Pubdate: Mon, 06 Jan 2003
Source: Associated Press (Wire)
Copyright: 2003 Associated Press
Author: Roger Alford

METHADONE CLINICS WELCOMED IN APPALACHIA

PAINTSVILLE, Ky. (AP) - In other places, attempts to open methadone clinics 
for drug addicts have spawned protests, even court fights. Not in Appalachia.

Residents and political leaders, grappling with an epidemic of OxyContin 
addictions, have welcomed at least 10 methadone clinics in a region that 
previously had none.

One of the newest clinics opened in the former office of a Paintsville 
physician who was arrested last year for allegedly overprescribing 
OxyContin and other painkillers to patients in eastern Kentucky.

The change of tenants has made a dramatic change in the small town. Traffic 
jams are no longer the norm around Jefferson Avenue where people seeking 
prescription drugs used to park. Since the methadone clinic opened, the 
parking lot has remained uncrowded and calm.

Police Chief Doug Wallen said he expected an outcry when the methadone 
clinic opened. "We haven't had the first complaint," he said.

Similarly, clinics that have opened in the Kentucky cities of Hazard, 
Morehead and Corbin did so without opposition, as did one in Cedar Bluff, 
Va., and five in the West Virginia cities of Charleston, Clarksburg, 
Parkersburg, Martinsburg and Beckley.

New clinics have opened in the Virginia cities of Richmond and 
Charlottesville, as well as other cities outside central Appalachia to 
serve people addicted to OxyContin and other opioids.

OxyContin became popular in eastern Kentucky because of the economically 
depressed areas, police have said. Residents with insurance or Medicaid 
could get the pills for free. The drug's popularity grew for its quick high 
that produces effects similar to the more expensive drug heroin.

But in some communities outside Appalachia, methadone clinics haven't been 
so warmly welcomed because of concerns that addicts may bring an increase 
in criminal activity in the neighborhoods where they locate. An attempt to 
open a methadone clinic in Covington, Ky., a Cincinnati suburb, spawned a 
four-year court battle that ended in June when the 6th U.S. Circuit Court 
of Appeals ruled in favor of the clinic. City officials, responding to the 
concerns of residents, had gone so far as to amend a zoning ordinance to 
keep the clinic from opening.

"Methadone can be controversial because some people see it as trading one 
drug for another drug," said Merritt Moore, adult treatment coordinator in 
the West Virginia Division of Alcoholism and Drug Abuse. "These clinics 
opened without fanfare. It went smoothly."

Eastern Kentucky sociologist Roy Silver, said nearly everyone in mountain 
communities have been affected in some way by OxyContin abuse, often 
because a friend or relative got hooked. The methadone clinics have been 
more warmly welcomed, he said, because of the perceived help they can provide.

"OxyContin abuse has been so devastating," Silver said. "It's the most 
serious drug problem that's ever hit the region, and that's why people are 
more amenable to having something like their in their communities."

Methadone is used to curb the cravings of people addicted to heroin, 
morphine and other opioids, including the painkiller OxyContin, which 
became the drug of choice in Appalachia over the past three years. 
Methadone, when used for treatment of opioid addiction, can be dispensed 
only in the special drug-treatment clinics.

Harlan County Sheriff Steve Duff said he opposes the use of methadone 
because addicts have learned to mix the drug with others to achieve the 
kind of euphoric high that OxyContin gives.

"To me, it's just replacing one drug for another drug," he said. "Any drug 
you put out there right now, they're going to abuse it."

Former Mayor Robin Cooper said he expected at least some opposition when 
word got out that a methadone clinic had applied for a business license in 
his town. He said he received four phone calls from people who had more 
questions than concerns.

"People are able to accept it because it is a needed service," said Cooper, 
whose term ended in December. "We've got a problem in eastern Kentucky that 
has to be dealt with."

Clients pay an average of $8 to $10 a day for methadone at the private, 
for-profit clinics.

Michael Townsend, head of the substance-abuse division of the Kentucky 
Cabinet for Health Services, said the methadone clinics opened in the 
smaller cities specifically to serve OxyContin addicts.

"People who have switched over from OxyContin to methadone are people who 
have gotten addicted probably because of legitimate pain issues," Townsend 
said. "They're not as prone to be involved in criminal activities."

Jim Rectenwald, a substance abuse counselor for Paintsville Professional 
Associates, said methadone is key in the fight against the OxyContin 
epidemic in the mountain region.

Rectenwald said methadone was the best option for allowing those addicted 
to OxyContin to function. He said that was important because OxyContin 
quickly took hold in the region.

"It was a brand new drug that was everywhere at once," he said. "The 
opiates just really dig in, like a worm under the skin."
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