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FRANKFORT – After failing last year to stop a controversial clinic from dosing local addicts with methadone, Elizabethtown leaders turned Thursday to Frankfort in hopes of tightening the licensing process for opiate replacement clinics operating in Kentucky.
E’town Addiction LLC is the clinic now operating in Hardin County, but Sen. Elizabeth Tori, who filed Senate Bill 200 last week, said “these centers should not be allowed to start up unannounced, and with no local input or participation.”
Donna Hillman, former Division of Behavioral Health director, approved E’town Addiction’s controversial permit to treat some of Central Kentucky’s estimated 2,000 addicts with methadone despite widespread opposition to the controversial technique.
Hardin County elected officials, hospital officials and health care providers, heads of city and county governments and law enforcement agencies, Hardin County Schools Superintendent Nannette Johnston and a large number of residents opposed the clinic’s opening last year on U.S. 62, a quarter-mile from Central Hardin High School.
One key change proposed under Senate Bill 200 – which Tori, flanked by Elizabethtown Mayor David Willmoth, 9th Circuit Commonwealth’s Attorney and Assistant Hardin County Attorney Jenny Pitts, formally presented Thursday for review by the Senate Health and Welfare Committee and consideration for passage by his year’s General Assembly — would require local governments to adopt a resolution of support for any “narcotic treatment program” prior to approval of a clinic’s application to operate in Kentucky.
Support last year for the Elizabethtown methadone clinic was scant compared to the numbers of those who opposed it, but opposition to clinics offering methadone as a form of treatment for narcotic addiction is not uncommon since methadone, itself, is a powerful and addictive pain medication.
Most opponents of the drug’s use in addiction therapy see methadone replacement as swapping one narcotic for another.
Methadone, however, is but one of several drugs addiction therapists use to help those addicted to derivatives of the opium poppy end reliance on what often are illegally obtained substances.
Suboxone is another substance used at E’town Addiction.
Stepworks’ Dr. Tom Ingram explained that Suboxone can reduce painful and nauseating symptoms of narcotic withdrawal while not allowing euphoric signals to the brain – unlike methadone.
Senate Bill 200 does not differentiate between clinics using methadone from those using Suboxone, so the bill, if passed, will impose tighter permitting procedures on “all narcotic treatment programs,” despite their method of treatment.
While much of last year’s controversy over E’town Addiction’s application revolved around the common debate over methadone’s use as an opiate replacement, serious allegations against the clinic’s methods in gathering documents needed to support its permit arose.
Most alarming for all parties involved were claims by Elizabethtown and Hardin County representatives of health care, law enforcement and corrections that agents of E’town Addiction misrepresented their plans to administer methadone to patients altogether.
Theresa Bailey, an administrator with Hardin County Detention Center, and Greg Lowe, executive officer with the Hardin County Sheriff’s Office, were among those who questioned methods that Dr. Lori Nation – the clinic’s managing doctor – and others working for Eastern Kentucky clinic businessman Terry Scott used to obtain signatures for memorandums of understanding.
Such documents are required to be signed by representatives of health care, law enforcement and corrections agencies for clinics wanting to operate in Kentucky prior to the Division of Behavioral Health and the DEA approving a clinic’s application.
Bailey questioned why agents of the clinic didn’t seek signatures from the department head, rather than a subordinate of a local jailer, or sheriff. Bailey said she was duped into signing the memorandums, as did others.
In addition to local governments’ passage of resolutions of support, Tori’s bill would mandate the required memorandums of understanding identify any support from the community and specify the extent of the proposed working relationship between the proposed clinic and those agencies providing signed memorandums.
As is, the memorandums of understanding are vague – stating only that the health care, law enforcement or correctional agency understands that a clinic will be operating in the community.
Claims that agents of the clinic didn’t tell the entire truth to those from whom they solicited signatures, didn’t only appear last year.
A 2007 letter from Hardin Memorial Hospital to Scott — the clinic’s head – and the state show the same sentiments of local officials feeling duped into signing memos in 2009.
That letter, which HMH provided The News-Enterprise in response to an open records request, shows the hospital rescinded prior support for the clinic after learning it planned to use methadone replacement therapy – and not just Suboxone or counseling to help addicts recover.
That first attempt was shelved after local officials voiced opposition, but the clinic’s 2009 application was filed and processed by Kentucky’s Division of Behavioral Health with little knowledge of local officials. Only late in the process did local officials begin to speak out against the clinic.
It was too late, apparently, since the clinic is now open for business. Elizabethtown police have reported no problems there since it began operating.
Clinic representatives, including Dr. Lori Nation, say worries have been overblown and denied any claims of misrepresentation.
Nation said each memorandum of understanding identified the clinic as an opiate replacement therapy operation.
Only a handful of clinics offering methadone to addicts now operate in Kentucky.
At least three are under the supervision of Eastern Kentucky businessman Terry Scott, who owns E’town Addiction.
Defending methadone treatment last year, Scott said opiate replacement therapy helps those reliant on narcotics return to a normal life, transitioning from a person who’ll do most anything to obtain the substance they’re addicted to, to a productive, law-abiding member of society.
Hillman, who told The News-Enterprise last year that she supports the use of methadone for addiction therapy, was removed as director of Kentucky’s Division of Behavioral Health after last year’s controversy, according to records the Cabinet for Health and Family Services released Friday.
Hillman approved E’town Addiction’s application to operate, while having knowledge of local officials claims of the clinic’s agents alleged misrepresentation. Elizabethtown City Attorney D. Dee Shaw said Hillman mismanaged E’town Addiction’s application and did not properly investigate the claims and vast opposition to the clinic.
DEA officials said last year that drug enforcement officials only look for the state’s approval of a methadone clinic’s application to operate, thus making Hillman’s call the final decision.
Gwenda Bond, a spokeswoman with Kentucky’s Cabinet for Health and Family Services, of which the Division of Behavioral Health is part, confirmed Friday in an e-mail that there have been no policy changes in the application or permitting processes for methadone clinics.
In a joint statement, Chris Shaw, D. Dee Shaw, Willmoth and Pitts said they were pleased with Tori’s proposed bill and the willingness of the Senate to “address the extreme lack of oversight and investigation of methadone clinics.”
The statement continues to state that, if passed, Senate Bill 200 “will prevent a re-occurrence of the travesty that occurred in the licensing process in Hardin County last year.”
While proposing tighter restrictions for the licensing of methadone and other narcotic addiction therapy clinics, Tori said in a news release that “these centers, when run well, have benefits,” but that a “community must be assured that the centers are operated in a professional manner.”
Bob White can be reached at (270) 505-1750.