Methadone Clinic

HEALTH EXPERTS', RESIDENTS' OPPOSITION VALID

In response to your "Solomon's Wisdom," Dec. 17 editorial, I strongly
disagree with several of the facts you presented regarding the methadone
clinic. I find it disturbing that our local newspaper reported nothing on
this story until two months ago, especially since the Center of Hope
insists it advertised its intentions clearly to the public in a legal
notice. No one reacted to the intention of opening an outpatient substance
abuse treatment center because there is a need for treatment in Horry
County. However, outpatient treatment and methadone maintenance (or
narcotic treatment program, as termed by the U.S. Food and Drug
Administration) are different services, according to the American Society
of Addiction Medicine, and the licensing standards for methadone clinics
are differentiated in the S.C. Department of Health and Environmental
Control requirements for outpatient substance abuse treatment facilities.

To generalize the resulting public outcry as uneducated denial based upon
imagery of grungy smack addicts shooting up in front of the clinic is not
only flippant, it is insulting. Many of the residents and professionals in
opposition to this clinic have valid concerns related to its location,
necessity and impact on the community.

The most insulting and inaccurate statement in this editorial was that
"Those who deal with addictions say the Grand Strand needs such a clinic. ..."

As the director of the Horry County authority for substance abuse
programming (Horry County Ord. No. 6-85) and the largest entity of active
licensed, certified and credentialed addictions counselors in the county, I
say you were misinformed and wrong to make such a statement. Our licensed
and professional staff members deal with addictions each and every day yet
do not believe we need a methadone clinic. While I do believe your
assessment that dozens may be currently receiving methadone, what happened
to the hundreds that were claimed in order to justify the clinic's operation?

There are valid reasons that the U.S. Drug Enforcement Administration
requires an evaluation of the availability of local police or security
personnel (not a requirement for outpatient treatment centers). There are
also valid reasons for the FDA to insist that methadone clinics have a plan
to ensure that patients have access to emergency psychiatric/medical
services and social services, including employment placement.
Representatives from the medical community (including one emergency room
physician and a physician specializing in pain management) and the
Fraternal Order of Police were included as members of the coalition of the
frenzied.

Additionally, the FDA has provisions in place that allow a program
physician to grant the patient privileges that decrease the number of
clinic visits through take-home medication. Some of the requirements for
take-home privileges include the absence of recent drug abuse, absence of a
serious behavioral problem at the clinic, absence of known recent clinical
activity and stability of the patient's home environment. With regular
compliance, it is possible for a patient to decrease clinic visits
significantly.

According to a recent study by the Substance Abuse and Mental Health
Services Administration, the mean recorded cost per outpatient methadone
visit was $14.50 (minimum $7.82, maximum $58.81). If there are 200
individuals receiving methadone from Horry County (a figure yet to be
verified), it is plausible that all 200 could have been medically
detoxified and provided with outpatient counseling (public or private) for
the same $500,000 cost that the Center of Hope spent to renovate a former
strip club (located inside the recommended distance requirements, with or
without an exception).

Finally, you state that if the Center of Hope successfully sues the county,
it will be at the taxpayers' expense. It is my opinion that should this
clinic be allowed to operate, based on bullying tactics and legal threats,
the consequences will be far more expensive than a lost lawsuit.

Horry County Council may have to begin to plan now to determine where money
for additional funding will come from to cover the need for more police,
social service agencies and indigent medical care. This will inevitably be
an expensive lesson for all involved. Regardless of the outcome, please
refrain from speaking on behalf of addictions professionals who live and
work here without checking with them.