Looking for Answers with Methadone

Posted at: 11/08/2012 10:47 PM
Updated at: 11/10/2012 11:00 PM
By: Darren Danielson

Wednesday night, Eyewitness News introduced you to Dave and Kathy Lingren. Their son, Mitch was killed, along with co-worker Zach Gamache in what authorities say was a methadone related crash. In part two of the special series, we look into the controversies of methadone treatment and dive in even deeper to find if there really are, no good answers.   

A stretch along Highway 210 is where it happened. Authorities say Mitch Lingren and Zach Gamache died at the scene.  
"He was a good kid," his mother, Kathy Lingren told us. "Quiet, sweet, those were some of the words used by some of his classmates that came to the visitation, he was very well liked," added his father, Dave. 
The driver of the oncoming car, 26-year old Vanessa Rae Brigan, faces two counts of vehicular homicide. Authorities report Brigan showed signs of controlled substance impairment. Court records say a bottle of methadone was at the scene, along with a used needle and syringe. The criminal complaint says she was on her way back from a methadone clinic in Brainerd.
"We know that methadone can be an effective treatment when it's administered the correct way," says Ann Busche, Director of Public Health and Human Services for St. Louis County. 
So, what exactly is methadone? It's a substitute drug for people addicted to heroin and other opiates. Busche says methadone has been used for over 40 years across the country. It's administered only through doctors orders to help addicts stay functional, hold down a job or raise their children. 
"It's really a medication that they need to have a good quality of life and be free from a higher addiction drug, or illegal drug," Busche said. 
Like most of us, Sen. Roger Reinert, DFL-Duluth, admits he didn't know much about methadone.  But after the accident, he said questions started flying.
"Why are we doing this? Why are we helping pay for it?  Does it do any good? What do we know about methadone as a treatment? All those sorts of things," he said.
And he began looking for answers. 
Reinert explained, "Methadone is to a heroin addiction what a nicotine patch is to nicotine addiction.  It is a step for people who want to get healthy and away from that."
Rep. Tom Huntley, DFL-Duluth, also spoke with us. He said, "Not everybody is the same and somehow we've got to understand that there's not one treatment that's going to work for everybody."
Huntley found that even health professionals can't agree, saying "There's one group that says we should treat this, that there's no cure and we're just going to treat forever. But you have the opposite group of academics and health care providers that say total abstinence is the only way to go."
While the treatment itself is being debated, so is the management of the programs. The Lake Superior Treatment Center in Duluth has one of the 15 methadone programs in Minnesota. It had its license revoked this fall. The center remains open while it appeals the revocation. The state found numerous and repeated violations, including failing to adequately document treatment and excessive caseloads for counselors. Huntley commented, "You go to these clinics and they don't have proper supervision, they are all overwhelmed with the number of people they have to see on a given day."
Another violation cited was for not monitoring take-home doses. Huntley gave an example on how methadone programs can be abused: "So they say I'm having withdrawal pains, I need a bigger dose. So, they give them a bigger dose to take home, and what do they do with it? Some of them overdose and kill themselves, while others sell it on the street."
Many centers, like Duluth's operate for-profit. Which is a model both Reinert and Busche have qualms about.
"Quite honestly, if you do the math, for a provider, it brings in a fair amount of income," said Busche.  
Another important part of the equation? Busche and Reinert said that of those using methadone, only five to ten percent end up clean.
"We have a for-profit at play with taxpayer dollars that's increasing the use of methadone as a treatment modality, when we know that it's effective for only five percent of the population. I mean, there really are a series of questions that beg answers," Reinert said. 
There is also the question of taxpayer dollars. From 2005 to 2011 Reinert says Minnesota spent about $45 million for uninsured addicts to get methadone. He sees that price tag climbing, right along with the growing number of users.  He explained, "we've seen the treatment of methadone as a treatment modality that has increase 60 percent over that same time period. That's a pretty substantial increase."
While lawmakers and health professionals agree that better scrutiny is needed, Ann Busche says the programs cannot be just about the drug.   
"I personally believe they should be more focused on treatment and less focused on just continuing to provide a dose of methadone to addicted individuals," she said.
This summer and fall, St. Louis County professionals and others who deal with the problem have been meeting to find solutions.  Just this week they received six proposals for a possible, new methadone operation in Duluth.    
In addition, Representative Huntley told us changes could be coming from St. Paul, because committee hearings have been scheduled with the Republican Chair of the Minnesota house health and human services finance committee. 
"We are going to have hearings. I talked with Jim Abler and he wants to have joint, non-partisan talks just to get information about the problems with methadone treatment," Huntley said.
They could be small but positive signs for those looking for answers. Like the Lingren and Gamache families.  
"I just don't want it happening to another family, to have to go through what we have to go through," Kathy Lingren said.  
Senator Reinert told us, "there will be steps taken because of their loss.  There will be good that comes from it."
"Hopefully in the process of answering some of the questions they can help to avoid this type of accident happening again," Dave Lingren said.  
In addition to those legislative meetings and the companies wanting to be considered for a new treatment center here, the Minnesota State Commissioner of human services and the State Health Commissioner are coming to Duluth Friday morning.  They will meet with local law enforcement, court officials and treatment providers to discuss the newly developed state-wide substance abuse strategy.