Methadone clinics in northwest Georgia draw addicts across state lines

The sign outside a northwest Georgia clinic caught Josh Harrison’s attention. Pay only $1 a day to kick your drug habit, it advertised.

It was a steal compared with what Harrison had been paying at another clinic — 10 times more, cash — for the methadone he hoped would finally help him escape the Xanax addiction that had taken over his life. Instead, he simply became hooked on the methadone — a cheaper drug that’s more widely available in Georgia than other Southern states and has ensnared thousands of addicts like Harrison.

“That’s how they did it. They run a special. For the first 30 days, it’s $1 a day and after that it’s $11,” said Harrison, who had been taking Xanax since he was 15 for obsessive compulsive disorder but, at 37, is now sober. “That’s just a scam to get people hooked on methadone.”

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Northwest Georgia, along the Tennessee and Alabama borders, is prime territory for narcotics treatment centers, commonly known as methadone clinics, where there are more such facilities per person than any other region of the state.

The four-county region has five clinics compared with just 12 in the entire state of Tennessee and 20 in all of Alabama. Georgia is home to 72 clinics in all — the easier access drawing addicts from out of state on a daily basis, usually before dawn, for methadone treatment. That’s particularly true in the northwest where officials say two out of three patients are from out of state.

July 28, 2017 Ringgold - Catoosa County coroner Vanita Hullander pauses as she talks to Johnny Long while she is visiting her daughter’s office in Ringgold on Friday, July 28, 2017. A new law gives Georgia a little more power to address potential problems of methadone clinics. HYOSUB SHIN / HSHIN@AJC.COM

Credit: Hyosub Shin

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Credit: Hyosub Shin

“The laws in Georgia were much more lax than surrounding states and the location of our county put us close to Tennessee and Alabama,” said Ringgold Mayor Nick Millwood. “That made us a key spot and it was becoming a problem. … They are selling something that is just as addictive as something they are trying to get folks off of.”

A new law that took effect in May aims to change that by dividing the state into 49 regions and limiting each to no more than four methadone clinics.

“At the time when we did the research, we had only two clinics (in Gwinnett County),” said Sen. Renee Unterman, R-Buford, one of the law’s sponsors, adding that more clinics began moving in after they found out the state would be cracking down.

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IN-DEPTH: Is Georgia overdosing?

“All they do is transfer people addicted to opioids to the methadone,” Unterman said. “You don’t need to be on methadone for the rest of your life.”

But getting the rules in place and hiring enough staff to enforce them takes time, according to the state’s health agency. And those areas that already have more than four methadone facilities will be “grandfathered” in and can stay.

An addictive treatment for addicts?

Methadone, which itself is an opioid painkiller, has been a less expensive treatment for addiction for four decades. But it too is addictive.

“Methadone is a money maker,” said Don Hicks, chief detective with the Dade County Sheriff’s Office. “It’s like a Kool-Aid stand. You can’t give a drug addict drugs so he’ll get well.”

Because it takes longer for the body to process methadone — as much as six times longer than hydrocodone and up to three times longer than OxyContin and oxycodone — it is used to prevent withdrawal symptoms and reduce cravings. But the slow-acting nature of methadone also makes it easy for users to take too much, officials say.

It can be dangerous if the dosages are not closely monitored, especially if a user takes another narcotic while on methadone.

According to the Centers for Disease Control and Prevention, 3,301 people died of methadone overdoses in 2015, the most recent data available.

In Georgia last year, 91 people who died of overdoses had methadone in their system, Georgia Bureau of Investigation data shows. And there have been 15 so far in 2017, including three in northwest Georgia.

GBI spokesman Bahan Rich said methadone was found in one out of every eight drug-related deaths.

But usually there are other drugs involved, said Johnny Gray, the coroner of Dade County, which has 16,000 residents and one methadone clinic.

For example, in June, two brothers were hospitalized after overdosing. When they returned home the next morning, they found their mother dead.

“They (all) had methadone in their systems, but they had also (overdosed) on other things,” Gray said. “The stuff people are playing with today will kill you.”

