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Opiate addiction grows; methadone clinics expand



Published: Sun, July 6, 2008 @ 12:37 a.m.

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.


Comments

1undead76(63 comments)posted 6 years, 2 months ago

Go to rehab for 6-12 months. I worked with someone who went to a methadone clinic and he used to try and sell his doses to buy the good stuff.

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2truth_in_knowledge(2 comments)posted 6 years, 2 months ago

Thank you for taking the time to write an article with a positive view of Methadone clinics. Once this has been received by the anti-methadone groups you will unfortunately receive their cut n' paste letters of false statistcs telling of hidden agendas by addicts to stay high & pharmaceutical companies/clinics to stay in business ...None of which are true. They will state that Methadone is the #2 killer drug in the US (also false... This is taken from the CDC mortality statistics which lists the number of Methadone deaths as being a “possible contributing factor” in death. They also note other medications found in the toxicology were not accounted for. Meaning if 5 drugs were in the system and 1 was Methadone it was listed as a “possible contributing factor” not the cause of death and the other drugs in the system were not included).
They will tell you even the enormous death rates they list are underestimated due to an error in the coding system. This too is false because although there was an error in coding of ICD10 stats it was corrected in 2005 and never even applied to the “Drug Related Death” portion of the charts.
They will attempt to frighten people by their “One Pill Can Kill” campaign which stems from a research paper about prolonged QT Intervals in the hearts rhythm. However, the research article has since been pulled because a doctor from Australia specializing in addiction decided to check the references only to find out they didn’t exist and were totally made up!
A final attempt to persuade people that this 40 year old medication is deadly is often backed up with a statement claiming Heroin deaths are exceeded by Methadone deaths therefore concluding the treatment kills the population it is suppose to save. However, the number of deaths from Oxycodone, Hydrocodone, Morphine, Hydromorphone, Oxymorphone, Fentynal, Darvocet, Demorol, and all the other narcotic opiates Methadone more commonly treats these days is withheld making this statement useless.
Lastly, these letters usually close with recommendations for clinic guidelines that either are already in place and enforced or are so extreme that if put in effect they would close the majority of clinics in no time.
Which leaves me with the result their tactics have had so far... the least of which is a society that has been misinformed and misled regarding the Truth about Methadone. This is causing a fear in communities (despite research to the contrary) about these clinics leading to massive opposition whenever a clinic wants to enter an area. Property values do not drop, crimes do not increase, etc, etc….However, people ARE dying on waiting lists to get into the few clinics available. Deaths whose blood is on the hands of these grieving mothers claiming they exist to save lives. I guess as long as that life isn’t saved by a Methadone clinic. Thank You for taking the time to read this!

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3truth_in_knowledge(2 comments)posted 6 years, 2 months ago

Thank you for taking the time to write an article with a positive view of Methadone clinics. Once this has been received by the anti-methadone groups you will unfortunately receive their cut n' paste letters of false statistcs telling of hidden agendas by addicts to stay high & pharmaceutical companies/clinics to stay in business ...None of which are true. They will state that Methadone is the #2 killer drug in the US (also false... This is taken from the CDC mortality statistics which lists the number of Methadone deaths as being a “possible contributing factor” in death. They also note other medications found in the toxicology were not accounted for. Meaning if 5 drugs were in the system and 1 was Methadone it was listed as a “possible contributing factor” not the cause of death and the other drugs in the system were not included).They will tell you even the enormous death rates they list are underestimated due to an error in the coding system. This too is false because although there was an error in coding of ICD10 stats it was corrected in 2005 and never even applied to the “Drug Related Death” portion of the charts.They will attempt to frighten people by their “One Pill Can Kill” campaign which stems from a research paper about prolonged QT Intervals in the hearts rhythm. However, the research article has since been pulled because a doctor from Australia specializing in addiction decided to check the references only to find out they didn’t exist and were totally made up!A final attempt to persuade people that this 40 year old medication is deadly is often backed up with a statement claiming Heroin deaths are exceeded by Methadone deaths therefore concluding the treatment kills the population it is suppose to save. However, the number of deaths from Oxycodone, Hydrocodone, Morphine, Hydromorphone, Oxymorphone, Fentynal, Darvocet, Demorol, and all the other narcotic opiates Methadone more commonly treats these days is withheld making this statement useless.Lastly, these letters usually close with recommendations for clinic guidelines that either are already in place and enforced or are so extreme that if put in effect they would close the majority of clinics in no time.Which leaves me with the result their tactics have had so far... the least of which is a society that has been misinformed and misled regarding the Truth about Methadone. This is causing a fear in communities (despite research to the contrary) about these clinics leading to massive opposition whenever a clinic wants to enter an area. Property values do not drop, crimes do not increase, etc, etc….However, people ARE dying on waiting lists to get into the few clinics available. Deaths whose blood is on the hands of these grieving mothers claiming they exist to save lives. I guess as long as that life isn’t saved by a Methadone clinic. Thank You for taking the time to read this!

