More clinics for treatment of drug addiction are opening in Montgomery County to battle an opiate epidemic.
Project Cure Inc., a nonprofit drug rehabilitation center and one of 12 licensed methadone clinics in Ohio, has long been the only place in Montgomery County where the general public could seek medical treatment for an opiate addiction, other than the emergency room or a private doctor.
Opiates are highly addictive drugs such as heroin and medications like Vicodin, Percocet and Oxycontin.
By summer’s end, there will be four clinics offering medicated opiate addition treatment in the county. The types of medication offered also are expanding from heavily-regulated methadone to include Suboxone, which experts say is less risky for overdose.
The hope is the new services will reduce accidental overdose deaths in Montgomery County. A record 162 deaths occurred last year, and toxicology reports identified heroin in 95, or 59 percent, of those deaths.
Statewide, a record 1,765 people died in 2011 from unintentional drug overdoses.
“The sheer volume of overdoses in this community warrants the need immediately for these kinds of services,” said Ann Stevens, spokeswoman for the Alcohol, Drug Addiction and Mental Health Services Board for Montgomery County. “We’re at epidemic proportions on overdoses of heroin use and opiate use.”
Treatment services will be offered at:
• Project Cure, a methadone clinic operating since 1970 at 1800 N. James H. McGee Blvd in Dayton. Project Cure is expanding services to dispense Suboxone. It accepts Medicaid, Medicare and commercial insurance. A $2 a day fee is charged for non-Medicaid patients. Most Montgomery County residents don’t pay a fee because the cost is covered by funding from the Alcohol, Drug Addiction and Mental Health Services Board, or ADAMHS.
• Consortium Clinical Services LLC, a private opiate addiction treatment center that opened in 2012 prescribing Suboxone at 4124 Linden Ave., Suite 100, Riverside. The center accepts Medicaid, but not cash.
• Access Hospital Dayton, a private, for-profit mental health services hospital that in April opened a new detoxification inpatient unit to treat patients for drug and alcohol abuse and co-occurring substance abuse and mental health disorders at 2611 Wayne Ave., Dayton. Treatment includes administering Suboxone for opiate-addicted patients. Patients pay for services with private insurance, Medicaid or Medicare.
• Samaritan Behavioral Health Inc., a Dayton nonprofit offering community behavioral health services, is being awarded approximately $465,000 in public dollars to start medication-assisted treatment services with Suboxone in September at its Elizabeth Place offices, 601 Edwin C. Moses Blvd., Dayton. Samaritan will offer free services to people who have no insurance coverage.
The Dayton Veterans Administration Medical Center also operates a federal methadone program.
Methadone and Suboxone are U.S.-government approved drugs to wean people off opiates such as heroin or pain medications. Methadone and Suboxone curb drug cravingsand helps them with withdrawal symptoms, said Brad DeCamp, with the office of the medical director of Ohio Dept. of Mental Health & Addiction Services.
Suboxone is not as heavily regulated and considered by experts to be safer than methadone because people who take it have less risk of overdose, DeCamp said. Suboxone is a relatively new treatment approved in 2002 by the U.S. Food and Drug Administration for treating opiate dependencies.
A form of Suboxone that dissolves on the patient’s tongue, similar to breath freshener strips, is approved for use in Ohio.
Methadone, a red liquid, works best for high level addictions, and those with a long history of heroin use, DeCamp said.
Addiction to opiates can be deadly. Experts say the abuse of narcotics stems from the growing availability of prescription medicines. As the state has worked to better control access to painkillers, use of heroin has risen in southwest Ohio.
Heroin has similar effects as painkillers, but is easier to obtain and cheaper than pills, said DeCamp and Orman Hall, director of Gov. John Kasich’s Opiate Action Team. Heroin, however, is more lethal because it’s hard to predict from one batch to the next the quality or potency, Hall said.
“Opiate addiction is a huge problem in the state, but I think what you’re seeing here is a response to a very serious problem in an important and major urban area in our state,” Hall said.
