Opiate addiction grows; methadone clinics expand

By Jeanne Starmack

Some of your friends might get treated in the suburbs for heroin dependency.

NEW CASTLE, Pa. — If you were a suburbanite in the 1970s, chances are you didn’t think too much about methadone clinics.

Once in awhile, a fleeting media reference might have conjured up an image of a publicly funded, inner-city establishment that catered to a steady stream of emaciated, needle-pocked junkies.

Those junkies weren’t your neighbors. You certainly wouldn’t be able to look out your window and see a clinic from your house, or drive by one on your way to the shopping center.

Well, pull back your curtains and take a look at how methadone clinics are fitting into the landscape of 2008.

You may not only drive by one on your way to work, you might share an office with a person who got up early to visit it at 5 a.m. to get his daily dose.

You might never know about his addiction, to heroin or oxycodone, from the way he acts. He does his work, gets in his car and goes home to his family at night. There are no needle marks on his arms.

He seems perfectly normal, and that’s because the methadone is keeping him stable. It stops his cravings for the other opiate, so he doesn’t go through debilitating withdrawal. If he’s dosed properly, he isn’t getting high, and he can function just like anyone else. He can reason and think, and he has an average range of emotions.

If he does decide to snort heroin anyway, methadone will even block the rush he’d get. So he may as well not bother.

Today’s methadone clinics started dotting suburbia about 10 years ago after supermodel Kate Moss’ heroin-chic and grunge bands glamorized the drug back to popularity. Private and for-profit, these clinics accept medical insurance and are federally and state-regulated.

If you still feel you’d be leery of wanting one in your backyard, you aren’t alone. Communities often fight companies that try to locate a clinic in their midst.

The reason, says Rob Kornacki, a spokesman for a company that operates clinics throughout the country, has a lot to do with that old image from the ’70s.

Kornacki is with Smart Management of Providence, R.I., parent company of Discovery House clinics. Discovery House has operated a clinic in Hermitage, Pa., for 10 years, and one in upper-middle-class Cranberry Township for 12.

Inside two months, said Kornacki, a Discovery House that could eventually serve 350 clients will open in Union Township on U.S. Route 224 near New Castle.

Union Township supervisors said at their June meeting that the clinic meets zoning requirements. At a February supervisors’ meeting, the township board heard from residents who complained that there won’t be enough of a buffer between the clinic, which will be in the old J.D. Byrider building, and about 75 homes.

But there are a lot of clinic rules, and a lot of monitoring will go on, said Kornacki. The state encourages clinics to move patients in and out as quickly as possible, so there is no waiting around. They take their methadone at the clinic in front of a nurse who makes sure they swallow it, though some who are deemed stable enough are permitted take-home doses that are monitored by recalling and counting pills.

If patients have counseling scheduled, they go to it. Then, they simply go about their days, Kornacki said.

In the program, they have to pass drug screening, prove a stable home environment and refrain from criminal behavior.

The clinics, Kornacki said, encourage a lifestyle that is productive and good for the community.

He said the company decides on clinic locations by analyzing where they’re needed.

The Hermitage and Cranberry Township clinics have a lot of clients who travel from the New Castle area, he said, and that’s why the company chose the Union Township location.

New Castle has seen an explosion of oxycodone abuse in the past five years, he said.

“In western Pennsylvania, there’s a tremendous need for opiate treatment,” he said.

That need is being seen statewide, said Robin Rothermel, acting director of the state Bureau of Drug and Alcohol Programs.

Heroin use is in a cyclical upswing for the East Coast, she said.

It’s more appealing to younger users now, Rothermel said, because it has become cheaper. It can be cheaper to buy heroin than to buy a pack of cigarettes, she said.

The heroin available today is also much more pure, she said, and that means it can be smoked or snorted. The stigma of needle use was a deterrent that’s no longer a factor, and that helped bring the drug out of the back alleys to the suburbs. But with purer heroin comes more potential for addiction. “You get addicted more quickly,” Rothermel said.

With oxycodone, prescribed as a powerful painkiller, many people who obtained it legally became addicted, Rothermel said.

Kornacki said Discovery House clinics in this area treat more oxycodone addicts than heroin addicts.

The goal of treatment, Rothermel said, is to gradually wean people off methadone so they’re opiate-free. Some, she said, may need to be in treatment for 10 years — others, one year.

“And a whole bunch in the middle,” she said.

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