PROTEST OF METHADONE CLINIC MARKS CHANGE IN APPALACHIA

MIDDLESBORO, Ky. (AP) - Faced with increases in violent crime that came
with widespread drug addiction, some of the hardest hit communities in
central Appalachia wanted help so badly that they embraced even methadone
clinics.

No more.

About 300 people, many with anti-methadone placards, protested outside
Middlesboro City Hall last week, signaling what may be an end to the free
pass that clinics have enjoyed in the mountain region since illegal
trafficking in the painkiller OxyContin began wreaking havoc about five
years ago.

Mac Bell, state narcotic authority administrator in the Kentucky Cabinet
for Health and Family Services, said opposition to the Middlesboro clinic
has been overwhelming. "This is the first time in my history that we have
had such a public outcry, and I've been doing this for 22 years," he said.

Dr. Ronald Dubin, a physician who leads a group involved in the Middlesboro
fight, said a methadone clinic would make the city near the Tennessee
border a magnet for addicts from other parts of central Appalachia,
including southwestern Virginia, which is under a state-imposed moratorium
on new methadone clinics.

"The location is terrible," Dubin said. "It's the worst location in the
city to put up a methadone clinic - one block from a Catholic school, three
blocks from a public elementary school, and right in the middle of a
shopping area."

A dose of liquid methadone once a day helps addicts escape their cravings
for illegal drugs and avoid withdrawal symptoms. Although patients do not
get high when they use the drug properly, they do become dependent on it.

Clients pay about $85 a week for methadone, drug screening and counseling
at the clinics. One OxyContin pill purchased on the black market can cost
that much.

For some communities, methadone was a welcome alternative to OxyContin,
which drug addicts crushed and snorted or mixed with water and injected to
get the same kind of euphoric high that heroin brings, thus its nickname
"heroin of the hills."

In the past five years, clinics opened without opposition in five eastern
Kentucky towns and seven West Virginia towns.

When used for treatment of addiction, methadone can be dispensed only in
the special clinics.

The number of methadone clinics has grown nationwide from 775 to 1,100 over
the past 12 years, according to the American Association for the Treatment
of Opioid Dependence in New York. The number of people being treated has
grown from 115,000 to 205,000 over the same period.

Barbara Smith, co-owner of the proposed Middlesboro clinic, said it could
initially serve up to 120 clients who would drive in everyday to swallow a
liquid dose of methadone. She said these would be people trying to kick
addictions, not drug-crazed criminals who are a danger to the community.