Treatment clinics: Time to take a ‘listening tour’


By Jeff Keeling

For the most part, I saw what I would have expected among the billboards that assailed our view as we began the drive home Sunday after a week in South Carolina’s low country. Scattered conspicuously among the enticements to enjoy the beach or find antiques at quaint (and probably quaintly decrepit) downtowns a few miles off of Interstate 95, though, were a couple of outliers.

Apparently, the prescription drug addiction problem is alive and well in South Carolina – so much so that clinics dispensing Suboxone, Subutex and other medication assisted treatment (MAT) can afford billboards to beckon addicts who want to get clean.

The overuse of prescription opiates is a nationwide problem, for sure. So is the proliferation of MAT clinics making easy profits off of the problem, but paying mostly lip service to the federal Substance Abuse and Mental Health Services Administration’s description of MAT. That description says that MAT, “combines behavioral therapy and medications to treat substance use disorders.”

From all accounts, far too many clinics add a smidgen of behavioral therapy to a dollop of medication and call it a combination, which is about like someone adding a thimbleful of cranberry juice to three shots of Everclear and calling it a mixed drink.

But Anderson, S.C. native Dr. Robert Califf wasn’t in the Palmetto State yesterday afternoon, after this column went to press. The Commissioner of the Food and Drug Administration was at East Tennessee State University, speaking with faculty and staff about ETSU’s newest center of excellence, the Center for Prescription Drug Abuse Prevention and Treatment. Califf was here for the same reason the new center is here: prescription drug addiction is worse in these parts than pretty much anywhere in the country.

Califf is on a “listening tour” of Tennessee, Kentucky and West Virginia, visiting treatment facilities, youth-oriented prevention programs, colleges and universities, and pain clinics.

From my perspective, a listening tour is something from which all of us could benefit when it comes to the difficult topic of prescription drug addiction, and all the issues that swirl around it.

Take the citizens of Gray, for instance, who learned May 11 that ETSU and Mountain States Health Alliance want to collectively operate a drug addiction clinic just off of Highway 75. If approved, the not-for-profit clinic would draw on the center of excellence’s resources and combine research, counseling, group therapy and other supportive services to clients – along with MAT. That sounds a lot like MAT done right, but apparently many people in Gray heard suboxone and envisioned junkies breaking into cars and jeopardizing schoolchildren in their neighborhood.

The folks in Gray had a meeting a week after the announcement. From what I can gather, they listened to each other, but they didn’t invite ETSU or MSHA to answer questions, though both entities were willing to do so.

I understand the “not in my backyard” initial reaction, but I begin to lose sympathy when people are unwilling to listen and gather information.

Legitimate questions remain about the most effective methods to help people overcome addiction. Abstinence proponents should listen to MAT proponents, and vice versa. I suspect numerous paths can lead to recovery. I am certain none of those paths is easy.

The planning commission should listen to ETSU and MSHA with regard to location. The state should listen to them with regard to approving or denying the clinic. The people of Gray, or another community should the proposed location change, should listen to ETSU and MSHA, and ETSU and MSHA should listen to them.

People are dying, families are suffering, our economy is threatened – all as a result of our prescription drug abuse epidemic.

I don’t know where the solution lies, but I know it doesn’t lie in closing off our ears and our minds to one another’s perspectives.

I’ve driven by the proposed clinic site. Maybe it’s an appropriate place for the proposed clinic, maybe it isn’t. If ETSU can establish the clinic somewhere and achieve its objectives, much good will be done, people’s lives will be changed and the country will have a model of best practices it can replicate elsewhere.

Before all that, though, we have to do a better job of listening to one another.


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