Getting off opioids is hard enough, but in Connecticut, some people are struggling just to get transportation to a methadone clinic. Could traveling treatment vans help?
WSHU’s Ebong Udoma spoke with CT Mirror’s Andrew Brown to discuss his article, “The problem with accessing opioid treatment in parts of CT: Getting there,” as part of the collaborative podcast Long Story Short. You can read his story here.
WSHU: Hello, Andrew. You say state officials and nonprofits are spending millions of dollars to increase access to methadone treatment. What’s the big barrier?
AB: One of the biggest barriers that the state is trying to overcome right now with methadone treatment is the significant travel times that some people face when they need to get to a federally licensed outpatient clinic to receive their methadone dose, and the therapies that they’re required to have when they first start their treatment. Travel times in Connecticut, I don’t think it’s a surprise to people, if you don’t have a car, it’s extremely hard to get to some places in Connecticut. And even with a car, the state, with some help from some Yale researchers, has found that it can take 30 minutes to 45 minutes for someone to travel from their home in Connecticut to one of these federally licensed methadone providers.
WSHU: These methadone providers are not located everywhere.
AB: No, there are around 30 methadone treatment providers that provide outpatient services, meaning you can walk in, receive your methadone liquid dose and walk out. The problem is that the way Connecticut is structured and the way that the treatment network is structured in Connecticut, many of these clinics are in the more urban centers like New Haven, Bridgeport, Waterbury, Torrington and Hartford, etc. And what that leaves is pockets of the state, the northwest corner, the northeast corner, the southeast corner, even parts of the lower Connecticut River Valley, where people have to spend significant amounts of time either driving or taking the bus or train to get to these clinics. And that is what the state is trying to solve.
WSHU: How are they trying to solve the problem?
AB: I talked about both of these in my story, but the nonprofit providers, right, the organizations that are already providing methadone treatment, some of them are expanding the locations where they have brick-and-mortar type methadone clinics. To the Root Center, for instance, which kind of got its start in Hartford but has clinics all over the state now, just opened up a brand new clinic in Middletown. It’s the first one in Middlesex County.
At the same time, APT, another provider that’s based largely in New Haven, is trying to build a brand new clinic in Milford. So the nonprofit providers are taking that angle. What the state is doing is intending to use around $4 million in opioid settlement funds to build new mobile clinics. Essentially, they are RVs that are outfitted to dispense methadone, and they want to send those out into the areas of the state that are not currently served in the same capacity as Hartford or New Haven.
WSHU: How far are we into implementing this?
AB: We’re in the infant stages. The state Opioid Settlement Advisory Committee, which is controlling hundreds of millions of dollars of settlement funds that are going to come in over the coming decade, decided to appropriate $4 million for these mobile methadone vans. But the state is still going to have to go through a bid process, which could take months that will decide which nonprofit providers get to run those vans and who gets the money to staff those vans. So we may not see these vans in operation and actually out in communities until next year, the state is saying. So while it’s a big step in trying to solve a rather difficult problem for opioid treatment in Connecticut, it’s not gonna happen overnight.
WSHU: There’s been some pushback from communities to setting up clinics in the towns. How is the state dealing with this?
AB: The state really isn’t dealing with that aspect of it, that is up to the nonprofits to essentially make the case for building some of the centers. I mentioned the Root Center, which is the largest methadone provider in the state. They had to spend five years and a bunch of legal fees to challenge a zoning law in Middletown, just to be able to build that clinic in Middlesex County. It’s the first of its kind in Middlesex County. So they advanced and spent millions of dollars out of their endowment fund to make sure that that clinic was there.
The case that I cited over in Guilford that’s currently going on, there’s local opposition to locating that methadone clinic there. People have a perception that it brings the wrong people into their community, right? Because these people have opioid use disorders, there is a stigma that these people will bring additional crime or other negative connotations into their community. So there are officials, people in Guilford, who are resisting that clinic, local zoning laws allow for that medical facility to be built there. And that’s what this is; it’s a medical facility. That doesn’t lessen the center’s community pushback, right? The first selectman in Guilford has been getting heat from some of his constituents over the fact that, you know, the town is allowing this. So it really is a story that I think most Connecticut residents are familiar with, which is local opposition to development that local residents don’t want.
WSHU: Yeah, but right now, it seems as if most of the effort is toward having these mobile clinics that can go into different facilities and make it easier for people to be treated. How much of a problem is opioid abuse in Connecticut right now?
AB: It’s kind of hard to know, right? Because the numbers can be slow coming in. So it’s hard to gauge, like, how we’re trending from year to year until the numbers come out at the end of the year of overdose deaths and stuff like that. But it is not an exaggeration to say Connecticut is still dealing with an epidemic. It’s a crisis. There are around 1,000 people every year who are dying in Connecticut. So the death toll continues to mount. There was a slight drop in last year as far as the number of people who overdosed on opioids, including fentanyl, heroin, etc., but it continues to be a major problem.
WSHU: What I’d like to end with is just talking about the fact that, apparently, money is not the issue here. It is how to implement the treatment policy to reach everyone.
AB: I think these mobile methadone vans are part of a larger effort by the state of Connecticut right now to lessen the number of barriers related to opioid treatment. It is clear from the reports that have come out of the opioid settlement advisory committee that their number one goal is to make it easier for people to enter evidence-based treatments and not just abstinence-based treatment where you try to quit heroin or another opioid cold turkey, they want to support and try to increase the ranks of people who are entering these medication-assisted treatments like methadone, like buprenorphine as kind of the frontline of driving down the number of people who are dying every year. And so that’s where we’re at.