EXPAND THE CLINIC DEBATE

Whether methadone treatment will be a good thing for the valley depends on
more than location, location, location.

For all its volume and passion, the Roanoke Valley's community debate about
two planned methadone clinics has been silent on what might become the only
relevant question:

How well will the clinics be run?

Roanoke city and county officials can put zoning barriers in the way of
future clinics. But one clinic faces no legal obstacle to opening in the
city. And the other might well clear the county's hastily constructed legal
hurdle.

If - as even ardent clinic foes are careful to assert - drug addicts should
have access to opioid treatment, the safety and effectiveness of the
treatment must be assured.

Only then will the larger community be protected from the illicit drug use,
crime and diseases that can result when treatment centers are poorly run -
or, conversely, when addicts don't receive treatment at all.

State and federal regulations set only minimum standards - not high enough,
unfortunately, to ensure that a methadone clinic will be a good neighbor
and a responsible corporate citizen.

But many are.

If National Specialty Clinics and Life Center of Galax each goes forward
with plans to set up a methadone clinic in the city and county,
respectively, disputes about location eventually will be settled, happily
or not.

Larger issues cannot be ignored.

The clinics should follow voluntary best practices. The two localities and
the clinics' neighbors, whoever they may be, should insist. But on what?
What would a good clinic look like?

Gail Burruss, director of prevention, assessment and counseling services
for Blue Ridge Behavioral Healthcare, did a thoughtful analysis of
methadone's potential for good and harm. She asks a host of questions that
clinic operators should address publicly, among them:

How comprehensive is the treatment approach? Will clients be assessed
individually, and will appropriately credentialed staff provide counseling
that is intense enough and last long enough to meet their needs?

How will the clinic coordinate care with other medical and social services
providers to meet addicts' complex needs, which can include chronic pain,
multiple addictions, mental illness, legal, family and financial problems?

How will the clinic manage patient crises? Will it offer counseling by
phone 24/7, and make physician consultation available to emergency care
providers?

How will the clinic provide for the public safety when patients leave
disgruntled?

What are some outcomes at other sites, such as average duration of
treatment, long-term success rates and discharges due to patients'
inability to pay?

Will the clinic set up a consultation group to talk about coordinating
services and resources, and a community advisory panel to hear and respond
to public complaints?

A yes to the last would let all of these questions, and more, be answered.
It would make the community its own watchdog - clearly a best practice.