Lisa Kidd knows the drill. She flashes her identification card without needing to be prompted and has her lockbox open, ready to go. This is what she’s up to every fourth Tuesday of the month: picking up her methadone prescription at Counseling Solutions Treatment Center in Chatsworth, Georgia.
For over 30 years, Kidd has been on methadone—a Schedule II narcotic that treats opioid addiction by blocking withdrawal symptoms. Before getting clean, she says she was a “hardcore drug addict” who would “hit you in the head with a lamp in a hotel room” or dance for money—“whatever [she] had to do to get the money [for drugs].” Her addiction landed her in prison and other places she doesn’t want to return. And methadone, she says, is what keeps her from going back there, into addiction.
Today, she lives with her husband in Walland, Tennessee. There are methadone clinics closer to her—Knoxville has two—but she says that those are too expensive.
“I’d rather just come to Georgia. I’d rather drive straight down here for two hours and pay this amount of money and be done with it, you know?”
Treatment at a methadone clinic can be up to $40 a week cheaper in Northwest, Georgia, than it is in Tennessee.
Zac Talbott, who owns and operates this clinic, claims that Kidd is in the minority and that three-fourths of his patients are from surrounding Georgia communities. Still, his clinic sits about 20 miles from the Tennessee border and so he considers out-of-state patients an unavoidable reality. “Our county borders Polk and Bradley counties of Tennessee,” he reasons, “so obviously we’re going to have some Tennessee patients cause it’s right next door.” But Talbott chose to open up in Chatsworth, not for the proximity to the state line, but because it in itself was a community in need.
Talbott felt compelled to serve “an area of need” and found that in Chatsworth. The town’s overdose death rate and dearth of treatment options convinced him that Chatsworth would benefit from a methadone clinic. “When we opened,” he explains, “we were the only opiate treatment program in our county and all the counties that border us.” Today, methadone clinics are scattered all throughout Northwest Georgia.
Some locals object to the “treatment tourists” that these Northwest Georgia clinics attract. Catoosa County Sheriff Eric Sisk is one of the loudest voices speaking out against these visitors. Georgia leads the Southeast with 72 methadone clinics. In comparison, Tennessee has 12—but Sisk says that’s more than enough to get Tennesseans by. “It’s not that there aren’t any methadone clinics in the state of Tennessee,” he says. “There are answers within their own jurisdiction and within their own boundaries. I have my own home area that I have to look after.”
He worries about an uptick in crime and sharing the road with these “treatment tourists.” Plus, he’s skeptical about whether methadone is an effective way to treat a problem that is ravaging his community. He calls opioid abuse a “huge problem, a definite problem” for Catoosa County. But he just doesn’t know if methadone is the answer. “A methadone clinic is in the business to make money,” he says, “so why would they want to wean their clients off of methadone?”
Neil Campbell, Executive Director of the Georgia Council on Substance Abuse, admits that there are good and bad clinics. And it is the bad clinics, she says, that have given people like Sisk the wrong idea about methadone. “When it’s prescribed and used in the right way,” she says, “along with behavioral therapy, it’s highly successful in treating opiate addiction.”
But Campbell says greater regulation is needed in order to ensure that these success stories happen more often. She says that objectors like Sisk, “may be right; there may be some nefarious things going on in those clinics but if they’re well-run clinics that are well-regulated and operated, I think they would change their minds.”
And that’s what this may all come down to—regulation, or a lack thereof on Georgia's part. Campbell explains that “because Georgia hasn’t regulated [methadone clinics] well and done a Certificate of Need type situation with these, they’ve just exploded.”
Certificate of Need (CON) laws are part of what keeps the methadone clinic count low in Tennessee and Alabama. A CON requires that prospective clinics prove that they would be helpful to a certain community. Georgia doesn’t regulate methadone clinics with a CON program. Or at least it didn’t until this past February, when the Georgia state Senate passed a bill that replaced a year-long moratorium on methadone clinics with new regulations. Now the state is divided into 49 regions, with each allowed a maximum of four methadone clinics. Any pre-existing clinics were grandfathered in when the bill went into effect on July 1. But anyone who wants to open a clinic in a region that's already met its cap will have to prove that they can fulfill a community need.
None of this changes the fact that Kidd “just can’t afford the price [of methadone] in her hometown.” That’s why, regardless of new regulations, she’ll still drive two hours--each way--every 27 days to get her methadone prescription.