Pubdate: Tue, 11 Oct 2005
Source: Courier-Journal, The (KY)
Copyright: 2005 The Courier-Journal
Contact:  http://www.courier-journal.com/
Details: http://www.mapinc.org/media/97
Note: Only publishes local LTEs
Author: Alex Davis

DRUG CLINIC'S GROWTH DIVISIVE

Methadone Center Wants To Expand

To ease her craving for heroin, Wendy Roberts drives to a clinic in 
Jeffersonville, Ind., several times a week for a dose of methadone 
that makes her "feel normal."

"Without it, I can't complete anything," said Roberts, 38, of 
Shepherdsville. "I can't even run a sink of water and do the dishes."

Roberts is one of more than 1,400 recovering addicts from Kentucky 
and Indiana who are patients at the clinic, making it one of the 
nation's busiest providers of methadone, a synthetic opiate that acts 
like morphine and soothes the anxiety of withdrawal.

In fact, business has been so good that CRC Health Group, the 
California company that runs the clinic on 10th Street in 
Jeffersonville, wants to expand. It's seeking zoning approval to move 
to a nearby location that would allow it to nearly double in size.

But concerns about the plan already are surfacing, just as they did 
soon after the clinic opened at its current location in late 1993.

Along Grubbs Avenue, just behind the shopping center where the clinic 
wants to move, LaNae Smith said she worries about increased crime and 
the safety of her 6-year-old daughter. "It's going to be bad news for 
everyone who lives here," she said, adding that the neighborhood 
already has "enough problems from drunks" who frequent taverns on 10th Street.

Charlie Thompson, a detective with the Jeffersonville Police 
Department, said crime near the clinic -- including the sale of 
methadone -- is a "fairly large" problem.

And some city officials are also concerned.

"They're in business to sell drugs, and I don't think we need that," 
City Councilman John Perkins said of the clinic, called the Southern 
Indiana Treatment Center. "I'm going to fight like hell against it."

Growth In The Business

Although methadone traditionally has been taken mostly by heroin 
users, the abuse of prescription painkillers such as OxyContin has 
also contributed to the region's growing number of methadone 
patients, authorities say.

According to state records, the clinic's income topped $4.3 million 
in 2003, more than double its revenue in 2000. The number of patients 
has similarly increased.

Each person pays $12 a day for his or her dose, and the cost is not 
covered by Medicaid in either Kentucky or Indiana. Private insurance 
plans also seldom cover it.

Like nearly two-thirds of the clinic's customers, Roberts lives in 
Kentucky, where methadone is more tightly regulated.

Standing in the clinic's parking lot on a recent morning, she talked 
about how she tried to enroll at one of Louisville's two methadone 
clinics but was discouraged by a waiting list and its stricter 
requirements, including more frequent meetings with counselors.

Other patients at the Jeffersonville clinic said they preferred going 
there -- even if it meant driving from Frankfort or Lexington -- 
because they can buy up to 30 days' worth of methadone in a single 
visit. Most Kentucky clinics hand out no more than six days' worth of 
these so-called "take home" doses.

Mac Bell, an administrator with the Division of Mental Health and 
Substance Abuse Services in Kentucky, said the state may be "a little 
overregulated" when it comes to methadone. He voiced concerns about 
Kentucky residents driving long distances to other states for 
services that they could receive in their own communities.

None of the 11 clinics that Bell oversees has more than 300 patients a day.

The MORE Center, at 1448 S. 15th St. in Louisville, had 184 patients 
on a recent day this month.

Janice Cunningham, its on-site supervisor for the Louisville Metro 
Health Department, said she takes a strict approach to regulating patients.

"We have patients who have left us and gone to Indiana and come back, 
telling us they need more structure," she said. "We expect people to 
do certain things, not just dosing on methadone."

Joycelyn Woods, president of the National Alliance of Methadone 
Advocates in New York City, said patients typically need a lot of 
personal attention to make full recoveries. Any clinic with more than 
300 patients runs the risk of losing control of them, she said.

For CRC Health Group, out-of-state commutes to its Indiana facilities 
are nothing new. A CRC clinic in tiny Lawrenceburg, on the Ohio River 
near Cincinnati, drew more than 2,500 patients in 2003, with 94 
percent of them coming from Ohio and Kentucky.

The company bought the Jeffersonville clinic in December 2003. It 
also owns clinics in Evansville, Indianapolis and Richmond -- it 
doesn't operate in Kentucky -- and it describes itself as the 
nation's largest provider of treatment for substance abuse.

Phil Herschman, who oversees the company's network of 49 methadone 
clinics, said Jeffersonville is CRC's second-busiest site, behind 
only Lawrenceburg.

Differences In State Rules

Tight methadone restrictions in Kentucky and Ohio have fueled demand 
at the Indiana sites, Herschman said. But he argued that Indiana's 
rules are adequate and that they meet all federal guidelines. He also 
said the company is striving to expand treatment options and that 
there is at least one counselor for every 50 patients at the clinic.

"There's a tremendous amount of myths and stigma about methadone 
treatment," Herschman said in an interview, adding that the current 
expansion plan is one of several options being considered to serve 
more customers. "Before we make a move, we would want to meet with 
the community and develop some support for the location."

Herschman also said concerns about crime and drug sales at methadone 
clinics are overblown. He pointed to statistics showing that drug 
addicts are 50 percent to 70 percent less likely to commit crimes or 
visit an emergency room after they begin methadone treatment.

Views About Clinic Vary

In fact, views about the Jeffersonville clinic, at 1713 E. 10 St., vary widely.

Ron Grooms, a pharmacist who is president of the Jeffersonville City 
Council, said the clinic has not created a major crime problem over 
the years. And he said the vast majority of patients seem to be 
law-abiding and on the road to a healthier lifestyle.

But several of the clinic's patients said drug-dealing regularly 
occurs in the area. Anthony Evans, a recovering OxyContin user who 
lives in southern Louisville, said he is approached by someone 
selling drugs in the clinic's parking lot at least once a week.

And Thompson, the police detective, said there have been numerous 
complaints over the years about patients selling methadone and 
prescription drugs in the area. Some of the complaints have resulted 
in arrests, he said.

"It's not that we're not compassionate," Thompson said of the clinic 
and its patients. "Maybe that is the best alternative that they have, 
to get help for their problems. But we're no different than any other 
community. We want to look out for our community first."
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MAP posted-by: Elizabeth Wehrman