A Feb. 8 Bloomberg News report that questioned the methadone treatment practices of CRC Health Group and suggested that profit trumps safety in the company’s methadone maintenance protocols has led to a sharp rebuttal from the for-profit giant. In a letter posted in response to the article on the Bloomberg News website, CRC’s chief clinical officer calls the report “misleading and biased” and states that its conclusions serve to complicate the effort to offer effective treatment options to millions of Americans who are not receiving care.
“It’s the stigma that keeps people out of treatment,” CRC’s Phil Herschman, PhD, said in an interview with Addiction Professional last week. “It creates barriers, and these cause damage and conceivably can cost lives.”
The Bloomberg article, titled “Drug Users Turn Death Dealers as Methadone From Bain Hits Street” (Bain Capital Partners owns CRC), reports on instances in which the practice of take-home dosing of methadone for some CRC patients led to disastrous consequences, such as the overdose death of a friend of a patient who had illegally received a quantity of the take-home methadone from the patient.
The article cites a number of public officials who say that diversion of methadone originally obtained from CRC clinics in their states has led to responses such as expanding local jail capacity and reconsidering whether for-profit companies should be allowed to offer methadone maintenance services. CRC operates 58 methadone clinics in nearly one-third of U.S. states.
Yet Herschman says take-home dosing of methadone is highly regulated at both the federal and state level, and that CRC meets all government guidelines that govern the practice. Patients receive take-home doses only after being in treatment for a period of time and after showing responsiveness to the individual and group therapeutic services that are offered in addition to the daily methadone, he says. “To get up to being able to have 30 days of take-home doses, that takes a couple of years,” Herschman explains.
The isolated instances in which take-home medication is misused or diverted illustrate the challenges of combating the disease of addiction in general, he says. “I think we do an exceptionally good job when there’s a problem, and there always will be a problem,” says Herschman. Comparing addiction to other chronic illnesses, “[Some] pain patients overdose on their pain medication. Diabetic patients abuse their medication to manage their weight,” he says.
Herschman says that when a methadone patient is found to be misusing the medication, CRC responds decisively but compassionately. “You don’t shoot somebody—you adjust the treatment. You offer more supervision, or more services.”
He adds that the company’s methadone treatment programs are routinely reviewed for quality and compliance in the same way that all CRC operations are reviewed, and that none of the ongoing review of these operations has been influenced by the Bloomberg News report.
The Bloomberg article quotes former CRC staff members who say there was pressure at methadone clinic sites to keep enrollments high despite chronic understaffing in the facilities. Herschman says any challenges in staffing the centers has stemmed from CRC’s increasing the quality standards in the facilities and then finding it difficult in some remote communities to identify a qualified workforce.
“I don’t want to just put a body in a slot,” says Herschman, who developed and for a time ran the methadone treatment component of CRC’s clinical services.
Herschman’s letter in response to the article accuses Bloomberg News of omitting several positive comments it had collected about CRC’s methadone services in its inquiries leading up to the article’s publication. “Numerous officials, agencies and employees past and present have reported sharing positive testimonials only to have those comments turned into a search for something negative,” he wrote.