CLINICS FOR DRUG ADDICTS EMBRACED

Appalachian Sites Address Epidemic Of OxyContin Abuse

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

Residents and political leaders, grappling with an epidemic of Oxy-Contin
addiction, have welcomed at least 10 methadone clinics across the region in
towns that previously had none.

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

Police Chief Doug Wallen said he expected an outcry when Paintsville's
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.

"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."

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.

In some communities outside Appalachia, methadone clinics haven't been so
warmly welcomed. An attempt to open one in Covington 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.

Former Paintsville Mayor Robin Cooper said he expected at least some
opposition when word got out that a methadone clinic had applied for a
business license. 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 last month. "We've got a problem in Eastern Kentucky that
has to be dealt with."

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

"It's pretty alarming to think so many people need treatment to make those
clinics profitable," Cooper said. "They're not here out of the goodness of
their hearts. They're here to make money."

Dr. Stephen Lamb, a Lexington psychiatrist who works with addicts, said the
epidemic of OxyContin abuse brought on a crisis that Kentucky wasn't
equipped to deal with. Lamb said methadone has allowed the addicts to get
on with their lives, and the clinics have made that form of treatment
possible for those living in the most isolated mountain communities.

Many people were driving up to four hours round trip each day to get to a
methadone clinic outside the region.

Michael Townsend, head of the substance-abuse division of the Kentucky
Cabinet for Health Services, said the methadone clinics opened in the
smaller cities 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 substanceabuse counselor for Paintsville Professional
Associates, said methadone is key in the fight against the OxyContin epidemic.

Before the methadone clinic opened in Paintsville, Rectenwald worked for
public substance-abuse agencies that could not provide the drug.

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."