Methadone clinic fights public perceptions
Our court system in 1917 declared that addiction was a CRIME and not a DISEASE and any prescriber that treats/maintain a addict by prescribing them opiates would lose their license. But now we have the Surgeon General claiming that addiction is a “brain disease” and the DEA is providing a legal mechanism for opiate addicts to be treated and become “functioning addict”.. while the DEA/CDC/FDA discourages prescribers from treating chronic pain pts with opiates because apparently they still believe that prescribing opiates can cause a “brain disease”. Where is the disconnect ?
The Florida company fighting to open a methadone clinic in Shenango Township said much of the opposition to such clinics is based on misconceptions.
Cheryl Zelenak, director of marketing for Colonial Managment Group, the parent company of Metro Treatment of Pa., said 90 percent of such a clinic’s clients are employed full time and are paying for their own treatment. The remaining 10 percent are on Medicare or Medicaid programs.
She said this is why the peak hours for methadone clinics are so early. She said they open at 5:30 a.m. in order to give clients time to get their dose of the drug and then go to work.
Zelenak said Friday that though people in methadone treatment are stigmatized, “this could happen to your loved one.” She compared methadone treatment to diabetics being kept alive with insulin or heart patients living with the help of blood pressure medicine.
Colonial Management, which has been in business 20 years, wants to spend $1,375,000 to build a clinic on the approximately three-acre site at 1901 Butler Road. Plans call for a privacy fence that would surround the building on three sides and for the front doors of the building to face the back of the 5,000 square foot property.
According to Zelenak, as well as to testimony during the clinic’s initial zoning hearing last year, the clinic would be licensed for a maximum 470 patients, with 100 patients expected to be on the caseload after one year operation. Twenty-five percent of the clients would be expected at the clinic each day, or about 125 at the maximum caseload, with most of those coming between 5:30 and 6:30 a.m.. Clients would begin arriving at 4:30 a.m. and wait for clinic doors to open at 5:30 a.m.
The for-profit business operates 65 similar clinics throughout the United States and is the second-largest provider of opiate addiction treatment, Zelenak said. She and others from the business also have provided the following information about the proposed clinic:
•Clients must be at least 18 years old, and addicted for at least one year to be accepted. They would refer themselves and there would be no court referrals.
•The clinic would employ two physicians or one of the following combinations: one physician and one nurse practitioner or one physician and a physican’s assistant; one pharmacist; multiple nurses; five to 10 counselors; and a treatment services coordinator.
•Hours would be 5:30 a.m. to 2 p.m., with methadone being administered from 5:30 a.m. to 11 a.m.
•Treatment would progress in phases, with patients being allowed to take up to 13 doses home in later phases. In earlier phases of treatment, they would be dosed with oral methadone by personnel who watch to make sure they swallow the drug.
•There would be no security guard on premises, only an electronic security system.
•Government rules require that clients who come only for their methadone does must be out of the clinic within 15 minutes.
•Patients are not referred by courts, but reach out for treatment themselves.
•The goal is not weaning patients off drugs although this happens in some cases. The goal is to stabilize the patient on methadone so they can lead normal lives.
•A physician testifying at the initial zoning board hearing said methadone generally does not make a client “high” or euphoric although in rare cases, this could occur. Even though there is a caution about driving on the methadone drug package, company officials and a physician who testified at the zoning hearing said clients are considered able to safely drive from the clinic as soon as they receive their dose.
•New patients must be in drug withdrawal to be treated at the clinic, meaning they are not taking an opioid, and this is confirmed at the clinic through blood and other tests.
•Methadone dosing is combined with counseling to lessen chances of a relapse.
•Maintenance on methadone allows patients to regain stability in their lives and remain employed, and minimum length of time on treatment on methadone is 12 to 18 months.
•Clinic officials say there is no evidence of increased crime around such clinics and said two university studies actually show a slight decrease.
•One half of the clinic’s intakes for new patients are “no-shows.”
•Federal Medicaid rules provide gas mileage payments for patients coming from beyond a 30 mile radius for treatment. Those abusing this rule , by carpooling to a clinic and all the clients in the car filing for gas mileage reimbursement, can have their payments pulled.
•The clinic would accept patients from any geographic area.
•It would be open every day, but would have abbreviated hours Saturdays and Sundays.
•The company chose a Pennsylvania site is because the state has the nation’s second-highest rate of opiate and painkiller deaths, and Western Pennsylvania is an area of need.
•The facility would be regulated by state and federal agencies that set detailed parameters of how they must operate. Some of the agencies are the Pennsylvania Department of Substance Abuse and Alcohol, which licenses it, and the Drug Enforcement Agency, the Board of Pharmacy and other federal and state regulators.
•Company officials would not put a number to the percent of clients who relapse, stating this is difficult to do because it is self reported by clients.
*They claim that the only alternatives to methadone clinics are expensive in-patient treatment, or “cold turkey” abstinence, which they say is ineffective. Physicians are not licensed to provide methadone treatment to their patients, they said.
Filed under: General Problems
Once again I don’t get it. If you’re an addict you can go to a methadone clinic for treatment, often paid for with taxpayer dollars. We as pain patients are accused of being addicts yet can’t be treated in a methadone clinic because we don’t qualify. So which is it, are cpp who take opiates as treatment for pain addicts or not?!