NO ONE WANTS A DRUG CLINIC

Communities fight to bar methadone treatment centers

There is a universal truth to remember when opening a methadone clinic for
the treatment of heroin addiction in a community setting.

No one wants it.

"You can't ram it down anyone's throat," said Iburia Scott-Johnson,
director of a methadone clinic operated by St. Francis Health Center on
Kelly Street, Homewood, since 1981.

To pave the way for St. Francis to open the clinic 20 years ago,
Scott-Johnson knocked on doors of neighbors in Homewood, held community
meetings, and sought the support of everyone from community leaders to
local ministers. She hired security guards and set up regulations
forbidding loitering among the some 200 clients who stop by each day to get
a dose of methadone, a synthetic drug that suppressed withdrawal symptoms
from opiates including heroin, prescription drugs, painkillers and cough
suppressants.

She even gave her phone number to neighbors in case they saw something
suspicious.

"I would not dare to attempt to go into a neighborhood without meeting with
neighbors," said Scott-Johnson, who operates a clinic that she contends is
strictly monitored and open to only clients who have tried -- and failed --
at every other treatment for heroin addiction.

"Our philosophy at St. Francis is that you must have tried everything else
to get off heroin before coming to a methadone clinic," she said.

Other treatments include hospital-based detoxification and residential
rehabilitation or outpatient treatment at such places as Gateway
Rehabilitation Center in Aliquippa.

"This is the last resort. Methadone is a serious step. Methadone is an
addictive substance."

St. Francis Health Center is one of five entities licensed by the state
Department of Health and operating in Pittsburgh. Its clinic is in a
free-standing building at 6714 Kelly St., in the heart of Homewood.

Others that operate methadone clinics are: Tadiso, formerly operating as
PBA Inc., which operates a clinic on Beaver Avenue in Manchester;
Progressive Medical Specialists Inc. at 2900 Smallman St. in the Strip
District; and Discovery House at 1391 Washington Blvd., East Liberty.

The newest methadone clinic, a for-profit clinic operated by Alliance
Medical Services, is at 729 Ensign Ave., a dead-end street off Route 51 in
Bon Air. It was licensed by the state Department of Health on Dec. 8.

On Jan. 4, Amy Montgomery of Brookline, then a candidate for City Council
District 4, led a group of residents of neighboring communities of
Brookline and Overbrook who tried to get Alliance Medical Services'
occupancy permit revoked, but failed to do so. Initially, they were going
to give up, but now Kevin Cagni, one of their leaders, said they may try to
file an appeal with the Allegheny County courts. They have 30 days to try
to challenge it.

'Too few' programs

With heroin use on the rise, there are more methadone clinics opening
nationwide than ever before.

Methadone is a synthetic drug used in medicine to treat persons who are
addicted to heroin or prescribed painkillers such as Percodan, Percocet or
Oxycontin

Methadone is prescribed to addicts to relieve withdrawal symptoms and
reduce opiate cravings. It is dispensed daily to those who are addicted.

Studies done by the National Institute on Drug Abuse and other national
organizations report that when methadone is properly prescribed, it is not
intoxicating or sedating, and its effects do not interfere with ordinary
activities such as driving a car.

Former drug czar Barry McCaffrey, a strong supporter of methadone as a
treatment for opiate addiction, estimates that only about one-eighth of the
estimated 810,000 opium-addicted individuals are participating in methadone
maintenance programs.

"The problem isn't that there are too many methadone programs; it is that
there are too few," McCaffrey has said.

Critics say the methadone clinics are concerned more with making profits
than with helping wean heroin addicts off the addictive drug. Locally,
methadone treatment costs about $90 a week. Sometimes it is covered by a
medical plan or public funding; sometimes the client pays.

But when the clinics open, they usually create controversy and spawn
community opposition.

Generally, opponents are afraid that the clinic will bring undesirables to
their neighborhood. They fear that people who stop by to get their doses of
methadone will cause more traffic accidents, because they may be mixing
methadone with other drugs. They fear that the clinics will be targets of
break-ins or thefts by people who want to gain access to methadone.

And there have been problems in some clinics.

In Portland, Ore., home to a growing number of heroin addicts, several
methadone clinics have been shut down by authorities because of a long
history of questionable management practices, issues about maintenance and
staff accreditation, and after one client suffered a fatal methadone
overdose, the Business Journal, a local publication, reported in 1999.

In some communities, police have supported residents who want to keep
methadone clinics out, but generally, police don't see methadone clinics as
magnets for criminal activity.

City police Cmdr. William Valenta of the Hill District zone said he hadn't
received any complaints about crime problems caused by the methadone clinic
on Smallman Street, also in an industrial district.

"In the two years I have been here, I haven't had a member of the community
call and say that because of that methadone clinic, there is a problem,"
Valenta said.

