CLINIC DIRECTORS DEFEND METHADONE TREATMENT

TAZEWELL, Va. - They are 18 to 75 years old. They are coal miners, teachers,
nurses and administrative staff workers.

They have shared the same symptoms: muscle cramps, chills, sweats, diarrhea,
vomiting blood.

In total, there are almost 700 patients at Life Center of Galax's Tazewell
office attempting to wean themselves off opiate abuse. They travel here from
52 surrounding counties each day to kick their opiate addictions through
methadone in a controlled environment.

Methadone is a synthetic narcotic that blocks opiates from the brain's
neural transmitters, diminishing cravings and preventing the euphoric
feeling of opiate use.

"Addiction doesn't respect who you are, what you make, your color or
religion," said Dr. Maria Encarnacion, the Life Center's medical director.
"People don't get up one morning and say, 'Gee, I want to be an addict.'"

According to Encarnacion, the overwhelming majority of addicts coming to
Life Center methadone clinics in Tazewell and Galax are not heroin abusers,
as in large metropolitan areas. Rather, she said OxyContin is the drug of
choice for many patients she serves.

Encarnacion said many of their methadone patients have become addicted to
opiates prescribed after surgery. Life Center encourages patients to have
steady jobs and holds counseling sessions with their entire families to
facilitate healing from all angles.

"We teach them skills so they can be good husbands, wives, parents and
hopefully go back in to the community," Encarnacion said. "They can go see
their son or daughter play Little League and basketball or participate in
PTA again."

About 20 percent of Life Center's methadone patients reach full recovery,
Encarnacion said, meaning they get off methadone and other drugs for good.
Of the other 80 percent, some drop out and later return, some leave to never
be seen again, and others keep taking methadone on and on.

It's the latter that evokes much criticism from opponents of methadone
clinics. They say it is exchanging one drug for another.

Encarnacion agrees that is indeed the case. However, she said patients in
methadone clinics are distancing themselves from illegal activity. Through
supervised methadone management, patients are able to control their pain and
cravings and become productive members of society, she said.

"It gives them an opportunity have quality of life changes," Encarnacion
said. "If people get to the point where they feel their life is back to
normal and want to come off the methadone, we strongly encourage that. It
just needs to be a slow process so their body can adjust to that."

Methadone in the Life Center clinics is dispensed in liquid form, not pill
or wafer. The Tazewell clinic's executive director, Ed Ohlinger, said this
reduces the chances of methadone getting in the wrong hands.

To further deter criminal activity, the clinic's parking lot is watched by a
security person during hours of operation, 5 a.m. to 4:30 p.m., seven days a
week. Patients are not allowed to talk or hang out in the parking lot.

"The misconception of us bringing criminals to communities is just not
true," Ohlinger said. "We do a very good job of making sure people don't
hang around and have the opportunity to do things like that."

Patients can also earn the privilege of take-home doses of methadone in
locked security boxes. However, the patient must have urine tests absent of
illicit substances, regular clinic attendance and counseling, a good home
environment, no recent criminal activity, and be employed, disabled, retired
or a homemaker.

For about $11 a day patients pay for their dose of methadone, all urine and
blood screenings, annual physicals, and group, individual and family
counseling sessions.

Encarnacion said public fear and contempt of methadone clinics is forged in
ignorance.

"Most people that have never used drugs will look at a person on drugs and
go, 'Why can't you quit? I quit smoking cigarettes. I gave up the bottle.
Why can't you?' They don't understand addiction, the cravings and side
effects."