PATIENT COUNT LOW SO FAR AT NEW METHADONE CLINIC IN COUNTY

A new methadone clinic in Clark County is getting off to a slow
start.

Vancouver Treatment Solutions, tucked away at 2009 N.E. 117th St.
behind Ricky's Pool and Spa, opened without fanfare in late January.
To date, it serves just 17 patients.

That's not unusual, says acting clinic director Dave Cush; most
methadone clinics start small and build their clientele through word
of mouth.

Last year's furor over the clinic's siting near Salmon Creek Park has
died down; these days, the main disruptions in the commercial and
industrial zone where it is located are caused by the widening of
117th Street in front of the clinic and the replacement of two
Interstate 5 bridges over Salmon Creek.

CRC Health Corp., the California-based company that operates the
Vancouver clinic, is the nation's largest chain of opiate addiction
treatment clinics. The company agreed to give The Columbian a tour,
but only at a time when no clients were present, to protect patient
confidentiality.

The clinic is spacious, well-lit, comfortably furnished and empty.
Even during the hours when methadone is dispensed, 5:30 a.m. to 11
a.m., there's almost never a wait, said receptionist Melissa Gladden.

So far, the clinic staff consists of Cush; Gladden; Mary Camacho, a
licensed practical nurse who dispenses the methadone; a second nurse;
a full-time counselor; and a consulting physician. But the staff is
likely to grow to fill all those empty offices.

The clinic was designed to handle up to 350 clients, a figure based on
projections of the unmet need for opiate addiction treatment in Clark
County. The county's first methadone clinic, operated by Columbia
River Mental Health Services, serves a mix of private-pay and Medicaid
clients at its Northeast Fourth Plain Boulevard location.

Nationwide, CRC Health has been designated as a preferred health care
provider by more than 600 insurance companies, managed care
organizations, labor unions, government agencies and businesses.

But the company has not yet negotiated contracts with insurance
companies to provide coverage for pain pill or heroin addiction at the
Vancouver clinic, Cush said. All its current patients are paying out
of pocket for treatment at a cost of $11 per day or $310 per month.

Strict Regulations

Because the clinic dispenses an addictive synthetic opiate, it
operates under strict state and federal regulations. For example,
staff members must test patients' urine for the presence of drugs
other than methadone at least eight times a year. In the early phases
of treatment, however, urinalysis happens much more frequently, said
Camacho, a registered chemical dependency counselor since 1968.

The clinic is equipped with the latest security technology, including
computer software that allows Camacho to match a patient's photo to
the person standing on the other side of the dispensing window. Each
day's supply of methadone is removed from a heavy metal safe with dual
locks; each dose of the liquid is dispensed in silence and consumed by
the patient at the window while she watches.

Cush said the clinic's clients so far break down into three groups:
those specifically addicted to pain pills like Vicodin and Oxycontin,
those specifically addicted to heroin, and those addicted to a mix of
substances.

"We see a lot of people who started on pain pills due to chronic
pain," he said. "We have patients who never used any illegal drugs.
Their problems started after surgery," when they could no longer get
refills on their pain pill prescriptions, he said.

Weekly individual counseling sessions for the first 90 days are part
of the treatment regimen.

'Watching and Waiting'

Opponents of the clinic site are taking a wait-and-see attitude, said
Elizabeth Thomas of Friends of Salmon Creek, a group formed to oppose
the siting of the clinic near the park and schools. Opponents
organized community meetings, lobbied county and state officials and
held a protest against the clinic site.

In response, CRC Health President Philip Herschman appointed an
advisory group of community members, agreed to listen to neighbors'
concerns, especially about the safety of children, and said the
company would consider alternate locations.

In November, the state Division of Alcohol and Substance Abuse granted
the clinic its certification at the original site, and Clark County
issued an occupancy permit. CRC agreed to hire security guards and
install security cameras, a concession it has not made at its other
Washington clinics.

Thomas said she hopes for the best but continues to have concerns
about the clinic.

"We're watching and waiting," she said. "Seventeen (patients) is not a
lot. They are allowed to go up to 300 or 350 patients. I'm very
curious to see what is going to happen. The numbers aren't there yet,
the park isn't busy yet. When they get up to 150 clients, that might
be the time to draw a conclusion."