To deter theft of methadone, a valuable drug, the federal Drug Enforcement
Administration requires methadone clinics to have well-monitored security
systems. Stephen Shaner, a partner in Alliance Medical Services, said his
new clinic installed what the DEA required and "went beyond that."

Scott-Johnson said her clinic employed security guards who have extensive
state-mandated training and who make sure clients don't hang around after
getting their drugs.

"You will not loiter here. You come in and get your methadone and leave,"
she said.

Most have jobs

In recent years, municipal officials in the South Side, Braddock, Castle
Shannon, Edgewood and Regent Square, North Huntingdon and West Homestead
all have blocked methadone clinics from opening in their communities.

Some communities enacted laws to restrict where clinics can do business.

For example, Braddock, enacted an ordinance in June that limited the
location of methadone clinics to an industrial area near the Monongahela
River and required all methadone clinics to be 2,500 feet from each other.

In the South Side, residents were able to block a proposed clinic on South
Sixth Street in 1998 because it was planned for an area that was zoned M-4
for manufacturing, which allowed medical facilities only if they were to
serve people who work in the immediate area. The city zoning board of
adjustment used its discretion to decide that the clinic wasn't an
appropriate use.

Daniel Bienstock of Squirrel Hill, who unsuccessfully tried in recent years
to open methadone clinics in the South Side, West Homestead and North
Huntingdon, now has proposed opening a methadone treatment facility on
Route 286 in Plum's commercial district. Plum council has scheduled a
public hearing for 6 p.m. March 12.

The newest methadone clinic on Ensign Avenue in Bon Air is located in a
neighborhood industrial district, which allows medical offices and clinics.

On Jan. 4, Clifford Levine, chairman of the zoning board of adjustment,
told opponents of the Ensign Avenue clinic that the board had no discretion
to revoke its occupancy permit.

In Pennsylvania, Act 10, a new state law passed in 1999, bars methadone
clinics from being established or operating within 500 feet of an existing
school, public playground, public park, residential housing area,
child-care facility or church.

Shaner said it was difficult to find a location for a new clinic because of
the restrictions established by state Act 10.

He said Ensign Avenue seemed like a perfect location. It is a dead-end
street that is accessible by Route 51. Although it is technically in Bon
Air, Ensign Avenue is a no-man's land, not really part of any community.

There are no homes there -- only a couple of businesses. The clinic moved
into a building that formerly housed Wild Thingz, a club where police had
made arrests for prostitution and obscene performances last year.

"We measured everything," Shaner said, adding that according to
calculations done for his organization, the clinic was far enough away from
schools and homes to meet the 500-foot requirements of the state law.

Shaner and his partner, Mark Raymond of South Park, got an occupancy permit
with no problem. But when residents found out, they felt as if that clinic
had "sneaked" into the community, said Cagni, an opponent.

The residents are fearful that the clients who make daily visits to the
clinic might loiter around it, might be using other drugs or not be sober
enough to drive. They contend that the clinic is within an easy walking
distance, up a path through the woods, to several schools and a public park
in Brookline and that the methadone users might wander into those parks or
drive up the side streets into Brookline.

Cagni said the clinic sat right in front of a piece of land along the south
busway that Mayor Tom Murphy has earmarked for what the mayor has called
his "last great park," a greenway that would use a railroad right of way
for a park and bicycle trail through the city's southern neighborhoods.

But Murphy's spokesman, Douglas Root, said the mayor's office "doesn't see
any way that this clinic could cause any hindrance to the plans for a park."

Root said the clinic was not in a residential or recreational area. It is
monitored frequently and, "We have received no complaints about any
activities."

Local methadone clinics are privately operated, but licensed and monitored
by the state Department of Health and the federal Drug Enforcement
Administration.

Shaner, former executive director of the Washington-Green Drug and Alcohol
Planning Commission, said the clinic was seeing about 50 clients each day,
but was licensed to dispense methadone to 105 clients. He said each client
must receive counseling before and during the time the methadone is prescribed.

"To get in here, you must have tested positive on a urinalysis and have it
confirmed by a physician. And you have to have a one-year addiction," he said.

Clients visit between 5 and 11 a.m., and spend about five minutes receiving
a dose of methadone from a registered nurse.

"The nurse shows you the pill, dissolves it with Tang and watches you
consume it," Shaner said.

Shaner said the people who visit the clinic are not vagrants or drifters.

"You would never pick these people out of a crowd. They are the people in
your community," Shaner said.

Government studies show that seven out of 10 people who use illegal drugs
have full-time jobs.

Former drug czar McCaffrey said studies show that when methadone is
properly administered, it "reduced participants' heroin use by 70 percent,
their criminal activity by 57 percent and increased their full-time
employment by 24 percent."