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Tribe Opens Methadone Facility

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Stillaguamish fights opiate addiction

SEATTLE - After several years of bureaucratic red tape based on public
opposition to a proposed methadone clinic the tiny Stillaguamish tribe
stepped in with an answer.

Since last October the tribe's Island Crossing Counseling Services, a
tribal drug an alcohol abuse treatment facility, has provided methadone
treatment on an out-patient basis for qualifying local residents, Indian
and non-Indian alike.

"Because of tribal sovereignty we were able to cut through the bureaucratic
hassles," said Stillaguamish tribal Executive Director Eddie Goodridge Jr.

Given the divisive nature of the debate in the community Goodridge said
that he was surprised that when the tribe decided to use their sovereignty
they were met with little opposition.

Goodridge and tribal opiate substitution treatment program (OTP) Director
Thomas Ashley said there has been a need for such a facility in the
northern parts of Washington state for several years. They say that before
the treatment facility opened at Stillaguamish people undergoing methadone
treatments had to travel an hour and a half each way to Seattle on a daily
basis to receive methadone treatments.

In all, Washington state has 14 public and nonprofit drug treatment
facilities that provide methadone treatment plus an additional few that
serve veterans. However, most of these are located in urban Seattle and its
surrounding metropolitan communities on Puget Sound. Rural communities such
as Stillaguamish have been lacking such facilities despite increased opiate
abuse in these areas.

The need is certainly there and Ashley reports that already more than 100
people have undergone methadone treatments at the Stillaguamish facility
since it opened. Some of the surrounding tribes have been experiencing
problems with opiate addiction including the Lummi who went public with
their problems earlier this year in a New York Times article.

Washington state Division of Alcohol and Substance Abuse Acting Director
Doug Allen said there has been "a definite problem" in regard to opiate use
with the area's tribes and throughout the area generally.

Though Seattle made a dubious name for itself during the early 1990s as a
major heroin center, Ashley and Allen said much of the current increase
largely deals with prescription medications such as Vicodin and Oxycontin.

Methadone is a common treatment for people addicted to opiates. Methadone
is in itself considered a narcotic and is opiate based. However, it is far
less detrimental than other opiate-based substances such as heroin and is
used to ease the pain of withdrawal from more severe opiates.

Not everyone who seeks treatment for opiates is given methadone and it is
generally regarded as a final measure when all other forms of treatment
fail. Patients seeking treatment for opiate addiction usually have to go
through several hoops first, including counseling and more standard drug
treatments.

It is only when these options are exhausted that a patient is eligible for
methadone treatment. However, the Stillaguamish facility does provide
counseling through the treatment.

"We also try to address the root of the addiction," Ashley said.

This is only the second tribally run methadone clinic in the country, the
other being near Tucson, Ariz., and it is the first to be accredited by a
state.

The road to both federal certification and state accreditation is a long
one. In order for a facility to dispense methadone in Washington state at
least four different agencies, two federal and two state must sign off on
the project, something that the Stillaguamish tribe has done. First the
facility has to be inspected by the Drug Enforcement Agency and the Mental
Health Services Administration's Center for Substance Abuse Treatment to
make sure that the facility is meeting federal guidelines.

Since states then have the option of imposing even more stringent rules, as
is the case in Washington state, two more state agencies, the Department of
Pharmacy and Division of Alcohol and Substance Abuse also must sign off on
the project.

Ashley said there are many reason that so many agencies have to sign off on
a methadone treatment facility and not the least among them is security.

Needless to say security at the Stillaguamish facility is very tight.
Patients must first go to an ATM-like machine, where they are photographed
just to get in the door and then go through four more security points to
make sure that it is the person who qualified for treatment that is
actually ingesting the methadone.

Since methadone is also considered an addictive narcotic there is a problem
with people who then gain an addiction to methadone and the goal, Ashley
said, is to wean patients off of methadone.

Ashley said the facility utilizes some of the most high tech dispensing
devices available. The computerized system can measure, with accuracy, to
one hundredth of a milligram and patients are then slowly weaned from
methadone at gradually lower and lower dosages. However, Ashley admits that
this is not always successful and sometimes patients remain addicted to
methadone.

Goodridge claims the tribe enthusiastically supports the facility and calls
it a pioneering effort. He said that the tribal council, some of whom had
family members addicted to opiates, has supported the facility "every step
of the way."

Goodridge described the problems that the surrounding local communities,
such as Everett, had when a methadone treatment facility was proposed. He
told of stories in which some local residents tried to wage a campaign of
fear and misinformation regarding the facility.

"It was all of the usual stuff," explained Goodridge. "They said that crime
was going to go up and that neighbors were going to have their homes broken
into and all of that kind of stuff. The thing they didn't realize is the
people that are seeking treatment are not the ones to worry about, it's the
ones that don't."

Goodridge, whose brother lives "a stone's throw" from the facility said he
has not noticed any increase in crime and that he spoke to the local
sheriff who confirmed this.

Calls to the Snohomish County Sheriff's Department were not returned by
press time to confirm.