Region's History Not Favorable To Methadone Clinics: The Opioid War

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Tri-Cities, Tennessee
the
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NEONATAL INTENSIVE CARE
Exploring East Tennessees battle with the pain of painkillers
Regions history
not favorable to
methadone clinics
By Nathan Baker
ABOUT THIS SERIES
Assistant News Editor
nbaker@johnsoncitypress.com
A topic of discussion for more than a

decade, proposed methadone clinics in
Northeast Tennessee have frequently
faced opposition from residents and officials. Now, Mountain States Health Alliance
and East Tennessee State University are
facing the same challenges to their own
proposed facility.
Since the first methadone-dispensing
opioid substitution clinic was proposed
in Johnson City in the summer of 2002,
locals have feared the negative effects a
facility catering to addicts might bring
to their neighborhoods.
So far, their efforts to thwart treatment centers offering the synthetic
opioid have been successful.
That first effort, the Johnson City
Addiction Research and
Treatment Center, was the only
so far to receive a certificate of
need from the state, then
under the purview of the
Health Facilities
Commission, a precursor
to the Health Services
and Development
Agency.
The boards certifSee HISTORY, Page 7A
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While epidemic prescription

drug abuse has long been a
concern in Northeast
Tennessee, the issue took the
spotlight this year when
Mountain States Health
Alliance and East Tennessee
State
University
proposed to
establish a
substance
abuse clinic
in Gray. The proposal generated
tremendous concern among
Gray residents about safety
issues associated with methadone treatment. With state
and local authorization
pending, the Johnson City
Press has developed a five-day
series of articles discussing
the proposal, the challenges of
opioid addiction, legal implications and treatment options.
Coming Monday: Methadone
treatment, personal experience with opioid addiction and
the voices of opposition.
Coming Tuesday: Law
enforcement and courts.
Coming Wednesday: Pain
clinics and pharmacies.
Coming Thursday: Impact on
local agencies and the future
of the proposal.
the
opioid
war
Contributed/Mountain States Health Alliance
The neonatal intensive care unit at Niswonger Childrens

Hospital.
Even the youngest are

caught in opioids snare
Caregivers fight a
complicated battle
against NAS
A proposed
opioid addiction treatment clinic
would use a
multipronged
approach
health officials say is
rare. Page
2A
By Jessica Fuller
Press Staff Writer
jfuller@johnsoncitypress.com
Amid the conversations about methadone

clinics and a rising drug
abuse epidemic, the
regions most vulnerable
population has become
tangled in the complex
web of opioid addiction.
According to data
from tn.gov, 485
Tennessee newborns
have been diagnosed
with neonatal abstinence syndrome so far
this year. NAS is what
medical professionals
call a cluster of symptoms a newborn shows
when it is born withdrawing from drugs
DEATHS/4A, 6A
JOHNSON CITY
Irene Chase Bryant
Naomi Katherine Zeoli
KINGSPORT
Steven Andrew (Andy) Hale
THERES
MORE
LIMESTONE
Pamela Block
Doris J. Ramsey
Jessica Fuller/Johnson City Press
Dr. Des Bharti, a neonatal specialist at

Niswonger Childrens
Hosptial works with
hundreds of babies
diagnosed with NAS
each year.
that the mother used
during pregnancy.
Dr. Des Bharti, a neonatal specialist at
Niswonger Childrens
Hospital, said infants
See YOUNGEST, Page 7A
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Tennessees
medical
director of
substance
abuse services understands the
pain of
addiction.
He should.
He was once
an addict
himself.
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HISTORY
Sunday, July 31, 2016
Johnson City Press, Page 7A
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who are born withdrawing

