One of the ways health officials have tried to stem the growing amount of heroin and prescription opioid abuse in New Hampshire is methadone treatment. Methadone is an opioid, but given in the proper dose, it can reduce cravings without getting users high. A series of reports from the Keene Sentinel found a clinic serving the Monadnock Region may be prescribing addicts with dangerous doses of methadone, and has been operating with almost no state oversight.
Ella Nilsen, the Sentinel’s health reporter, joined All Things Considered to talk about the series.
Your investigation begins with an encounter in 2008 between a jogger, Jenna Lydon, and a driver, Addison Southwick. What happens?
In 2008, Jenna Lydon was a graduate student at Antioch New England in Keene. She was just out for a jog one morning, and all of a sudden noticed a car coming toward her. Addison Southwick, the driver of the car, who was a methadone patient at the Keene Metro Treatment Center in Swanzea, had fallen asleep behind the wheel, and unfortunately hit Jenna Lydon and injured her quite severely.
If you’re on the right dose of methadone, you're not supposed to get tired. What are the rules around distributing methadone, and what do we know about Keene Metro’s track record on distribution?
It's tough, because there's no real standard dose for methadone. It's supposed to vary depending on how severely an individual patient may be addicted. That being said, there is a federal standard for doses that ranges between 60-120 milligrams. From what I've heard from former employees and some former patients, Keene Metro was dosing clients up to 200, sometimes up to 260 milligrams.
The Metro Treatment Center is owned by Colonial Management Group, which one person in your story calls “the McDonald’s of Methadone.” This company has faced lawsuits for similar car accidents in other states. It also operates in Concord and Manchester along with Keene. What’s the state oversight like for these facilities?
The state oversight that I've found is very little. And that is, in part, because state officials told me that there's just no real funding on the state level to regulate these clinics. Most of what happens with regulation is done by an entity called CARF, which is an independent, nonprofit accrediting commission. A lot of the time it seems that CARF is really only going into clinics once every three years for site visits.
When you reached out to Metro Clinic, what did they have to say?
They did not return any of my phone calls or emails. At the local level, the program director for Keene Metro told me that she could not talk to me. At one point there was a community forum in Keene, and she was one of the panelists on this panel to discuss drug abuse as a community problem. She did invite any member of the community to come check out the methadone clinic. But when I went up to her after and asked if I could come to the clinic and see what it was like, she told me I could not.
Where are Jenna Lydon and Addison Southwick today, some six years after the accident?
Jenna has made a truly incredible recovery, I think. The day of the accident, her face was badly smashed on a windshield, one of her legs was very badly broken, and it took months of what she called torturous physical therapy. But she's just completed a couple of triathlons this summer, is a very active woman.
Addison Southwick told me that he is trying to make sure that he is clean. While he knows people that methadone does work for, it's not something he would ever want to go on again.