EXAMINER, OFFICIALS: CLINICS NOT BEHIND METHADONE WOES

BRISTOL, Va. - While methadone is becoming a growing drug problem in
Southwest Virginia, some state and local law enforcement officials say
methadone clinics aren't to blame.

Residents of the Lowry Hills area have risen up in opposition to a planned
clinic in their neighborhood. The matter is to be taken up by the
Washington County Board of Supervisors today.

Dr. William Massello, chief medical examiner for the state's western
district, said his office has seen almost an exponential climb in
methadone-overdose deaths since 1992. But he said he didn't believe
methadone clinics have had much of an impact on that increase.

From 1992-95, seven deaths were attributed to the drug, commonly used to
wean addicts off heroin. By 1999, the annual total climbed to 12, and in
2002, 62 people died of methadone overdoses, he said.

"We've had 37 deaths as of mid-year, and this year we're projecting in
excess of 70 deaths in the western district," Massello said. "Methadone is
the number one killer drug in this district."

Massello said it is difficult if not impossible to tell what form of
methadone a person has ingested. Clinics typically supply their patients
with methadone in liquid form, while pills usually are prescribed outside
the clinic setting as a chronic pain reliever.

But he said the circumstances he's heard behind many of the deaths do not
point toward methadone clinics.

"This started in 1996 around the time when the philosophy of pain
management was in full swing," he said. "The methadone clinics may have
some connection, but it's a very low percentage."

1st Sgt. Bill Purcell of the State Police is in charge of the agency's Drug
Diversion Office in western Virginia, and he agreed with Massello that
methadone treatment clinics have played a minimal role in methadone abuse
in the region.

"The most we've ever seen when we do see it is in pill form," he said of
the agency's investigations and undercover enforcement. "Maybe it's like an
exclusive little segment of abusers who are getting or distributing it."

The relative prevalence of pill-form methadone suggests that some abusers
could be doctor-shopping or getting it from people with legitimate
prescriptions in much the same way OxyContin abuse started growing in the
region in the late 1990s, he said.

"I have not, nor do my people have any problems with methadone clinics in
the region," Purcell said.

Chief Deputy Harry Cundiff of the Tazewell County Sheriff's Office said his
department has had a methadone clinic in its jurisdiction for almost two
years with little or no impact on drug abuse or dealing.

While officials of The Life Center of Galax have declined requests for an
interview, Cundiff said the Life Center's methadone facility in Tazewell
County has not been a source of problems.

"They've been real cooperative with us," he said. "Most of the people that
come (to the clinic) are from out of the county, and any problem we're
seeing from methadone is not from the clinics."

Larry Worley, one of the principals behind the proposed Appalachian
Treatment Services methadone clinic now under review by Washington County
officials, said his experience operating a clinic in Greensboro, S.C.,
reflects the experiences of Massello, Purcell and Cundiff.

"Our South Carolina program started in 1997," Worley said. "It's about 50
yards away from a church and near a housing development. They hardly know
we're even there."

About 85 percent of the center's clients are being treated for addiction to
prescription opiates such as OxyContin, hydrocodone and other pills rather
than heroin, Worley said.

While clients sometimes are provided take-home doses of methadone to carry
them over a day or so when they may not be able to get to the clinic,
Worley said those clients have to go through checks to ensure they haven't
been selling it.

"You're not seeing people with needles hanging out of their arms or people
dealing in the parking lot," Worley said. "Many of these people hold jobs
and are trying get on with their lives. The people we should be worried
about are not at those clinics."

Worley said police have been called to the South Carolina clinic only once,
when a building security alarm accidentally sounded.

"We are very low-key," he said. "Our patients come in, check with a nurse
and counselor, and finally see the pharmacist. They are required to have
the pharmacist make sure they take their dosage right there."

Worley said most of the clinic's patients come from referrals from other
programs or doctors and that the center is accredited by the Commission on
Accreditation of Rehabilitation Facilities.

Accreditation would be a goal of the Washington County facility, if it
opens, he said.

"I'm hoping there will be a forum where there can be a frank and fair
exchange of ideas," Worley said when asked whether he planned to attend
today's Board of Supervisors meeting on his request for zoning and
occupancy approval.