DRUG CLINICS STUDIED FOR WORTHINESS

W.Va.'s addiction rates for heroin, OxyContin near double U.S. average

Privately owned methadone clinics are popping up all over West Virginia, and
a legislative interim committee Monday tried to determine whether that's a
boon or bane for behavioral health care in the state.

Lawmakers heard from David Gnass, chief executive officer of National
Specialty Clinics, a Nashville, Tenn.-based company that operates six of the
seven methadone clinics licensed in West Virginia.

He told the Legislative Oversight Committee on Health and Human Resources
Accountability that West Virginia has proved to be a lucrative market for
the company, with percentages of residents addicted to OxyContin and heroin
running nearly double the national average.

When the company first entered the state, he said, they believed they would
have about 1,800 clients. The company now has more than 3,000 clients at its
six clinics, and has filed applications with the state Health Care Authority
to open three more locations.

Gnass said clients range in age from 20 to 72. Sixty percent are male; 98
percent are white.

"These are people like everybody in this room," he told the committee.
"We've got attorneys coming in. Unemployed. Coal miners. You name it - we've
got a whole cross-section coming in."

Although methadone can curb addicts' craving for opiates like heroin and
OxyContin, critics maintain that the methadone maintenance keeps addicts
from coming to the behavioral health centers to go through detox.

"Methadone is not something you can quit overnight," Genise Lalos, director
of addiction services for the Prestera Center in Huntington, told the
committee.

She said national figures indicate that only 10 percent to 20 percent of
people on methadone maintenance are able to get off of methadone and
maintain drug abstinence.

Lalos said Prestera Center is receiving patients who stop methadone
maintenance because they get tired of paying the cost for the daily dosage.
(National Specialty Clinics charges $12.50 a dose - all strictly
private-pay.)

Gnass argued that requiring patients to pay for methadone is part of the
treatment.

"Patients got themselves into this. Part of their treatment is they have to
pay to get out of it," he said.

He said the $12.50 is much less than the $300-a-day habit typical for many
OxyContin and heroin addicts.

"They've learned to do whatever they need to do to get their drugs ...
stealing to prostitution, you name it," he said.

Gnass conceded his clinics could do a better job coordinating with local
behavioral health centers to help patients make the transition from
methadone maintenance to sobriety.

"We're relatively new here. We have room to improve. We need to work better
with the Presteras of the world. No question about that," he said.

But he added, "We've put millions of dollars into West Virginia in a number
of ways .... In my view, we're the best bargain to ever hit the state."

Sen. John Unger, D-Berkeley, said he believes the state should do more to
require private methadone clinics and behavioral health centers to work
together. He said the state can force that cooperation, since it licenses
the private clinics and provides major funding to the behavioral health
centers.

Sen. Jon Blair Hunter, D-Monongalia, said the Legislature shares the blame
for the controversy.

Over the past decade, he said the Legislature moved behavioral health care
from residential settings to community-based care, but never adequately
funded the community-based programs.

Those programs, he said, are "trying to do too much with too little money."