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Ore. Methadone Clinic Aims to Curb Opioid Overdoses

The Daily Astorian, Ore.

May 1—Emergency responders in Clatsop County consistently administer naloxone for opioid overdoses at rates higher than the state average.

It's one aspect of a larger opioid abuse problem that some hope can be eased by a methadone clinic scheduled to open in Seaside this fall.

Last week, representatives from the Columbia Pacific Coordinated Care Organization, Greater Oregon Behavioral Health Inc. and CODA, a Portland-based drug treatment provider, shared with the county Board of Commissioners how a methadone clinic might help.

"It's not a magic bullet, but it's a tool," said Tim Hartnett, CODA's executive director.

Methadone acts as a powerful pain reliever that mimics some of the same effects as heroin or prescription opioids to help ease withdrawal symptoms. Having a local option is driven by the desire of the Columbia Pacific Coordinated Care Organization, which oversees the Oregon Health Plan in Clatsop, Columbia and Tillamook counties, to reduce the high cost of paying for people to get help in the Portland metro area.

The clinic would treat up to 300 people.

"There's a lot of people spending a lot of money to go to Portland for something they should be getting here," said Leslie Ford, Behavioral Health Clinical Integration Advisor for the coordinated care organization.

But some on the North Coast have raised concerns over whether the methadone clinic would increase the call load for medics and other emergency responders who are already responding to a higher-than-average number of overdose calls.

There are several factors that contribute to a high rate of naloxone use by emergency responders. Part of the reason is Clatsop County is among the top four most heavily impacted by opioid misuse and overdose deaths in the state, Ford said. Oregon Health Authority data shows the county as one of the highest in the state for hospitalizations for opioid overdoses in 2017.

Clatsop County has also been among the worst in the state for prescribing a large number of opioids. In 2015, more than 27 percent of county residents were prescribed opioids, according to the Oregon Health Authority, though that number has steadily decreased over the years.

"I think the rate of addiction in general is higher here," Ford said.

Higher abuse rates could also be related to the labor-intensive jobs in the timber and fishing industries that can lead to injuries or chronic pain, said Mimi Haley, the CEO of the coordinated care organization.

Data can also be skewed because it relies on self-reporting by emergency responders, meaning a county that consistently reports naloxone use is likely going to be higher than counties that do not. But the high rate also suggests a need for more resources before addictions turn into overdoses, Haley said, a problem reflected in many rural Oregon counties.

One of the misconceptions that surround methadone clinics is the fear that more people with addictions will be attracted to the region, and therefore increase the burden of medics and firefighters to respond to more overdoses, Haley said.

"The idea is people are so much less likely to overdose because they are in treatment ... because they are using this medicine," Haley said. "We don't represent an increase in probability. We represent a decrease."

"It's not like we're bringing in new people," Ford added. "They're here."

Duane Mullins, the general manager of Medix, said it's no surprise to hear the rate of naloxone being dispensed by emergency responders is high in Clatsop County, though he attributes some of the trend to the fact that more agencies are carrying it than before.

Mullins also doesn't anticipate the methadone clinic will bring any more calls than the ambulance service would already be handling.

But he hopes the clinic will help make it so fewer people will need his service down the road.

"The value (of the clinic) is going to be after I'm done with them," he said.


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