Pope's visit poses challenges to methadone clinics
Roland Lamb keeps a spreadsheet, updated daily, with 750 numbers, each representing a client in drug treatment whose life will be disrupted by the pope's visit.
Roland Lamb keeps a spreadsheet, updated daily, with 750 numbers, each representing a client in drug treatment whose life will be disrupted by the pope's visit.
These are people who must receive methadone every day, in person, to avoid the awful withdrawal sickness that used to keep them on heroin. But some of their clinics will be closed. Other people take bus routes that are being so snagged by security measures that it would add two to three hours to their travel time.
So clinic staff and city officials have been spending hours a day for the last month finding ways around the problem.
Methadone maintenance is "the most heavily regulated medical intervention out there," said Lamb, director of Philadelphia's Office of Addiction Services. Each transfer must be verified in advance with consent forms and proof-of-last-dose forms, transmitted via communication that complies with a privacy provision in state drug law that's even tougher than federal law.
This weekend will be a test of an "encrypted drop box" that the clinics have developed to securely share necessary records.
On Tuesday, Lamb's spreadsheet showed numbers representing 378 clients shaded green - all paperwork complete - and an additional 372 in yellow. By Saturday, he said, "there will not be a chad hanging out there."
If he's wrong, people could end up in vastly overcrowded emergency rooms or crisis centers, or buying methadone - or, conceivably, heroin - from a street dealer.
About 5,000 Philadelphia residents are in treatment with methadone plus counseling, Lamb said. Roughly 1,000 of them normally go to three clinics that will be closed this weekend or to 10 that will be difficult to reach from some areas.
The logistical solution will be announced Wednesday at a news conference.
About 200 to 250 of the clients will be authorized to take three or four days' worth of medication home - an approval that must meet stringent federal requirements. A major concern in handing out multiple doses is the risk of overdose, so people who get this privilege have to have shown consistent progress toward meeting goals, among other standards.
Another risk is the potential for resale. Methadone sells for "four times the value of heroin on the street," said Tom Baier, an executive who oversees two centers for JEVS Human Services, and the Drug Enforcement Administration spot-audits clinics to ensure there is no diversion.
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@DonSapatkin