Inside look at Overmountain Recovery treatment program

GRAY, TN (WJHL)- Two months after a controversial medication-assisted treatment center opened in the Tri-Cities, News Channel 11 got an inside look at the treatment process.

Overmountain Recovery is the first methadone clinic to open in the Tri-Cities and there was a lot of controversy surrounding it.

“We were really apprehensive about it to start with,” said Margie Hale, who lives across the street from the clinic in Gray. Like many people in the Gray community, she believed the clinic belonged in an area closer to other medical services and first responders. Community members protested and wrote letters to local and state officials expressing their opinions but the clinic received the necessary approval and opened in early September 2017.

“I feel like we won’t see the effects of it for awhile,” said Hale. “After they get hundreds of patients I don’t know what it’s going to be.”

Overmountain Recovery, owned by East Tennessee State University and Mountain States Health Alliance, recently gave News Channel 11 an inside look at the treatment process.

Program Director Laurie Street said currently the clinic treats about 70 patients, many of whom abused heroin. “Withdrawing from a drug like heroin is very painful. It’s like the flu times 10 so you can imagine… it’s hard,” Street said. “Many of them have done this for awhile so they know what those withdrawal systems are like. Asking them to quit altogether is not realistic in a lot of ways so this allows them to take the medication and not have those withdrawal symptoms and allow them to function as a person.”

Street said potential patients must go through an intake process which can take up to three hours. During that time they will meet with the doctor, counselors, nurses, take a urine test to confirm the presence of opioids, and have blood drawn to check for a variety of infections or diseases. If a person is approved for the program they will attend orientation the next day where an individualized treatment plan will be made.

Patients will go to the clinic every day to take a liquid dosage of methadone, a medication that eliminates withdrawal symptoms and cravings. Street says a nurse will always monitor patients as they take the medication and converse with them to ensure they swallowed it and do not have any adverse effects. During the first treatment, Street said the nurse will monitor patients for 20 minutes after dosing. Patients will be monitored for about 5-10 minutes during subsequent visits.

Dr. David Kirscheke, medical director for the northeast regional health of the Tennessee Department of Health, said methadone does not impact a person’s ability to perform everyday activities. “They’re not getting high from it,” he said. “It just kind of stabilizes them… It prevents cravings and it prevents them from re-lapsing. It also prevents, if someone does other drugs… it prevents that high or euphoria that {drug} can cause.”

Therapy is also a requirement of the program. Currently, there are nine therapy rooms at the clinic and five counselors on staff from Frontier Health, a behavioral health facility. During the first four months of treatment, Street said patients are required to attend at least two counseling sessions per week, including one individual session and one group session. After four months the requirements drop slightly but patients will always be required to attend therapy at least once a month. Street said several topics are covered in counseling, including anxiety and coping skills.

“Medication alone without talking about your life is just not as effective,” said Dr. Randy Jessee, who specializes in substance abuse and is a consultant with Mountain States and the clinic. “Recovery is a bigger topic than just medication. Recovery is a process. It’s a life process. Living is what we do and recovery is about that so to really engage in recovery you need to talk about who you are and where you’ve been and where you want to go and things that have impacted your trip so far.”

“We’re monitoring the whole person. It’s not just come in here and get medication by any means,” said Street. The clinic also offers wrap-around services for anyone that needs them. A navigator working at the clinic can help people find services and organizations to help patients who do not have transportation or housing or need job training and placement.

“We’re seeing it be such a success,” Street said about patients in the program. “Our patients, the feedback we’re getting is I have my life back . I feel normal again. It’s just phenomonal.”

A patient becomes elgible for one take-home dose of methadone per week after three months in the program. The number of take-home doses increase the longer a person has been in the program up to 7-13 take home doses per week.

“The medication will be prepared and sealed in a lockbox,” said Street. “They also have to return the bottle to us so we can be the one to destroy the bottle.” Street said patients have to meet several mandates before getting a take-home dose, including passing all scheduled and random drug tests, attending diverson control meetings and must have a sable home environment. The clinic will also check the Controlled Substance Monitoring Database before any take-home doses are issued. At any time the clinic can require the patient to come in so a staff member can check the lockbox. If they are not compliant with the rules, the patient will los their take-home privleges but can gain them back after 30 days of compliance. Repeated non-compliance can result in a patient being discharged from the clinic

When it comes to safety, Street said the methadone is stored in a safe behind several locked doors with limited access. She said staff conducts several counts to ensure the medication is always at the appropriate level. “We always have to have two nurses that do the counts. {we have} different reports we have to keep to make sure everything is correct,” Street said.

The clinic also has two security guards on-staff during business hours and security cameras. Johnson City police and the Washington County Sheriff’s Office said there have not been any issues at the clinic since it opened.

Since opening two months ago, Street said Overmountain Recovery has retained 95 percent of its patients. She believes that is proof the treatment works. “We’re starting to see these people who have been with us for awhile really take an interest in their appearance.”

Street said the clinic’s team constantly evaluates a patient’s treatment plan to determine how to move forward and while the goal is to eventually ween a patient off methadone sometimes it may not be possible.

“We’re just trying to do something for this opioid crisis which is huge,” Street said. “I think if it’s the difference in allowing them to take a small dose of methadone to function as a normal human being, the father of the mother they want to be, being able to hold down a job, versus going off the medication completely and not being able to function, probably going back to the street drugs then… I guess I just wish the community could see some of the successes… that really makes a difference.”

A patient can be discharged from the program if they abuse opioids over a period of time. Overmountain Recovery says it follows Tennessee guidelines for non-residential opioid treatment facilities. Click here to see the state guidelines.

Copyright WJHL 2017. All rights reserved.

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