REGULATIONS ARE BETTER, BUT SCRUTINY WARRANTED

An examination by state and federal authorities of a methadone clinic in
Grand Bay is appropriate in light of the death of a patient who was being
treated there. And while the state's regulation of such clinics deserves
review as well, it should be noted that the Department of Mental Health and
Mental Retardation has improved in that regard in recent years.

Richard Mitchell Shrum died last fall of what is described as methadone
intoxication, three days after he started treatments at Gulf Coast
Treatment Center. His family said the 24-year-old college student was
trying to kick an addiction to a prescription painkiller. Methadone at one
time was used primarily to treat heroin addicts, but today is also used for
other addictions and sometimes for pain management.

The Grand Bay case recalls that of the Baldwin County Treatment Center in
Elberta, which operated from 1993 to 1999 amid complaints from town
residents and, eventually, from a Baldwin County grand jury that
recommended it be shut down.

In a town of about 500 residents, the Elberta clinic treated 200 to 250
drug addicts at a time, many of them from across the state line in Florida,
where methadone clinics were much more tightly regulated. Residents and
town leaders complained about a variety of petty crimes they blamed on the
patients. Business operators said customers avoided their establishments
during clinic hours.

In 1997, after a clinic patient struck and killed a 14-year-old boy riding
a bicycle near Lillian, the grand jury concluded that the methadone clinic
at that location poses a clear and present danger to the people of Baldwin
County.

State Rep. Steve McMillan, R-Bay Minette, introduced legislation that would
have required new methadone clinics to get a certificate of need from the
state. The bill did not pass, but in 1999 the Elberta clinic moved to
Pensacola after town officials threatened its business license. Since then,
the state mental health department has tightened its regulation of
methadone clinics, including requiring a certificate of need for new
clinics, according to a spokesman for the department. However, the
seven-year-old Grand Bay clinic was grandfathered out of that requirement.

Other new regulations included increasing the number of hours a physician
has to be present, requiring a registered pharmacist on staff, lowering
staff-patient ratios, and increasing restrictions on take-home medications.

Still, the death of Mr. Shrum and what state officials admit is an
increasing number of complaints about methadone clinics merit a
re-examination by state and federal authorities. State officials say their
inquiry may be expanded to include other deaths that may be related to
methadone clinics.

The owner of the Grand Bay clinic says it is not responsible for Mr.
Shrum's death but that she welcomes a state review.

For-profit methadone clinics remain a subject of controversy in Alabama,
and the treatment of drug addictions of any kind merits continued close
scrutiny by state and federal health authorities. And the results of the
inquiry should be made public.