Albany and Twin County Addiction Centers Complete Five-Year Merger

The Addictions Care Center of Albany has absorbed Twin County Recovery Services, completing a merger that was finalized September 8 and announced Monday at the Albany organization's headquarters on McCarty Avenue. The combined nonprofit will keep the Addictions Care Center name and, according to its leadership, intends to bring residential treatment, a methadone clinic and expanded family services to Columbia and Greene counties, where patients currently travel to Albany, Dutchess or Ulster counties for medication treatment.

"I think that's what people can expect: New services. Stronger services. We want to do more," Keith Stack, the Addictions Care Center's chief executive, said at the announcement, which drew state and local officials.

Five years from a retirement to a merger

The consolidation did not begin as a merger. It began in 2021, when Twin County's chief executive retired and left a small Hudson Valley provider without a leader during a period of acute staffing shortages and rising demand. The two boards discussed a partnership that November, and by January a management-services agreement was in place that put Addictions Care Center leadership in charge of day-to-day operations in Columbia and Greene counties.

Merger talks only started two years later. "It just became very natural," Stack said. "I would spend half my time in Hudson and Catskill and half my time in Albany. It just started meshing together."

That sequence — shared management first, legal merger years later — is how most small-provider consolidations in addiction treatment actually happen. The management agreement lets both boards test whether the cultures and clinical models fit before either surrenders its charter, and it means the acquiring organization has already been running the satellite sites long enough to know what it is buying.

Patients will not see a change in their own care, said Maggie Graham, the former board chair of Twin County who now sits on the merged board. "Our mission continues. Our commitment to the people we serve is strong as ever and the programs and services our communities depend on will continue uninterrupted," she said, describing the shared approach as "treating people with dignity and compassion."

What the combined organization actually operates

The Addictions Care Center treated more than 1,100 people across 16 locations last year, in Albany, Rensselaer, Warren and Washington counties as well as the twin counties. It also delivered addiction education to roughly 5,500 children and served 350 families in 2025 through its Family Support Navigator Program, which coaches relatives on communication and recovery options. Stack said there are plans to extend the navigator program into Columbia and Greene counties.

Two construction and licensing projects are further along. A residential care facility for men in the town of Greenport is nearing completion and is expected to begin operating in February. Conversations about adding services for women and children in the region are ongoing.

"Addiction is a family disease and family members are on the front lines," Stack said. "So the more we can help and assist family members that are struggling with this — I think that's a great thing."

A methadone clinic forty minutes closer

The most concrete access change under discussion is a methadone clinic at the organization's Hudson location on Power Avenue, which the Addictions Care Center is negotiating with Lexington Recovery Center. Roughly 150 Columbia County residents would be able to start opioid use disorder treatment closer to home instead of driving to Albany or across into Dutchess and Ulster counties.

Distance is not a cosmetic burden in methadone treatment. Federal rules require frequent dosing visits, especially in the first months, and the travel time and vehicle access that make a clinic inconvenient for a commuter make it close to impossible for someone without a car, a license or an hour to spare before work. The New York State Office of Addiction Services and Supports has spent the past several years expanding mobile and satellite medication units precisely because the fixed-site network does not reach rural counties.

The region's mortality data explains the urgency. According to OASAS figures cited at the announcement, 135 people died of drug overdoses in Columbia and Greene counties between 2021 and 2025, another 419 died in Albany County and 237 in neighboring Rensselaer County over the same period.

Stack said most of the organization's patients are dealing with opioid addiction, but that cocaine and methamphetamine use are rising and that "alcoholism is still a real challenge." That mix is consistent with national trends: federal provisional overdose data has shown fentanyl deaths falling faster than deaths involving stimulants, and toxicology reports increasingly list more than one substance.

The consolidation question the announcement did not answer

What the merger does not disclose is the business case. Neither organization released a combined budget, a headcount, or the composition of the new board — the three numbers that determine whether a merger strengthens a provider or simply delays a financial problem. Addiction treatment nonprofits in New York operate on thin Medicaid margins, depend heavily on state grant cycles and compete for the same small pool of credentialed counselors, and a merger can either consolidate that fragility or spread it across a wider footprint.

The pattern in the Hudson Valley suggests the second reading is intended. The Addictions Care Center is not shrinking into the twin counties; it is adding a residential facility, negotiating a new medication dispensing site and expanding a family program into territory it had served only under contract. Whether Columbia and Greene county residents end up with more treatment than they had before the merger will be visible in one place: whether the Power Avenue clinic opens, and when.