Out of sight, out of mind

Methadone clinics a reality to community’s opioid fight


ORANGE PARK – The lights weren’t been turned yet at the McDonald’s across the parking lot when the line started to form in a secluded cove behind the Pine Tree Plaza.

A loud, thumping musical beat rattled the windows at Elevate Fitness while people in tight leotards and gym shorts worked up an early morning sweat. Around the corner, the sound of beeping delivery trucks backing into store stalls echoed throughout an empty parking lot. And while rush hour was still more than an hour away, workers at Dunkin Donuts were prepping by brewing extra pots of coffee to prepare for a rush hour of its own.

Meanwhile, the line on the sidewalk, mostly hidden by shadows and hoodies, continued to grow.

By the time the doors opened at River Region Human Services, more than 20 people had been impatiently waiting to get their daily dose of methadone before disappearing back into the morning haze.

For those who rely on methadone, it’s a routine with no end. There are no vacations or off days. Rain or shine, hot or cold. The opioid crisis only creates victims. For now, the best solution is treating it with a drug that’s equally addictive and disruptive.

Methadone patients are like social lepers. Out of sight and out of mind, they move through the community with few noticing. Clinics often are hidden – you can’t see the clinic from Blanding Boulevard – and the windows are blackened and offer few details of what happens inside. Make no mistake: it is far more prevalent than you think. Somebody you know is probably going through treatment. That’s why there are more than 35 clinics in Northeast Florida.

Compared to other treatment centers in Northeast Florida, the Orange Park clinic has a good reputation because it has stringent policies where excuses aren’t part of the treatment plan. Patients there often are drug-tested without warning. A failed test could result in missing a daily dose, or worse – the loss of “take-home” medicine. That means a patient forfeits any trust earned through sustained sobriety and must return to the daily line instead of being allowed to take their methadone at home.

While society pretends not to notice, methadone clinics are necessary and sometimes successful. In a world of addiction, it’s the most you can hope. When the dosage is correct, it can reduce the urge to pop pills or resorting back to needles – all without greatly affecting a daily routine. That’s why you see patients wearing hospital and veterinary scrubs standing in line, along with men with coats and ties and blue-collar workers with their names sewn on their shirts making stops on their way to punching a timeclock.

You also see the disheveled – some trying to keep a sleepy baby from crying, others trying to stay warm and a few who constantly are bumming cigarettes or a couple dollars.

There is no hierarchy at a methadone clinic.

“I hate coming here,” said one patient who’s been taking methadone for more than five years. “But I needed it. It stops my urges. I know I will be doing this for the rest of my life. But it’s better than going back [to drugs].”

The woman readily admitted methadone is a life sentence with no chance of parole.

“I can’t even think of not taking it,” she said. “If this is what I have to do to stay off drugs, then I’ll do it.”

“Methadone gets in your bones,” another patient said. “If you skip a day, you get sick. Your legs hurt. If you miss another day, you’re in trouble. It’s hard to do anything because you have to find a way to dose every day. You can’t win.”

Every patient has their own story. Some were legitimately prescribed pain medicine. If one pill takes the pain away, maybe two will accelerate the recovery. Before long, it takes several pills a day just to function. And it never ends.

Others intended to abuse drugs like heroin, opium, codeine, oxycodone, hydrocodone and the newest and perhaps most-dangerous threat to the world’s war on drugs, Fentanyl.

Whether by choice or by court order, patients on methadone are desperately trying to regain control of their lives, all while the rest of the world speeds past, seemingly unknowing of the pain addicts have afflicted on themselves.

And they’re forced to do it away from the community’s consciousness and under the cover of darkness, long before most of the most of us wake up to start our own routines.


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