Rob Pack Photos courtesy ETSU.
By Jeff Keeling
East Tennessee State University (ETSU) and Mountain States Health Alliance (MSHA) are seeking state permission to collaboratively operate a drug addiction clinic in Gray that will include methadone and buprenorphine (suboxone) treatments. The plan, like other proposals for “medication assisted therapy” clinics in the area, swiftly drew opposition from some citizens in Gray.
Leaders of both entities announced the plan last Wednesday. The non-profit corporation formed to operate the clinic, East Tennessee Healthcare Holdings, Inc., submitted a “Certificate of Need” (CON) application to Tennessee’s Health Services and Development Agency on Tuesday. If the HSDA deems the application complete in a decision expected by the end of May, it would rule on the request at its Aug. 24 meeting – the same meeting at which it is due to hear a request from New Path LLC, a company wanting to open a similar clinic on Princeton Road in Johnson City.
Cost for retrofitting a MSHA-owned building on Gray Commons Circle is estimated at $1.7 million, and the clinic – which could open sometime next year – would include staff from both MSHA and ETSU.
If approved, the clinic will combine the medication assisted therapy with counseling, group therapy and other social support services that are an important component of any successful recovery from addiction, organizers said. It also will have a research component led by ETSU’s newly formed Center for Prescription Drug Abuse and Treatment, center Director Dr. Rob Pack said.
Everyone affiliated with the center, Pack said, “will be … assigned to an evidentiary practice and part of a team that is monitoring the use of that practice, and then will report on its use and how it’s been disseminated and implemented.”
Alan Levine
The center, the result of four years of collaborative community work, was approved by the Tennessee Board of Regents late last month. It aims to address the region’s well-documented prescription drug abuse problem through education, outreach, research and treatment.
Along with prevention, overdose intervention and monitoring through databases, Pack said, treatment is an important component, “including buprenorphine, also including methadone. Methadone is an effective treatment, and there are many guides for its use.”
By the end of last week, opposition to the proposed location on Gray Commons Circle had ramped up. A citizens group in Gray will hold a meeting Thursday for people to discuss their concerns. MSHA CEO Alan Levine seemed to anticipate community concerns in his comments last Wednesday.
“We realize this is a controversial issue,” Levine said. “We’ve been through several rounds of the certificate of need process where clinics have come in, there’s been a lot of opposition, but I think we have to realize that these types of therapies are part of the continuum. They’re accepted by science and … the law does permit and in fact provide for a (CON) process for these clinics.”
Levine said the partners were sensitive to people’s concerns and tried to choose a site without a lot of commercial activity or residences close by. He said he believes the project “is a model that hopefully the community will rally around.”
In addition to Pack and Levine, ETSU Vice President for Health Affairs Dr. Wilsie Bishop and President Dr. Brian Noland both stressed what they said was the importance of a comprehensive approach to the drug problem.
Wilsie Bishop
In addition to research, Noland said, “revenues from this operation will be directed toward education and outreach efforts across (ETSU).”
Levine said counseling and other support services will be offered to clinic patients, and the research mentioned by Pack will strive to discover, “models that work using evidence-based practice, and (use) that to translate into treatment models for providers throughout the region.”
Pack said ETSU will continue its public clinical work and continuing education programs in addition to offering treatment through the center if it’s approved. Some of the research that could spring from a clinic includes working with MSHA’s Niswonger Children’s Hospital to help identify ways to combat one side effect of the area’s prescription drug abuse problem – neonatal abstinence syndrome, or NAS.
“We think by doing this we can push on many different fronts to help push back against the epidemic in a concerted way,” Pack said.
MSHA officials said Tuesday that they learned about the citizens meeting in Gray through the media, and that no one from that group had contacted MSHA or ETSU asking them to appear and answer any questions at Thursday’s meeting.
“ETSU and Mountain States are aware of the community meeting scheduled for Thursday night,” the systems said in a joint statement released Monday. “This is an important opportunity for residents to express their questions and concerns, and we appreciate any feedback that the community passes along to us. We will do our best to be responsive to any questions that are formulated as a result of this meeting.”
