HONEYMOON MAY BE OVER FOR METHADONE CLINICS IN CENTRAL 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.

Some 300 people, many carrying anti-methadone placards, protested outside
Middlesboro City Hall this month, signaling what may be an end to the free
pass the 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 the 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 a magnet for addicts
from other parts of central Appalachia, including southwestern Virginia,
which currently 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
heroine 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.

Ed Ohlinger, regional director for outpatient services in Virginia for CRC
Health, said some rural residents have to drive up to four hours round trip
to get methadone because their communities don't want such clinics.

Residents in Abingdon, Va., were successful in a fight to keep a methadone
clinic out of their town, and community and political leaders in Dryden,
Va., now are battling a proposed clinic there. Residents in Roanoke, Va.,
and Wheeling, W.Va., fought unsuccessfully to keep clinics out.

"I think with many people there's still misunderstanding," said Merritt
Moore, adult treatment coordinator in the West Virginia Division of
Alcoholism and Drug Abuse. "They don't understand the effectiveness of the
treatment."

Virginia has about 20 methadone clinics, three of which are in the
mountainous western part of the state in Cedar Bluff, Galax and Roanoke.
Denise Clayborn, a consultant to Virginia's state drug-abuse program, said
the moratorium on new clinics will remain in place until a review is
completed to determine if regulations on methadone clinics are adequate.

The number of methadone clinics have 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.

Dubin said he believes some clinics have opened without opposition because
residents didn't know about them until it was too late. He is lobbying for
a state law that would bar methadone clinics from opening within a mile of
a school or daycare center and would require the state to publish notices
in newspapers in communities where methadone clinics are proposed.

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

"The misinformation has escalated into something totally out of hand," she
said. "We're trying to get facts out to the people."

The fact is, Smith said, the clinic is needed to help treat addicts in the
Middlesboro area. Amanda Turner, 26, said she has to drive more than two
hours roundtrip from Middlesboro to a clinic in Corbin each morning to get
a dose of methadone.

Sherry Turner, the young addict's mother, is one of the strongest
supporters of the clinic, and she has been trying to persuade others to
drop the opposition.

"Methadone seems to be the only thing helping my daughter," she said. "I
would prefer her not to have take anything, but I'd rather her have
methadone than be out here trying to get drugs off the streets."