Second methadone clinic likely to be mobile unit

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(Host) The state of Vermont is shelving efforts to find a location for a second methadone clinic to treat drug addition.Instead, officials hope to have a mobile clinic operating by late summer.

As VPR’s Steve Zind reports, the idea has advantages – and drawbacks.

(Zind) Vermont has one methadone clinic operating in Burlington. For the past year the state has been searching for a site for a second clinic. No town is willing to host one. Now the state is taking a different approach to providing treatment for the estimated three to four thousand Vermonters who need it: A methadone clinic on wheels.

Vermont Health Commissioner Doctor Paul Jarris says a methadone clinic that follows a daily route, stopping in a number of towns will face less community opposition than a fixed clinic.

(Jarris) “The communities we speak to are very willing to treat the members of their communities and recognize the need to do that. What they weren’t as interested in is becoming a focal point for a region of the state where other individuals with addiction from other parts of the state travel to their community. So by bringing the mobile unit to the community, what it allows a community to do, is treat their members, their citizens, neighbors and then move on to another community.”

(Zind) Jarris says the state has talked to operators of other mobile methadone clinics. There are mobile treatment programs in several large metropolitan areas but it appears Vermont would be the first rural area to try the approach.
Habit Management Inc. operates a network of methadone treatment centers, including three mobile clinics in the Boston area.

(Tom Magaraci) “It isn’t ideal. A fixed site is certainly preferable.”

(Zind) Magaraci is CEO of Habit Management. Magaraci says the company resorted to mobile clinics when local opposition prevented them from opening a treatment center. The mobile facilities are converted vans outfitted with a waiting room and nurses station. The van follows the same route every day. Stopping for about two hours at each location. Magaraci says the mobile units aren’t able to treat as many people as fixed clinics because of time spent on the road. He says the most common problem with a mobile clinic is weather.

(Magaraci) “If you’ve got a significant snowstorm for example, that’s a challenge because not only do you need to be dug out early enough you then need to travel to where it is you’re going to.”

(Zind) Habit Management has arranged with nearby hospitals to dispense methadone in the event the van is waylaid. Unlike fixed clinics the mobile facilities are not one stop treatment centers. Patients who receive methadone from a mobile clinic have to go somewhere else for counseling, which is a required part of treatment.

For over a decade one of Habit Management’s vans made a daily stop next to the police station in Brockton, Massachusetts. Brockton Police Chief Paul Studenski says at first town officials and residents were concerned the mobile clinic would create problems.

(Studenski) “All the apprehensions that you would normally see came with that. People were afraid that there were going to be nothing but criminals coming.”

(Zind) But Studenski says there were no problems and over the years Brockton residents came to accept methadone treatment in their town. Now the van no longer stops there. Instead, Habit Management has opened a permanent clinic in Brockton. Tom Magaraci says it can take time for a community to feel comfortable hosting a treatment center for addicts.

(Magaraci) “Sometimes the only way to get there is through a mobile program and get the services out there and people say, ‘you know, this isn’t as bad as we were afraid it was going to be.”

(Zind) Paul Jarris says the state is also working to expand the use of a newer treatment called Buperenorphine. Unlike Methadone, Buprenorphine can be prescribed by a primary care physician. For Vermont Public Radio, I’m Steve Zind.

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