Consortium Clinical Services LLC first opened in Riverside in September 2012. It moved in March this year to bigger offices at 4124 Linden Ave. The clinic offers medication-assisted treatment to people overcoming certain drug dependencies and prescribes Suboxone.
Patients are required to attend doctor appointments and therapy sessions and pass screening tests for other drugs as part of the treatment, said Chief Executive Officer Keith Vukasinovich. In addition, Consortium Clinical officials are preparing paperwork to apply to be a methadone clinic and dispense Suboxone, Vukasinovich said.
“We definitely need more services, but we can’t be in such a rush to add services that it just becomes a come-one, come-all to services,” Vukasinovich said.
Access Hospital Dayton opened in April a second 30-bed inpatient unit for detoxification and co-occurring substance abuse and mental health disorders. Access Hospital doctors also use Suboxone to treat patients withdrawing from opiates.
Samaritan Behavioral Health is preparing to offer new medication-assisted services starting in September at its offices in the medical office building Elizabeth Place on Edwin C. Moses Boulevard.
Samaritan Behavioral is being awarded approximately $465,000 from the ADAMHS Board for Montgomery County to offer the services, said Sue McGatha, Samaritan president and CEO. The contract is not yet final. Unlike the other clinics, Samaritan Behavioral’s services are a pilot program targeting people with no insurance or Medicaid coverage.
The $465,000 would cover costs of medication, staffing, laboratory testing and a naloxone kit distribution program (a drug used by first responders for overdoses). Services will be free to patients during the pilot program, which runs until June 2014.
Samaritan Behavioral, affiliated with Good Samaritan Hospital, will administer Suboxone treatment to patients during an induction phase, keeping limited drug supplies on the premises, McGatha said. After patients finish the initial induction phase, Samaritan plans to prescribe Suboxone to them.
The program has space for 100 patients.
Project Cure, treating 650 to 700 clients per day, also is expanding services in the next 30 days to offer Suboxone in addition to methadone. Plans are to administer the drug on-site.
In the meantime, Project Cure continues its search for a better location. The clinic’s application to operate a methadone clinic at Elizabeth Place was turned down in June by the state based on new state law restricting some drug treatment programs from locating within a 500-foot radius of a public or private school, licensed day care center, or other child-serving agency. The state law restricting locations of methadone clinics does not apply to Suboxone, the brand name of the drugs buprenorphine combined with naloxone.
Having faced unwelcoming neighborhoods, buildings with environmental issues and the new state law, Project Cure is changing its relocation strategy.
“We’re looking for land. We want to build,” McDaniel said.
By the numbers: Ohio drug overdoses
440 percent increase in drug overdose deaths from 1999 to 2011
1,765 Ohioans died from unintentional drug overdoses in 2011, the most recent state-level information available. This is the highest number of deaths on record for drug overdose and surpasses the previous highest number (1,544) in 2010 by 14.3 percent
5 Ohioans died every day in 2011 from unintentional drug overdose
162 people died in Montgomery County in 2012 from drug overdoses, the highest on record
Unintentional drug overdose is the leading cause of injury-related death in Ohio, ahead of motor vehicle traffic crashes, suicide and falls. This trend began in 2007 and continued through 2011
SOURCE: Ohio Department of Health
Drugs approved for treatment of opiate addictions
Best for serious, high level users and those with long history of heroin use
Addictive drug approved by U.S. FDA to treat opioid dependence
People who take methadone within their tolerance level do not experience a high
Normally requires daily dose
Buprenorphine combined with naloxone (brand name Suboxone)
Alternative to methadone
Also addictive drug approved by U.S. FDA to treat opioid dependence, but has less potential for addiction than methadone
Because buprenorphine and naloxone have no additional effects beyond a dose of 16 to 20 milligrams, it’s considered safer and harder to overdose
Pill and sublingual film (under the tongue) form—only film is available in Ohio
Normally requires daily dose
SOURCE: Ohio Dept. of Mental Health & Addiction Services