‘A dark zone’

Catoosa County in the northwest has a population of 66,000 and three methadone clinics.

“It’s unique to this area because we’re in a dark zone of Georgia,” said Catoosa County Coroner Vanita Hullander.”We’re the feather tip of Georgia and next to Tennessee.”

In comparison, DeKalb and Cobb counties, about two hours away, each have two methadone clinics. And in Fulton, the state’s most populous county that is home to more than 1 million people, there are four. Only Gwinnett County, with just shy of 1 million residents, has more methadone clinics than any other region with nine.

Rip Connell, who runs Private Clinic North in Rossville, said it takes years to get off methadone and requires counseling and close monitoring by doctors.

July 28, 2017 Ringgold - Exterior of Private Clinic North on Chickamauga Ave in Rossville on Friday, July 28, 2017. A new law gives Georgia a little more power to address potential problems of methadone clinics. HYOSUB SHIN / HSHIN@AJC.COM

Credit: Hyosub Shin

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Credit: Hyosub Shin

Connell said one client had been coming to his clinic since 1998 and it was only three years ago she began the process of tapering off the methadone.

Still, he said, “93 percent of our patients are illicit-drug free within the first 30 days.”

Catoosa County Sheriff Gary Sisk said Connell’s clinic is well-run but that is not necessarily the case with others in the area. “There’s good and bad,” Sisk said.

Hullander said some do little monitoring once they hand out methadone dosages. She has seen long lines form outside some of the clinics in the area hours before dawn, people trying to get their daily doses before work.

July 28, 2017 Ringgold - Catoosa County coroner Vanita Hullander uses a laptop to read news as she visits her daughter’s office in Ringgold on Friday, July 28, 2017. A new law gives Georgia a little more power to address potential problems of methadone clinics. HYOSUB SHIN / HSHIN@AJC.COM

Credit: Hyosub Shin

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Credit: Hyosub Shin

Connell said his staff includes two doctors, a physician’s assistant, six nurses and 18 certified substance abuse counselors who treat about 700 clients. He said anyone who comes to the Private Clinic must have a job unless there is a reason they cannot work. Counseling and drug testing are key parts of the program.

‘Methadone was the worst’

The new law targeted at reining in the explosion of methadone clinics in Georgia may have technically gone into effect in May, but it may be months longer until it actually gets enforced.

The Department of Community Health is still “finalizing the rules” with an eye toward “open enrollment” for new clinics in December, spokeswoman Fiona Roberts said. The agency is also still looking at staffing needs.

And even then, law enforcement and coroners in the northwest and other regions with more than four clinics will still have to deal with the same number of facilities like the one Harrison found himself drawn too by the promise of a cheap high.

Harrison admits first turning to methadone mostly as an alternative way to get high. Soon it became “a whole new battle,” he said.

MORE: What the painkillers took from Georgia family

“After the first dose, I went high like methamphetamine. A rush — sweating, energy. I don’t think that high ever went away,” he said.

Withdrawal from a methadone addiction is just as bad as with other drugs, Harrison said. He said he weaned himself off methadone on his own after taking it for two years because the clinic had been increasing his dosages and there had been no discussions of getting him off the drug.

But, Harrison said, “of all the drugs I’ve been on, methadone was the worst. The withdrawal was the worst — sweats, shakes, stomach cramps, vomiting, diarrhea that lasted about three months. It was a nightmare.”

What is methadone?

Methadone is an opioid painkiller that was introduced in the United States shortly after World War II as a way to ease heroine addicts through withdrawal.

Though it too is addictive, it takes the body as much as six times longer to metabolize methadone than other narcotics and it does not bring the same rush. Taken in either pill or liquid form, methadone cuts cravings and symptoms of withdrawing from other drugs and people are able to function in their every day lives while using it.

The positives of using methadone to detox are also the negatives. Without the rush and with methadone remaining in the body longer, it’s easy to overdose. It also is dangerous if users mix methadone with alcohol or depressants.

Treatment is expensive at $10 to $12 a day in cash.

Once the initial addiction is gone, users can begin cutting back on their methadone doses, but it can take years to be rid of the methadone addiction.