Sarah Hipkens, MD, of Portland is an addiction medicine physician.

On June 9, Portland votes on its school budget. I’m voting “Yes.” Here’s why — starting with a patient I recently saw.

I’m an addiction medicine physician. The patient sitting across from me started drinking and using cocaine at age 12. The alcohol helped him fit in. The cocaine quieted his mind. He grew up with a violent father who had untreated alcohol use disorder. He couldn’t focus at school, acted out, got suspended again and again — and kept getting promoted anyway. No one noticed he had dyslexia. In high school he was reading at a fourth-grade level.

I’ve gotten good at seeing the sweet kids inside the adults I treat. The kid who wasn’t kept safe. The kid whose creativity and odd, original way of seeing the world was never cultivated. The kid who never had a teacher pull them aside and say, did you realize you’re really good at this? Many build wonderful lives in recovery. But it’s daily hard work that might have been less necessary if someone had intervened at 8, or 10, or 12.

This isn’t just a clinical hunch. The landmark CDC-Kaiser study on adverse childhood experiences found that adults who grew up with four or more sources of serious childhood stress — a parent with untreated addiction, violence in the home, abuse, neglect — were up to 4-12 times more likely to develop addiction themselves. The patient I just described checked most of those boxes.

So do many of the patients I see. In the two and a half years since our clinic opened, our panel has grown from 100 to over 450 patients, many of them young adults. I am not surprised — I see what we build by not catching kids early.

I think about this every time I walk into Reiche Elementary, where both my kids have gone. Reiche teachers and ed techs — the aides who work one-on-one with kids needing extra support — show up for children carrying enormous weight: homelessness, food insecurity, language barriers, parents in active addiction. Somehow they build a community where these kids laugh, learn and feel like they belong.

I recently went to the annual Reiche talent show, my favorite night of the year. The fifth-grade emcees introduced the acts in Portuguese, Spanish and English. One girl belted out Weezer’s “Sweater Song” while playing an inflatable guitar. I sat there crying and snotting, embarrassing my children, thinking about my patients. What if they had had more nights like this — to be goofy, show off what they were good at and hear a room applaud?

That’s what’s on the ballot June 9 — a school budget funding ed techs, arts programming and English Language Learner support, the programs that catch the kid who can’t sit still and hand a shy child a microphone. Vote a big “Yes.”

And Portland can’t keep funding this on property taxes alone. The state has far greater capacity to raise revenue. Lawmakers updated the school funding formula and added a surtax on incomes over $1 million this year, but they must go further, for schools and for addiction care.

I know the skeptical response. Schools can’t fix addiction. Parents matter more. We’ve spent plenty on education already. But the ACLU of Maine estimates we spend $111 million a year criminalizing people who use drugs (2022). Imagine spending some of it upstream instead.

The economists Jorge Luis Garcia and James J. Heckman showed that every dollar invested in high-quality early education returns 13% annually, for decades — through better health, higher earnings, less crime, less addiction. And the same dynamics extend into elementary school: a randomized trial in Baltimore found that a classroom behavior program in first and second grade reduced drug and alcohol use disorders in adulthood.

There’s a lot of hand-wringing about where the country is heading. That future is being decided in classrooms a few blocks from where you’re reading this. The kids on that stage will become our teachers and firefighters, our nurses and doctors, our artists and poets, our neighbors. We can wring our hands or we can vote “Yes.”