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4Melis11577(1 comment)posted 6 years, 2 months ago

In 2005 Methadone is indicated in over 4600 deaths nationwide and this number is underestimated due to an error in ICD10 coding and non uniform procedures in reporting and determining causes of death. Methadone is killing more people than any other prescription drug, killing 2 people for every 100 exposed.

Methadone is now the #2 Killer Drug in the U.S. Methadone is more addictive then any other pain medication including heroin and because of it’s extremely long half life, cardio toxic risks, numerous fatal drug interactions, dosages based on tolerance, and small margin of error.

It looks like the "gold standard" is killing more then the drug its supposed to save people from!!!!

Every day 10.9 people die from Methadone (according to 2004 stats, not including car accident deaths caused by drivers under the influence of Methadone)

We cannot continue to allow a legal medication to be killing more people then the illegal drugs. Our government cannot be allowed to use tax dollars to fund their legal drug dealing operations.

We are asking government agencies to enact stricter guidelines in prescribing methadone for any reason. It must be mandatory that all doctors be certified and trained in the pharmacology of methadone; inpatient stays must be required during induction to methadone; all staff be extensively trained in monitoring methadone patients for symptoms of toxicity. Clinic patients should be tested weekly for legal and illegal drugs that are taken with methadone to get “ high” or experience “euphoria” such as benzodiazepines, alcohol, cocaine, heroin, marijuana etc… and face severe consequences or mandatory detoxification from the methadone program after 3 dirty urines. Selling of take home doses must result in termination from methadone program permanently throughout the U.S. When presenting inebriated at clinic, clinic should also document such activity as well as prevent client from driving. Take home doses for all patients receiving methadone should be eliminated thus preventing the risk of diversion or precautions such as pill safe should be implemented. http://www.thepillsafe.com/

Diversion of methadone is a serious problem because it lands this most deadly drug on streets. Statistics also state that methadone is contributing to more deaths nationwide then heroin and only second to cocaine deaths.

The potential of abuse, diversion, and overdose to new patients being prescribed methadone is overwhelming. The unique properties of methadone, it's long half life, and it's negative interaction with numerous drugs make it an optimal choice as a last result treatment for chronic pain and addiction.

Helping America Reduce Methadone Deaths
www.HARMD.org

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5n2wishin(8 comments)posted 6 years, 2 months ago

It's not just junkies who need these clinics. I have been on a cocktail of antidepressants and vicodin since I had spinal surgery 2 years ago. I want to stop taking the vicodin but my body is physically addicted to it now, and it does little to quell my pain.
I asked my psychologist how we were going to get me off these pain meds and he said methadone and a pain management specialist are going to be my best bet. Great - what then? I will still be depressed and hurting a great deal but in less danger of harming my liver. I just want to stop hurting.

Can somebody tell me if they have had good results with acupuncture or something?

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