A CLINIC'S SILENT RUNNING

A Methadone Clinic In Coatesville Operates So Quietly, Its Neighbors Don't
Notice

COATESVILLE - When the night sky starts hinting at sunrise, before
the McDonald's sign lights up across the street, a half dozen people
sit in their cars and wait for the doors to unlock.

By 5:30 a.m., they can come in.

A bright blue-eyed blonde in leggings and a fleece sweatshirt checks
in with the receptionist.

"You're here early," the reception ist tells her.

"There's tons of construction on Route 202," the woman explains.
"Otherwise it would take an hour and a half to get here."

The young woman heads down a hall to a counter where a nurse behind a
window asks her name and identifies her face over a computer screen.
Her faces matches the one shown on the computer, so he checks her
prescribed dose, pours a small amount of red syrup into a cup and
slides it under the plastic window.

She drinks this. Then he hands her a cup of water. She drinks this to
prove she has swallowed her methadone, an opiate treatment designed to
keep her off heroin.

That daily chore tackled, she's out the door and commuting to
work.

While dozens of patients silently stream in and out of the building by
8:30 a.m., the surround ing neighbor hood continues to sleep and
prepare for the day.

Advanced Treatment Systems opened the clinic on Business Route 30,
just east of Coatesville, last May. Residents here in Chester County's
Caln Township experienced little rancor over the clinic's presence in
their working-class neighbor hood.

The company already operated a clinic in Fayetteville, N.C., and plans
to open another on South Queen Street in Spring Garden Township. The
plan for the York County clinic has drawn protest from neighbors who
say it will bring crime, drug dealers and sinking property values.

The trim, one-story building that ATS rents in Chester County, one and
a half hours from York, hardly looks like a place that would attract
people recovering from the throes of heroin.

There's no neon sign. It's next to the rush and roar of traffic headed
to a Superfresh grocery store, Downingtown Bank, McDonald's and a
nearby Laundromat. A block of row houses, called Brandywine Homes,
line a street to the northeast. The U.S. Census Bureau shares space
in the back of the clinic's 2,700-square-foot building.

"I think most people don't know who they are or what they do," Caln
Township Police Chief James Franciscus says Friday afternoon.

Franciscus has seen neither an increase nor decrease in crime since
ATS renovated the building. He said the only concern neighbors had in
the beginning was that the clinic was close to the area's vo-tech,
middle and high schools. That concern since has faded.

The clinic's Coatesville address is the former location of an
architectural firm and a juvenile counseling center. Neighbors have
become used to traffic quietly moving in and out of the lot, much as
it does at the bank next door.

Tammy Seachrist, manager of the McDonald's, says she didn't know there
was a methadone clinic across the street until three months after it
opened.

"I just saw people going in and out, in and out," she
says.

Inside the building, the layout is much like any medical
office.

The lobby is filled with chairs and copies of U.S. News and World
Report. To the right and left are offices for the counselors. Straight
back, the nurse dispenses methadone from a window that looks like one
in a grocery store pharmacy.

The methadone is locked inside the pharmacist's booth by a secured
door and a barred window. A monitor below the nurse's counter
broadcasts a static view of the hallway bathroom. By state and federal
law, the nurse has to monitor patients while they submit urine samples.

A line does form inside the building for patients waiting for doses,
but it doesn't stream outside.

Executive Vice President Jeff Kegley walked to the front door early
Friday morning and looked out at the lot filled only with cars.

"There is still a definite lack of criminal activity in the parking
lot," he announces with a smile. Kegley says he's surprised by the reaction in
Spring Garden Township: "We're not used to all this attention." He says the
York
County clinic would be run much as the one in Coatesville.

The clinic is staffed with seven employees, including a doctor,
nurses, counselors and office staff.

Patients pay a $100 fee for their initial intake. This covers a
physical examination, lab fees and counseling. After that, they pay
$70 a week or $10 a day to get their daily dose of methadone and
weekly hour of counseling.

Clinicians regularly screen the patients' urine to check for continued
or relapsed drug use.

In the beginning of their treatment, many patients will come in
showing the signs of withdrawal, Kegley says.

They will have runny noses and appear to have the flu. He says rarely
do patients come while suffering from the muscle spasms, nausea and
vomiting that accompany severe withdrawal.

Another dosing is offered at 11:30 a.m. for about 10 other patients
who work late or cannot make it in earlier. Generally, the clinic's
day is over at 3 p.m., but the bulk of its business is done before
8:30 a.m. The clinic is open seven days a week.

While the clinic's clientele has grown from 50 patients to about 125,
business around the area has grown, too.

A Rita's Water Ice and Ritzo's Pizza moved in two doors down, and
McDonald's added a Playland playground, says Larry Brown, whose house
backs up to the clinic's property.

He says he has friends who go to the clinic and is glad to see there
is someplace helping them.

"People don't hang around on the corner or anything. If they were to
do some trouble, they'd take it over there," he says, pointing to a
railroad bridge west of his Brandywine Homes neighborhood and toward
downtown Coa tesville.

He says he hasn't heard any neighbors talk about the
clinic.

County assessors say there has been no fluctuation in property values
over the last year for the area surrounding the clinic.

"Apparently, it's not a hot issue at this level," says Mark Sibert,
chief assessor for Chester County.

But just because people haven't talked about the clinic doesn't mean
they accept its presence.

"I would have a hard time with it, too," Kiss-Me Butterfield says
after learning of the York County controversy.

The Cheyney University senior found out there was a new methadone
clinic in Coatesville when she came home to Brandywine Homes for
spring break. Butterfield wasn't pleased with the news and said she
would have protested if she had known last year.

"We didn't have that opportunity," she says.

Karen Engle, who used to work at the Eckerd drug store behind the
clinic, says she worries about elderly people who walk by the clinic
to the Superfresh, where she spent the morning pushing her niece
around in a cart.

She says she wouldn't want to live near the clinic. But Engle didn't
develop her opinion about it until she learned of its existence on
Friday, almost a year after it opened.

"Do they live in there?" she asks. "Is it a rehab?"

Staff writer Jim Lynch contributed to this report.