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(EDIT: Chicago has always had some of the best MMT in the country and has been relatively stigma-free. The fact that we are now facing stigma and areas are trying to prevent clinics from opening is a true testament to the fact that we are truly facing hard times)
Methadone clinics rise in number, raising flags
Methadone clinics rise in number, raising flags
By Lisa Black Tribune reporter
August 16, 2009
One methadone clinic, Jem Treatment Inc., quietly accepts patients in a nondescript brick building shared by law firms and other agencies -- a typical low-profile approach to avoid neighbor confrontations and maintain client confidentiality.
Another, Green Dragonfly, under investigation after the December death of a 30-year-old patient, boldly advertises services outside with an electronic sign that scrolls: "Same Day Dosing." Inside, handsome couches and colorful decor feel more like a hotel lobby than a doctor's waiting room.
Despite their markedly different approaches, the two private methadone treatment clinics, which opened within walking distance of each other last year in Waukegan, are a testament to growth in the heroin addiction market.
The clinics dispense doses of the prescription narcotic methadone, with the goal of weaning substance abusers off opiates such as heroin and painkillers. The process can take years and is attracting newcomers to the treatment field.
In recent years, more private, for-profit methadone treatment clinics have opened in response to demand, especially because public funding for new programs has slowed to a near halt.
The trend concerns law-enforcement agents who track drugs sold illegally, although they say all methadone treatment clinics, public or private, are subject to the same record-keeping and inspection requirements.
"It concerns us more when the motive for treatment is profit," said Mark Caverly, with the Drug Enforcement Administration's Office of Diversion Control in Arlington, Va. He said he is not sure whether private clinics have experienced more problems than those that are public-run.
Nationwide, the number of clinics has risen to 1,200 from 750 in 1994, with almost all of the newcomers privately owned, said Mark Parrino, president of the American Association for the Treatment of Opioid Dependence.
A pizza store owner once called him for information, thinking he had discovered an easy new way to make money, he said. Parrino said he discouraged him, sending him back to food service.
"If the motivation is, 'Let me get my money and get out,' that's a problem," Parrino said, "but if the person opening the clinic says, 'I want to be here for the long run; I want to help,' then that person will meet all quality standards and have good relationships with the community and patients."
In Illinois, all eight of the new methadone clinics opened the past five years are privately operated, according to the Illinois Department of Human Services. The state licenses 57 clinics -- 25 of which are private, officials said.
A debate over whether the for-profit clinics need closer monitoring continues as the number of methadone-related deaths increases. Misuse of the drug led to 4,462 fatalities in 2005, up from 786 in 1999, according to the most recent statistics from the U.S. Centers for Disease Control and Prevention.
West Virginia authorities imposed a moratorium on new centers after they said they traced methadone deaths to treatment clinics. But most believe the drug has become more accessible because of its increasing use as a painkiller, said Caverly of the federal enforcement agency.
Doctors must warn their patients that methadone can cause death when combined with alcohol or certain other drugs, experts said.
In Waukegan, the Lake County state's attorney's office is investigating whether Green Dragonfly staff followed proper procedures in dispensing methadone to Steve Vaughn, 30, of Lindenhurst, who died at home Dec. 3 after his second day of treatment.
Complicating the case is that Lake County Coroner Richard Keller, who ruled on Vaughn's cause of death, is the doctor who prescribed methadone to Vaughn as the clinic's medical director. Keller ruled that Vaughn died after mixing Xanax with methadone, a dangerous combination that Keller has said he advised Vaughn against.
Jill Vaughn said her son lied to Keller and told him he was addicted to heroin, not Xanax. Investigators are trying to determine whether Keller screened Vaughn for drugs through a urine test, which is customary.
Keller said he was not sure whether Vaughn took a urine test and has not checked his records.
Kenneth Davis, CEO of Professional Diagnostic Services S.C., a treatment clinic in Glenview, said it is important to drug-screen first-time patients to determine methadone dosage. "You do not base it on what the person says, because their goal is to say whatever will get them into treatment and get them as comfortable as possible," Davis said. "We as providers have to keep their safety in mind as well as to understand that we don't want patients being their own doctors."
Keller acknowledged that he and the two women who own the clinic have no background in addiction treatment, which is recommended but not required by law. Methadone clinics must be registered and evaluated by the DEA, the U.S. Center for Substance Abuse Treatment and the state human services agency's Division of Alcoholism and Substance Abuse, officials said.
The state inspected Green Dragonfly in July, citing staff for violations that are being remedied, Keller said. One violation included the failure to report Vaughn's death as required, officials said.
On Friday, the state declined the Tribune's request for a copy of the report, citing exemptions in Illinois' open records law, including one in which a request can be denied if it "would interfere with pending or actually and reasonably contemplated law enforcement proceedings." firstname.lastname@example.org
Copyright � 2009, Chicago Tribune
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