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As Heroin Booms, Recovery Clinics Struggle To Keep Up

Jamie Heidenreich rides back to Hoquiam after getting methadone treatment in Olympia, Wash. It's an hour each way.
KUOW Photo/Elizabeth Jenkins
Jamie Heidenreich rides back to Hoquiam after getting methadone treatment in Olympia, Wash. It's an hour each way.

Heroin, the drug of the 90s, is back and thriving in Washington state.

“A hot batch of heroin hits the streets, and we will know it in a couple of hours because of the overdoses,” Hoquiam Police Chief Jeff Myers said. In Washington, opiate-related deaths have doubled in the past decade.

But efforts to provide recovery services have struggled to keep up with the drugs. And for many, particularly in rural areas where distances stretch for hours, it can be tough to reach clinics.

Jamie Heidenreich and Alexa carpool together five days a week from Hoquiam to Olympia to receive methadone treatment. Round trip, that’s a two-hour long commute.

On Tuesday, a ribbon-cutting ceremony took place in the city of Hoquiam for a new drug treatment clinic.

The Evergreen Treatment Service facility will dispense methadone to patients suffering from heroin and opiate addiction. Alexa and Heidenreich’s long journey will soon become a thing of the past. But for now, they still have to make the trip.

Recovery: A Third Job

Alexa, who asked to use her first name only because she fears repercussions from her employer, holds two jobs, but said sometimes treatment feels like she has a third occupation.

“Going to the clinic is a job in itself. It really is when it's this far away, especially when someone works full time and has a family,” said Alexa, who also coaches her son’s baseball team.

Alexa and Heidenreich met in 2006 while riding the Paratransit, a Medicaid-assisted bus, to the Olympia clinic. Both pregnant at the time, they struck up a conversation.

“The methadone and the babies: Everything we’ve been through, that’s what makes our friendship good. We both understand it,” Heidenreich said. Their babies were later born seven days apart.

The friends left Hoquiam in Alexa’s SUV for the clinic recently on a drizzly early morning. “This thing is a gas hog, so it takes 10 or 11 gallons to get up here and back every day. You add that up, it’s like $35 or $40 just to drive up here,” Alexa said.

Heidenreich helps pay for the gas with a transportation voucher from Medicaid. She can either ride Paratransit to the clinic or she can have a person drive her.

“Sometimes it’s just better to drive even though it costs so much more money,” Heidenreich said.

“I have the car and she has the gas, so it works,” said Alexa.

[asset-images[{"caption": "Program manager Linda Kruger prepares for the opening of the Evergreen Treatment Service clinic in Hoquiam.", "fid": "33339", "style": "placed_left", "uri": "public://201404/hoquiammethadone-clinic.jpg", "attribution": "Credit KUOW Photo/Elizabeth Jenkins"}]]Triple The Cost Of Treatment

Last year, the cost to transport Medicaid patients from Grays Harbor County to the Olympia clinic was estimated at $600,000. That’s triple the amount of the methadone treatment itself.

To get to the clinic, Alexa drives her SUV down the Olympic Highway, past the state’s capital, almost to Lacey. The 109-mile marker signifies the first part of the trip is almost over.

The clinic is tucked inconspicuously behind an auto parts store. Along with methadone, the Evergreen Treatment Service Facility offers counseling, access to a medical provider and even acupuncture.

Heidenreich and Alexa arrive around 9:30 a.m. The clinic parking lot is already packed.

Once inside, patients wait in line in front of a dosing window. A machine dispenses cherry-colored syrup into a paper cup and a technician watches as they swallow their prescribed intake of methadone. Lemonade is offered to chase down the medicine’s bitter taste.

After spending an hour in the car, the process takes just 15 minutes; then they're headed back to Hoquiam.

Patients like Alexa who have consecutive clean urine tests can apply to get a take-home dose. She doesn’t have to come in on Mondays, but Jamie has to commute six days a week.

Scot Fleshman, a medical provider at the clinic, said it’s not to be punitive but to be safe.

“We want to hold them to a standard that many of them have never been held to before,” Fleshman said.

Local Impact

Hoquiam Police Chief Myers said everyone in the community has felt the impact of the heroin and opiate epidemic.

“There’s so few degrees of separation in an area like Grays Harbor," Myers said of the community of 74,000. "There is not hardly a family in this community that doesn’t have someone who’s been affected by some drug abuse or issue."

Heroin comes up from Mexico and eventually makes its way to Washington. Its impact is immediate, Myers said.

[asset-images[{"caption": "Testing out a methadone dispenser at the Evergreen Treatment Service clinic in Hoquiam, Washington.", "fid": "33340", "style": "placed_left", "uri": "public://201404/hoquiammethadone-dispenser.jpg", "attribution": "Credit KUOW Photo/Elizabeth Jenkins"}]]Heidenreich and Alexa came to their addiction differently. Alexa got hooked in college to Oxycontin, an opiate similar to heroin. It elicits the same effect on the brain.   

“With opiates, it's a physical addiction. I know it’s psychological as well, but you sweat, you’re sick. It's like having the flu but 10 times worse,” Alexa said.

Alexa said she took out student loans to pay for prescription opiates and wrote bad checks, but she didn’t use heroin. She started on methadone treatment before it escalated to that.

Jamie started using heroin in her early 20s and was addicted into her 30s.

“I was on the streets. I was prostituting. I was stealing. You'll do anything for that drug. You'll sell your soul, and I did over and over again,” Jamie said.

Chief Myers said some of his officers aren’t thrilled about a methadone clinic opening in Hoquiam.

“In our business we see people at their worst. So for officers, we’re obviously a little bit reluctant or concerned about what the impact of this type of treatment center will be or the people that will be there,” Myers said.

Philosophically, he said, it seems wrong to provide government funds for drug addicts, but if the clinic provides some betterment, "it will be a good thing."

Grays Harbor County and the Division of Health and Rehabilitation estimate that 2,700 people need services in the area.

The new clinic has capacity for 350 patients. With the heroin and opiate epidemic swelling, two other counties are considering opening methadone clinics.

'I’d Rather Be On Methadone'

Methadone treatment can last decades, even a lifetime, but for Heidenreich that’s OK.

“I’d rather be on methadone the rest of my life than die on heroin any day. I know that’s what would happen if I ever went back. I would die,” she said.

When the Evergreen Treatment Service Clinic opens in Hoquiam, she and Alexa will no longer  have to make the two-hour commute to Olympia. It will be a short five minute drive to receive their methadone treatment.

For Alexa, this is a huge improvement to her quality of life. She works graveyard shifts at a medical job, so most mornings she gets off work and heads straight to Olympia.

“With the clinic being in town, I’ll be able to get off work, go dose, and go to bed. It’ll be like another three hours of sleep every day,” Alexa said.