METHADONE CLINICS: GOOD MEDICINE OR CASH COW?

ROANOKE, Va. -- Three methadone clinics have opened in western
Virginia, and soon there could be more, as the region tries to heal
from prescription drug abuse that peaked around 2000 with the
emergence of OxyContin.

Methadone clinics typically meet resistance from nearby residents who
fear that an influx of addicts will bring crime into their
neighborhoods. Opponents also say the treatment--which costs about $10
a day and can last for years--often becomes a business run by
corporations more concerned about the bottom line than with addicts
who have bottomed out.

"It's a cash cow," said Michael Bragg, an attorney who represents
residents opposed to a proposed clinic in Washington County. "You get
someone hooked on methadone, and you don't want to cure them. You want
to keep them on the methadone and keep the money coming in."

While methadone providers dispute that, they clearly are part of a
growing business.

Since March 2000, when the region's first clinic began treating
addicts in Galax, two other clinics have opened, in Tazewell County
and Charlottesville. Two companies have announced plans for clinics in
the Roanoke Valley. A third firm filed an application for a state
license and quietly surveyed the methadone market before putting its
plans on hold. Yet another clinic is proposed in Washington County.

What is happening in western Virginia has been playing out on a
national scale over the past decade.

In 1993, there were 775 methadone clinics in 40 states that treated
115,000 people addicted to opium-based drugs such as heroin and
OxyContin, according to Mark Parrino, president of the American
Association for the Treatment of Opioid Dependence in New York.

Today, more than 1,100 clinics in 44 states are treating 205,000
patients, Parrino said.

By downing a dose of liquid methadone once a day, opioid addicts can
escape their cravings for illegal drugs and avoid withdrawal symptoms.
Methadone, a synthetic narcotic developed during World War II as an
alternative to morphine, is also prescribed as a painkiller.

Although patients do not get high when they use the drug properly,
they do become dependent on it. Some methadone patients will take
years before they can stay off the drug. Others need it
indefinitely.

Methadone clinics are governed by extensive state and federal
regulations. They are also required by law to be accredited by one of
several agencies, and they must obtain a permit from the Drug
Enforcement Administration to prescribe methadone.

Blue Ridge Behavioral Healthcare Executive Director James Sikkema said
as long as methadone clinics provide quality care and work well with
other drug treatment programs, their profits should not be an issue.

"People can make money and provide quality services and do the right
thing; there's nothing wrong with that," Sikkema said. "The challenge
is not to compromise quality and services out of concern for the
dollar, which is hard."

Joycelyn Woods, president of the National Alliance of Methadone
Advocates, agrees.

"The issue is: Are you providing comprehensive treatment so the
patients can get their lives together and become productive members of
the community?" Woods said.

If the answer to that question is yes, methadone advocates say, the
real profits go to the community.