BOARD VOICES SERIOUS CONCERNS ABOUT PROPOSED METHADONE CLINIC

BRISTOL, Va. - Members of a local health agency's board said Thursday they
have some serious concerns about a proposed methadone clinic but did not
take a definitive stance against it.

Clinic operators from South Carolina have asked Washington County for
permission to open a clinic in Lowry Hills subdivision near the county-city
line.

Subdivision residents, county supervisors and state legislators are opposed.

Members of the Highlands Community Services Board, the government health
agency charged with providing substance-abuse treatment in Bristol and
Washington County, said they would draft a letter outlining their concerns
to be sent to the Board of Supervisors, County Administrator Mark Reeter and
state legislators.

Members said they would like to open communication with the clinic operators
to resolve potential problems.

One of the main concerns, they said, is that clinic operators have not
contacted Highlands Community Services about how the groups would work
together.

Chuck McHugh, acute services department director for Highlands, said that if
the clinic comes to the county, it would impact the services Highlands
provides.

"What we want is a quality treatment program that works collaboratively with
other agencies," he said. "We want them to be responsible for the consumers
they bring into the area."

McHugh said those discharged from the clinic likely would be referred to
Highlands, meaning an increased demand for services, including emergency
services. He said not only was it possible that clinic clients would need
Highlands' services, but it also was likely they would need
more-comprehensive care than the average person.

The Highlands staff also had concerns about care for clinic clients.

McHugh said the clinic's referral process to Highlands or other agencies was
weak, as outlined in its application for state licensure. He also cited a
lack of incentive to stop using methadone.

David Hever, program director for acute/intensive services for Highlands,
said it was possible someone could enter the clinic program and stay on
methadone for the rest of his or her life. He said methadone is addictive
and that the clinic, as a business, has an incentive to keep making money.

"That makes it questionable, in my point of view," he said.

McHugh said he had other concerns with the clinic's application, including:

* That it includes no requirement that clients show other treatment programs
have not worked;

* That no provision for emergency services or crisis intervention exists;

* That the clinic would have a counseling staff ratio of 1:60 with limited
staffing on weekends; and

* That no service would be available for those unable to pay.

If a client were unable to pay, he or she would be referred to Highlands,
which does not operate a methadone drug-treatment program, McHugh said.

The clinics use methadone, a synthetic opiate, to wean drug abusers from
other opiates like heroin or the prescription painkiller OxyContin.

Opponents say the treatment is ineffective and could bring crime to the
county.

The only objection to drafting the letter came from board member Kathy
Maggio, who said she thought the board was getting ahead of itself by not
contacting clinic operators first to see whether the problems could be
addressed.

Hunter Widener, Highlands' executive director, said it was important to send
the letter now so that it could be considered at the Board of Supervisors
meeting, scheduled for Tuesday.

"I think we're putting the cart before the horse for the sake of
expediency," Maggio said.

Appalachian Treatment Services, based in Greenville, S.C., applied to the
state to open a clinic in Washington County in 2002. The county was not
notified of the clinic's intentions to locate on Old Dominion Road in Lowry
Hills subdivision until early last month.

The issue has caused controversy among residents, members of the Board of
Supervisors and state legislators.

Opponents said the location is inappropriate because of its proximity to
Midway Baptist Church, John S. Battle High School and the subdivision.

The matter now is under county administrative review. Reeter, the county
administrator, must decide whether the clinic is appropriate for B-2,
general business, zoning.

The county's zoning laws allow medical facilities such as pharmacies,
nursing homes and personal-care facilities without on-site residency and
offices of physicians, dentists and other health-care professionals.