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Despite an attempt by several Metro Council members to enact regulations restricting new methadone clinics to certain zoning districts, last week the Planning Commission unanimously recommended amendments to current law that do not explicitly discriminate against such clinics. Several of its members and the director of the city’s health department made a point of saying that new methadone clinics in different parts of the city would be a welcome addition to Louisville’s medication-assisted treatment options in a city ravaged by a heroin epidemic.

Last year, Councilman Brent Ackerson, D-26, sponsored an ordinance asking the city’s Planning and Design Services staff to draft new rules limiting where methadone clinics could open, following his successful effort to block a company’s proposal to open such a clinic in a strip mall in his district. Ackerson said such clinics should only be allowed in industrial areas or near hospitals, with the original language of his ordinance stating that “methadone clinics can be destabilizing and threaten the safety and security of single family neighborhoods.”

After a long delay in these draft regulations being submitted to the Planning Commission, Ackerson suggested in August that Metro Council pass a citywide moratorium on all new private methadone clinics in Louisville. Louisville has only one private methadone clinic — the Center for Behavioral Health in St. Matthews — along with the MORE Center in Park Hill that is run by the city health department.

However, the draft regulations sent to the Planning Commission last week did not restrict methadone clinics to certain zoning districts, with the staff report stating that singling out such clinics would be a violation of the federal Americans with Disabilities Act, as those seeking treatment for substance abuse are a protected class. The staff report did suggest new changes to address loitering and parking at medical clinics — both common criticisms of methadone clinics — by requiring sufficiently large waiting rooms and parking lots.

At Thursday’s Planning Commission meeting, Covington attorney David Davidson — who served as legal counsel on these draft regulations for the city — spoke about why methadone clinics cannot be singled out for zoning restrictions. He said that when Covington attempted to ban methadone clinics by changing its zoning ordinances in 2002, he successfully won his case representing the company seeking to open one, with the court striking down the law based on the ADA. For those interested in bolstering the standards of methadone clinics, Davidson noted that the State Narcotic Authority already has strict regulations on clinics that address such concerns.

Dr. Joann Schulte, director of the Louisville Metro Department of Public Health and Wellness
Dr. Joann Schulte, director of the Louisville Metro Department of Public Health and Wellness

Dr. Joann Schulte, director of the Department of Public Health and Wellness, spoke in support of the amendments’ lack of strict and explicit limitations on methadone clinics. With Louisville witnessing a dramatic spike in fatal and non-fatal heroin overdoes, Schulte said expanding medication-assisted treatment services such as methadone would help fight the unique challenges of opioid addiction and “keep people alive.”

“Some people can get off of those drugs with a 12-step abstinence-based program, but Louisville needs to do some growing up in terms of medication-assisted treatment programs – one of which is methadone – as options to help keep people alive,” said Schulte. “The people who are showing up at the MORE Center or… at the Center for Behavioral Health are able to keep their lives because they’re on medication-assisted treatment. It enables them not to deteriorate. It enables them to be productive and functioning members of society.”

Dr. Lori Nation — a psychiatrist with a practice offering medication-assisted treatment in Middletown — said she still had issues with certain parts of the draft regulation, but praised the commission’s “open-minded dialogue” about the issue, as certain communities around the state have tried to banish methadone clinics for which she worked. She noted that any perceived backup of patients causing long lines at methadone clinics would be solved by opening more of them, which is why Louisville should not fear companies wanting to set up shop.

“If we should be doing anything, we should be rolling out red carpet for every national facility that is willing to relocate and to have an office in Louisville,” said Nation. “We need the help. We need facilities opening up. And we can’t all stand by and say ‘not in my backyard.’ They need to be everywhere… Unfortunately, the demand is there, and we need access, or otherwise we just keep seeing the (overdose) statistics every day.”

Schulte backed up Nation’s point about this “NIMBY” attitude, saying that the MORE Center has attempted to expand in other parts of Louisville, only to be discriminated against by Realtors due to concerns of it being too close to certain areas that wouldn’t want its patients there.

“There is a realization that has to take place for drug therapy overall, that there’s a lot of people doing drugs in a lot of bedrooms and a lot of places in Jefferson County,” said Schulte. “But there’s a whole lot of ‘not in my backyard’ when it comes to treating the people. Everybody wants their kid to be alive and treated, but they don’t really want to worry about anybody else’s kid. So there’s NIMBY here.”

The Planning Commission voted unanimously to recommend the amended regulation on medical clinics and send it to Metro Council for approval, with most of its members noting that the city should not put up roadblocks in the path of expanding access to medication-assisted treatment like methadone.

Noting that heroin and opioid addiction is wrecking families all over the city, commissioner Bob Peterson said “we need to be able to treat people near to where they’re residing, near to where they’re working. If we have just one location in the community, it’s totally inadequate.”

Commissioner David Tomes noted that the local jail has become the largest detox facility in the region, adding that any company wanting to open a methadone clinic would still have to go through the Board of Zoning Adjustment to receive a Conditional Use Permit, and he trusts them to weigh the facts of each case.

“There’s always this thing that it’s a ‘West End problem,'” said Tomes. “It’s an East End problem, I’m telling you. Just as it’s a South End problem. It’s every part of this city that has these problems.”

Commissioner Jeff Brown said he understands the concerns of those who do not want to live next to a methadone clinic, “but I think it’s a use that the community needs.”

Planning Commission chairman Vincent Jarboe said the council members pushing for stricter regulations and zoning limitations for methadone clinics were just responding to their constituents, “but they also have to remember that their constituents are also these people that are… going to these clinics and trying to get better. They’re trying to get on methadone so they can break this habit.”

“There are addicts all throughout our community, so these clinics need to be everywhere, and we should not be discriminating against any of these operators that want to open these clinics,” said Jarboe. “They should be the same as any other medical clinic.”

The draft regulations now will go to Metro Council, where they must find a sponsor and be assigned to a committee for further discussion. Councilman Ackerson did not respond to a request for comment on this story.

Over the summer, a national company attempted to open a private methadone clinic downtown, only to pull those efforts after behavioral health care provider Seven Counties Services voiced strong objection to the clinic moving into their same building, arguing that the for-profit business would hinder their ability to provide medication-assisted treatment to their own vulnerable population of patients.

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