in state law when determining the severity of criminal offenses like drug furnishing and trafficking.

Moreover, even if the town were to consider the clinic to be a form of illegal drug dealing, the business park location would still fall outside the safe zone, “since the setback is from the actual location of the furnishing or trafficking activity,” according to Lexier. 

Martins, who was elected last year and had been a vocal critic of Acadia’s original plans to open at the former Taylor’s Drug Store in downtown Madison, said ahead of the board’s first attempt at a vote that he studied the law at length and disagreed with Lexier’s opinion.

“I ask the board to stay in compliance with state and federal law and the obvious intent of our overwhelming vote of citizens to enact this ordinance,” said Martins, reading prepared remarks.

When it came time to vote, the tally was 1-1-2: Dwyer was in favor, while Bean and Estes abstained, without providing reasons until after the fact.

That left Acadia’s lawyer, Brian Rayback, looking for a clearer decision — yes or no from all board members. The unclear vote left Acadia “in limbo,” he said.

“May I ask, you’ve seen your own lawyer’s advice on this, correct?” Rayback said.

Bean said he was confused about the matter and was not sure if Lexier’s opinion was 100% correct.

“I can’t give you a yes or no,” he said.

Estes then said if she had to vote, she would vote against issuing the license.

Dwyer said Acadia complied with the ordinance, and the town’s legal counsel agreed.

“I apologize for the behavior that you’ve experienced here,” Dwyer told Rayback.

Later in the discussion, Estes said she looked over the ordinance again and was ready to vote in favor. The board agreed to reconsider its initial vote.

Dwyer and Estes voted in favor. Bean visibly struggled for a moment before raising his hand to join them. Martins remained opposed.

Rayback thanked the board and quickly left the Old Point Avenue school meeting room.

Per the ordinance, the license is issued for one year and is subject to annual review by the Select Board.

Acadia, a for-profit behavioral health care provider with headquarters in Franklin, Tennessee, and 262 facilities across 39 states, runs six clinics in Maine — in Bangor, Calais, Presque Isle, Rumford, South Portland and Waterville — that are similar to what it plans to open in Madison.

Acadia executives wrote in application materials submitted in August that the planned clinic is aimed at serving patients with opioid use disorder, “with the goal of supporting long-term recovery, personal stability and reintegration into daily life.”

Services offered at the clinic would largely focus on medication-assisted treatment.

A company representative, Adrienne Sass, said at a previous meeting that treatment would include administering methadone and Suboxone, a combination medication containing buprenorphine and naloxone. But Sass said earlier at the public hearings the clinic is expected to provide only methadone, both on-site and in take-home doses.

The drugs are controlled substances used widely to treat opioid addiction in adults. Methadone is typically administered in a daily dose.

Other services would include medical evaluations and monitoring, individual and group counseling, and education programs, according to the application.

Acadia would likely open in Madison in 2027, although it has no target opening date set yet, a corporate spokesperson said.