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Former Fla. clinic doctor says profits put above addicted patients

Clinics an important tool in opiod addiction war
Posted at 9:58 PM, Nov 17, 2017

Florida is ground zero for the opioid crisis, with more than 5,000 overdose deaths a year.

Methadone, which is a drug used to reduce withdrawal symptoms, is one treatment option.

But a local doctor told Tampa-based WFTS he believes the clinic where he used to work puts profits above the long-term well-being of patients.

The line forms hours before daybreak at the Tampa Bay treatment center in Pinellas Park, Florida.

Hundreds of addicts pay $16 cash every day for a dose of methadone.

“The line goes all the way around the building, and it just moves quickly. Next, next, next,” said Dr. Bob Wallace, who used to work at the clinic.

He said he observed no counseling going on, as addicts came to get their daily dose.

Wallace said he believes the clinic reduced his hours, then eventually let him go, because he refused to put and keep patients on high doses of methadone, which, like the drugs it replaces, is highly addictive.

“It's all about keeping them on the methadone as long as possible. Get them on a high dose and keep them on it as long as possible,” Wallace said. “One lady I saw was there for 15 years.”

Wallace said some patients tested positive for other drugs.

“They turned a blind eye to the patients who smoked pot,” said Wallace, who says the treatment plans he was supposed to monitor called for patients to give up all intoxicating substances.

Wallace said he believes some patients asked for higher doses of methadone in order to get high.

“I would see people who looked impaired and they were still dosing them,” Wallace said.

New Season Treatment Centers, which owns the clinic, says it trains staff to recognize signs of impairment and doesn't dose impaired patients.

New Season issued the following statement regarding patient impairment:

We do not provide doses to patients who are deemed impaired. Everyone from the program director to physicians, counselors and nurses are trained to monitor and recognize patients who are impaired and to act accordingly. When a patient is impaired, they are trained to intervene and alert the nursing staff immediately. Nurses are trained to ask probing questions of patients that appear impaired to determine whether they should be permitted to get medication. To reinforce this part of the process, each nurse station has a reminder to assess each patient individually before providing the medication. Dr. Wallace would have been trained to do the same.

But former patient Anthony Diflavis said it was easy to game the system.

“They give you as much as you want. They're overmedicating, that's what's wrong with it. They're overmedicating,” he said.

Diflavis spent most of his life addicted to drugs like cocaine, painkillers and heroin.

But he says methadone was the hardest to quit.

“I didn't go back to the dope man, I didn’t go back to people to try to buy pills. I went right back to the clinic,” said Diflavis.

Diflavis admitted the $16 cost was much lower than the cost to support his drug habits, and he liked the fact that he wasn’t having to commit a crime to get his daily fix.

But he said he often mixed other drugs with methadone.

And he said his observation was that the clinic was often a magnet for crime.

“I’ve seen people get in fights and steal their medicine, their take-homes,” said Diflavis, referring to take-home doses of methadone that can be given to patients after they have tested negative for other drugs over an extended period of time.

Diflavis said he observed some patients selling take-home doses in the parking lot, and he himself was arrested for selling methadone in 2012.

He said there are other dangers as well that come along with the big crowd that gathers at the clinic.

“There are car accidents constantly in there cause people are overmedicated,” Diflavis said.

New Season operates a methadone clinic on 49th Street North in Pinellas Park and one on Nebraska Avenue in Tampa.

Records show police have responded to hundreds of calls at both clinics for incidents including thefts, fights, narcotics and car crashes.

And Diflavis says some of those in potential danger aren’t just patients themselves.

“A lot of people bring their kids there,” said Diflavis, who says he took his own children to the clinic on weekends when they were growing up.

He said staff would give them lollipops while he dosed.

“I guess it comes with the territory,” he said.

New Season said safety is a top priority, which is why they hire off-duty police officers who are quick to respond to incidents.

The company says methadone clinics lead to long-term reduction of crime and risky behaviors like needle sharing and unprotected sex.

The company says there are many benefits of methadone treatment including:

  • Reduction in the use of illicit drugs
  • Reduction in criminal activity
  • Reduction in needle sharing
  • Reduction in HIV infection rates and transmission
  • Cost-effectiveness
  • Reduction in commercial sex work
  • Reduction in the number of reports of multiple sex partners
  • Improvements in social health and productivity
  • Improvements in health conditions
  • Retention in addiction treatment
  • Reduction in suicide
  • Reduction in lethal overdose

But Wallace said most patients he observed didn’t have a plan beyond the next dose.

“There should be a plan in place that says this should be an X-month process,” he said.

New Season said "12 months is considered the minimum, and some opioid-addicted individuals continue to benefit from methadone maintenance for many years."

Operation PAR, which has the largest non-profit methadone treatment in the Tampa Bay Area, said the average amount of time patients spend on methadone is a year, but a small percentage take the drug long-term.

New Season said after a year in treatment, 90 percent of patients tested negative for other opioids and 73 percent were employed or enrolled in school.

They could not tell us the average time of treatment for patients at their Tampa Bay area clinics.

Diflavis said he quit using methadone 21 months ago by going cold turkey.

Wallace left the methadone clinic in August and now works full time at his non-profit "Love the Golden Rule" medical center.

He believes methadone clinics are a good short term tool, but aren't a permanent solution for addiction.

“The danger that I see is that people get locked into the belief that they're ok, but they're still on drugs,” Wallace said.