Published: December 29, 2006 12:26 pm            

Charleston trip doesn’t end Methadone clinic debate

PRINCETON — The decision on a Mercer County methadone maintenance clinic rests with the West Virginia Health Care Authority, but that has not stopped the debate both for and against the proposed center.

The debate actually began three years ago, when CRC Health Group filed an application for a certificate of need to administer methadone treatment on an out-patient basis in Mercer County. A subsequent, state-wide moratorium on the establishments then put all clinic applications on hold throughout West Virginia.

When that temporary ban lifted, CRC did not immediately file the application again. Then, last summer, the June 18 edition of the WVHCA ran a notice that CRC had filed again for the certificate of need in Mercer County. An Aug. 24 hearing date was slated in Charleston to address public concerns and arguments from affected parties. In keeping with HCA regulations, that notice was also published in a Charleston newspaper and the State Register, but it went unnoticed by local leaders and residents until the week before the session, a time that left local opposition little time to prepare for the hearing.

Del. Marshall Long brought the situation to light locally, prompting a swift outcry from the Princeton-Mercer County Chamber of Commerce and some local physicians.

Some clinic opponents sought a delayed hearing in Mercer County. HCA refused to relocate the session but granted the delay, designating Nov. 28 as the day to address the Mercer application.

In the meantime, supporters and opponents rallied their troops.

Law enforcement officials from the Mercer County Sheriff’s Department, the Princeton Police and the Southern Regional Drug and Violent Crime Task Force all spoke out, calling for more regulation and better cooperation between clinics and law-enforcement officials.

Clinics responded that federal confidentiality laws prohibited them from sharing treatment information and that MMT was among the most highly regulated therapies in the country.

MMT clinics, such as the ones operated by CRC Health Group, administer methadone, a synthetic opiate originally created as a painkiller, to stave off the cravings of withdrawal symptoms from other opiates.

After time without a drug of choice, a person addicted to heroin, OxyContin, hydrocodone, Dilaudid or others, will begin exhibiting signs of withdrawal — anxiety, extreme restlessness, trembling, nausea and more. A therapeutic dose of methadone reportedly will not cause those people to get the high typically associated with their drugs of choice, but it will keep them from going into withdrawal.

Local leaders said the clinic would only draw more addicts to the area, but CRC representatives refuted that theory.

“Substance abuse knows no boundaries. Patients at our Beckley clinic come from all walks of life — housewives, construction workers, lawyers, healthcare providers, etc. Most have high school educations and some college education. Most are employed and pay for their treatment entirely out of their earnings. They are already residents of Mercer County,” Casey Bragg-Aust, Director of the Beckley Treatment Clinic, wrote in a letter to The Princeton Times in November.

Even Princeton Senior High School students became involved in the debate, choosing the clinic as one of the area agenda items they hoped to address during Student Government Day. They unanimously opposed the clinic.

A delegation of more than 30 Mercer County citizens and leaders rode to Charleston on Nov. 28, to speak on the issue they said would reshape their community, possibly hurting the business environment, attracting crime and increasing methadone-related deaths. Besides CRC officials, no one who attended the session from Mercer County spoke in favor of the center.

At the conclusion of the day-long event, HCA Assistant Counsel Cynthia Dellinger advised a decision would be months in the making.

That did not stop area people from speaking for or against the clinic as time wore on.

Since late November, the Princeton City Council has approved a resolution opposing the MMT clinic and ordered that a copy of the resolution be forwarded to the HCA for inclusion in the Mercer application file if possible.

An MMT patient, Paul Gibson, contacted the Princeton Times, advising people considering methadone to treat addiction to think twice.

“I wish I’d never seen a methadone clinic,” Gibson said. “I’ve been going to a clinic for more than four years, and I’m not a bit better off today than the day I started.”

Now addicted to methadone, Gibson pleaded for other detoxification alternatives.

His story prompted another, equally vehement response from a Princeton Times reader, who expressed interest in sharing her methadone success story. Holiday scheduling had prevented an interview at press time, but she wrote, “I have quit methadone, twice, so I can probably give you a better total picture if you are interested, as well as to offer hope to the many addicts such as your interview subject who are now taking methadone and have no clue how to get off of it.”

And, Addiction Counselor Rick George also wrote the Princeton Times with an op-ed piece he titled, “The pros and cons of methadone treatment.”

He encouraged both sides of the issue to set aside emotional preferences and look at the root of the debate: addiction.

“Addiction is a brutal beast, or as others have put it, a disease, much like the HIV virus that invades its host, cloaks itself and learns its victim inside and out only to bring about a slow, humiliating and painful death. Addiction treatment must encompass the necessary elements of compassion, patience, confrontation and the knowledge of when to intervene and when not to intervene in order to be successful. This is a balance which is in a constant state of tension and never a formula or technique which one may possess or grasp. The nature of addiction with its desperation, deception, manipulation and tenacity makes treatment an ominous and hard fought endeavor,” George wrote.

Although George currently works for a methadone maintenance clinic, he wrote that similar centers are not right for every community.

“In short, if opiate abuse is rampant in your community, you should be asking yourself why you do not have a methadone maintenance program available. If you do not have treatment facilities nearby you may need to have an inpatient clinic which also offers outpatient and detoxification services. However, if you already have adequate facilities in nearby towns, you may not want the hassle of bringing in an outside, for-profit clinic. You may want to simply coordinate care between already existing agencies and have them adhere to strict, specific guidelines for treatment and referral. Make sure that they are adequately staffed. Keep in mind that there are state and federal guidelines which pertain to the handling and distribution of methadone. Methadone treatment is an option, but it is only a handrail on the steps to recovery,” he wrote.

At year’s end, the debate continued, and the decision on the Mercer clinic was still out.

— Contact Tammie Toler at ttoler@ptonline.net.

        

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