I am prompted to weigh in in on the reaction of the residents to the idea of Concerted Care Group wanting to repurpose a Dollar General store in the Woodlawn Shopping Center in Stafford and make it a methadone clinic.
We have read, here in the Free Lance-Star, of fraught meetings where concern has been expressed about safety, increased crime, how such a clinic should be closer to some medical facility, of impact on property prices. Not helped by some logistical missteps in the publicizing.
My take is that these concerns are a bit of an overreaction, and that we should put our energies toward the more troublesome aspects of the opioid epidemic.
You might think it’s not my business as I’m not a resident of Wood Lawn. But my justification is that I practiced as a primary care doctor in Stafford for 24 years and saw my share of victims of the opioid epidemic - patients in crisis from withdrawal or overdose, or dependent patients harassing me to prescribe them ever more pain medicines. So anything that helps is desirable – and methadone clinics are much needed.
A Personal View
To get a personal take on methadone clinics, I went to talk to friend Christian Zammas who is in recovery from heroin dependence and himself on methadone. He explained how it saturates the opioid receptors, reducing cravings. “It’s what prevented me from dying” he told me.
Relating his story before methadone, he tried to quit “cold turkey” and suffered three weeks of vomiting, diarrhea, body aches, involuntary leg movements. “Like the worst case of flu” so “you are afraid you’re going to die – or sometimes wish you would.”
A reaction so bad it drives people to any lengths to get funds for another fix and avoid withdrawal – a withdrawal that methadone prevents.
He’s been on methadone now for 6 years now. Going every day at first, getting given a cup with a solution containing a carefully calculated dose, that you must drink there. Just enough to abolish withdrawal symptoms, but not enough to make you high.
I asked him about the objections people are bringing up and he told me at his clinic the security guards inside and out ensure that dealers aren’t hanging out in the parking lot, or patients aren’t selling their methadone.
Being on methadone has allowed him to become a productive member of society – the proprietor of Katora coffee on Caroline Street, and to previously run the Katora Institute that taught people life and coping skills, and to nurture their own sense of purpose.
He reiterated what Todd Abraham, clinical program director at Sandstone Care, Reston, is quoted as saying. That the idea that a methadone clinic “brings more crime to an area is just not true.” This is reinforced by a study by the Johns Hopkins Bloomberg School of Public Health noting “there may actually be less serious crime near clinics than other community businesses” by which they are referring to liquor and convenience stores.
What We Should Worry About:
You may think I’m being dismissive of the concerns about maintenance clinics, but, at a time when the CDC is reporting “the drug overdose epidemic continues to worsen” maybe we need to give our attention to things like:
- Fentanyl, a synthetic opioid which is 100 times more potent than heroin, that admittedly has a legitimate use as a pain medicine, but whose illicit counterpart, smuggled in from Mexico, China and India is killing people. Killing people by being mixed in with, a host of different street drugs as well as fake prescription pain medicines like counterfeit OxyContin. And in very unpredictable amounts – posing a risk to people overdosing while still apparently taking the same dose they have tolerated in the past.
- Naloxone – a drug that dramatically reverses the effects of opioid overdose – by blocking the opioid receptors, reversing the central sedation and respiratory depression that kill people. The trouble is it has to be available at the time and place that someone is having an overdose, and there is still a major challenge to getting enough education and availability of naloxone (often better known by its brand name Narcan).
- Xylazine – known as “tranq” or “the Zombie drug”- a non-opioid sedative used in animals by veterinarians, but which is being found mixed with fentanyl and a host of street drugs – and that is not reversable with naloxone.
- Getting the right balance on prescribing regulations so that we have neither “pill mills” with rogue doctors over-prescribing, nor people in genuine pain being treated as drug addicts and refused pain medicines.
- Holding pharmaceutical companies accountable when they promote their profits by selling people on addictive medicines (watch the Netflix series Pain Killer about the Sackler family and their massive promotion of OxyContin).
Methadone clinics are a useful tool for combating the opioid epidemic. I think the dangers associated are not as bad as being made out and would urge the neighbors of Wood Lawn to go along with it.