Birmingham POST-Herald, October 27, 2004.
Jerime Dunaway, 33, waits in line for his methadone dose Thursday at the Northwest Alabama Treatment Center in Bessemer.
Jerime Dunaway spends $70 a week on gas for driving his truck from Montevallo to Bessemer every morning to see his doctor before work.
Dunaway, 33, said he’d like to find counseling and treatment closer to home, but he’ll continue to make the long drive. He has no other choice.
Before he started going for daily methadone treatments three years ago, he was addicted to Oxycotin and heading toward an early grave, he said.
“I was near death,” Dunaway said. “I was a lost cause – irritable and hateful. I thought there was no help for me. I couldn’t even get up and go to work. I didn’t care if I lived or died.”
While dating a nurse, Dunaway started taking prescription painkillers and became addicted, he said. He and his girlfriend broke up, but he could not quit taking the drugs until his mother forced him to start methadone treatment at the Northwest Alabama Treatment Center in Bessemer.
Now Dunaway has a job in construction. He’s been married for two years and has a 1-year-old son.
“I go to work. I have a family. I have a life,” Dunaway said. “There is no way it could have happened before. They saved my life.”
Susan Staats-Sidwell and Dr. Glenn Archibald, part-owners of the Bessemer clinic, are building another clinic in Saginaw closer to patients in Shelby County. However, nearby residents oppose it and a circuit court judge has ordered an injunction to halt its opening.
On Oct. 12, Circuit Judge Dan Reeves placed a permanent injunction on operations at the Shelby County Treatment Center, which has already been built in Saginaw off of U.S. 31 in central Shelby County.
Reeves first placed a temporary restraining order on the opening of the methadone clinic in June, agreeing with a group of residents who said they never had an opportunity to voice their opposition.
Shelby County District Attorney Robby Owens said the owners originally planned to open the clinic in Calera but moved it to an unincorporated area in Saginaw in May, a few months after the opportunity for residents to voice concerns expired in February.
The owners need to start over, Owens said, filing for a new Certificate of Need through the Alabama State Health and Planning Development Agency so Saginaw residents have a chance to voice their opinions.
“It’s misleading to say you are going to put it in Calera and then put it in Saginaw without giving people in Saginaw their say,” Owens said. “All we’ve ever said is give us a chance to be heard. That’s just a basic human right in a democracy. You might not get your way, but you at least get to have your say.”
Sidwell said she has followed proper procedure in modifying the project location throughout the state.
In January, the state issued a Certificate of Need allowing the clinic to operate anywhere in Shelby County because a need was recognized in that area, Staats-Sidwell said. She said clinic owners plan to appeal Reeves’ decision.
“I have a lot of patients in this area that need help and they’ve got to drive another hour to get it,” Staats-Sidwell said. “The state of Alabama said there is a need. I’ve got a right to open anywhere in Shelby County.”
Owens, who represents the county, said the injunction won’t stop the clinic from opening if owners obtain another Certificate of Need. Owens said he is opposed to a methadone clinic in the county, especially in a small residential community like Saginaw.
Attorney Mickey Johnson is representing a group of Saginaw residents in a private lawsuit against the clinic.
The county has spent a large amount of money on programs including drug court, deferred prosecution and work camps to try to help people quit using drugs, Owens said.
“With methadone, they want to trade one narcotic drug for another,” Owens said. “I’m not in favor of methadone clinics. If they’re going to open one, they should locate it next to a hospital instead of in a residential community. They’re wanting to put 140 drug addicts into this community and bring them in every day.”
In November 1997, the National Institute of Health concluded that opiate addiction is a disease of the brain that can be treated effectively. The NIH panel of experts strongly recommended that addicts have broader access to methadone maintenance treatment programs and that federal regulations, state regulations and other barriers to this treatment be eliminated.
Hundreds of opiate addicts are working and living normal lives in Shelby County thanks to the treatment, and Alabama “attorneys and judges need to stop playing doctor,” Staats-Sidwell said.
Staats-Sidwell said many of clinic patients have never experimented with illegal drugs. They became addicted to prescription painkillers while recovering from injury or surgery. The Bessemer clinic, one of four in Jefferson County, treats 440 people a day, she said.
Methadone acts a lot like a nicotine patch, Staats-Sidwell said. It reduces withdrawal symptoms, cravings and the euphoric effects of opiate use. Staats-Sidwell said methadone patients are not seeking opiates to get high and committing crimes. They are living normal, productive lives – “these are good people,” she said.
Alan Edmondson, 54, whose family farm is next to the clinic property, said a methadone clinic will probably attract bad people to Saginaw. The clinic also will have a negative impact on property value, he said.
Edmondson said he talked to Birmingham business owners who operate next to methadone clinics, and did research on the Internet. The clinic does not belong in Saginaw, he said.
“The more research I did, the less I desired it being in my neighborhood,” Edmondson said. “There’s a lot of unsavory things that go on – people lined up out the Door at 6 in the morning”.
“I’m sure there are a lot of good people that get hooked on drugs, but a lot of bad people have, too.”
Methadone maintenance treatment for heroine addiction is extremely effective with medical supervision, showing a marked decrease in death rates, decreased crime rates, fewer communicable diseases and increased employment among those treated, the Alabama Board of Medical Examiners reported in a 2003 newsletter.
In the same newsletter, the board reported that more than 200,000 patients were being successfully treated for opiate addiction in nearly 1,200 registered methadone programs in 45 states.
The wait for treatment at the University of Alabama at Birmingham methadone clinic can be six months to a year, clinic director Dr. Norman Huggins said. Pregnant women, HIV-positive patients and those with chronic mental illness are accepted for treatment immediately, he said.
While a private clinic in Shelby County could meet the needs of some patients, most of the patients waiting for treatment at UAB probably couldn’t afford treatment through a private clinic, Huggins said. UAB, which accepts Medicaid, is the only nonprofit methadone clinic in the area, he said.
However, he said public and private clinics are treating narcotic addiction with more success than ever before, he said.
“Opiate addiction is a chronic disease of the brain that requires chronic treatment,” Huggins said. “We have patients that have been in treatment for 20 years or more and lead productive lives.”
Despite a lack of methadone treatment programs in Shelby County, two of three methadone distributors in the United States are located in the county, including VistaPharm, on Cahaba Valley Drive, and Cebert, Staats-Sidwell said.
VistaPharm President Roy Thrush said Shelby County residents shouldn’t be concerned about the treated addicts. It’s the untreated addicts that are committing crimes and causing problems for the community, he said.
“That’s a head-in-the-sand approach,” Thrush said. “These people are reaching out to lead normal lives and cure themselves. That’s not where the danger comes in.”
Dunaway said uninformed people think methadone treatment is like a clinical opium den, but the program is strict. Patients must visit the clinic daily to obtain a prescribed dose of methadone. They are tested for drug use twice a month, and counselors relentlessly urge patients to stay employed and off drugs, he said.
“Everybody thinks a bunch of people are going to be down there hanging out, but they have rules, strict rules,” Dunaway said. “It’s like going to a doctor’s office. When you start this treatment, you’ve got to have a job. You’ve got counselors that stay on you about what you’re doing.”