could be addicted to any
number of drugs, from narcotics to antidepressants and
anxiety medication, and the
syndrome can sometimes be
difficult to treat after birth.
Bharti said a baby with
NAS is scored on whats
called the Finnegan system.
The score is based on the
newborns symptoms that
have to be monitored around
the clock a shrill, highpitched cry, irritability, loose
watery stool, bad diaper rash
and insomnia. Some NAS
babies suffer from seizures.
A typical hospital stay for
a NAS baby can last as long
as three weeks and cost
upward of $45,000 per child
to treat. Treatment starts by
giving the newborn a small
dose of medicine typically
0.1 milligram for every kilogram of weight, Bharti says
and slowly weaning the
baby off the drugs while
keeping an eye on its
Finnegan score.
Our basic idea of admitting them to the hospital
here is to treat them with the
medication or without medication and make sure they
are comfortable and stable
at the time of discharge,
Bharti said. When we do
treat them with drugs, our
idea is to bring them to a
state where they can be
managed at home.
But some cases are harder
to treat than others.
Ideally, Bharti said, an
NAS newborn would receive
treatment with the same
medication it was used to,
but thats not always possible. Suboxone, also known
by its generic name
buprenorphine,
is
not
approved for use in newborns, so those babies are
typically treated with morphine which doesnt
always
work.
Babies
addicted to drugs like an
anti-anxiety medication usually receive a concoction of
drugs as treatment.
Treating hundreds of NAS
babies per year isnt something Bharti did on a regular
basis when he started
working at the hospital 25
years ago. In 1990, the hospital treated just a couple of
babies with NAS, but Bharti
said he noticed the numbers
begin climbing in the early
2000s, soaring at alarming
rates about 200 NAS
babies out of 568 neonatal
ICU admissions this year.
In Tennessee, babies born
with NAS has increased
elevenfold since 1999,
ranking it as the state with
the highest percentage of
NAS births in the nation. The
northeast region has the
highest numbers in the state,
with almost 18 percent of the
states cases reported here.
So what can be done to fix
it?
Thats a tall order with no
easy solution, said womens
health nurse practitioner
Joy McLain. McLain works
with the Sullivan County
Health Department in one of
the most heavily affected
counties in Tennessee.
McLain said that the medical community has been
shifting to high gear to try to
combat the growing epidemic within the last couple
of years.
Public health works to
intervene in three ways,
McLain said, the first of
which is educating the public
on handling their prescription medications by locking
them up and disposing of
excess medication at one of
the health departments drop
boxes around the area.
Knowing those tidbits of
how to handle your narcotics
at home are really going to
make a difference, because
over 55 percent of people
who are struggling with
addiction get their opioids
free from a family member
What are opioids?

Opioids are natural or synthetic chemicals that reduce feelings of pain.
Common prescription opioid pain relievers include: Hydrocodone (Vicodin);
Oxycodone (OxyContin); Oxymorphone (Opana); Methadone; and Fentanyl.
Are opioids safe?
Prescription opioids can help with some types of pain in the short term
but have serious risks. Before taking opioid medication for your chronic
pain: Discuss pain treatment options, including ones that do not involve
prescription drugs; Tell your doctor about past or current drug and alcohol
use; Discuss all the risks and benefits of taking prescription opioids.
What are the risks from opioids?
Patients taking prescription opioids are at risk for unintentional overdose
or death and can become addicted. From 1999 to 2014, more than
165,000 persons died from overdose related to prescription opioids in the
United States. Up to 1 out of 4 people receiving long-term opioid therapy
in a primary care setting struggles with addiction. In addition to the
serious risks of addiction and overdose, the use of prescription opioid pain
relievers can have a number of side effects.
Centers for Disease Control
or a friend, McLain said.

Secondly,
the
health
department works to make
sure contraception is available for women of childbearing age who are in substance abuse treatment programs or are struggling with
addiction. In non-substanceabusing women, the rate of
unintended
pregnancy
hovers around 50 percent,
McLain said, but for woman
who are addicted to substances, that number jumps
to 86 percent.
McLain said the health
department is working to
insert itself into the community through churches,
schools and anti-drug coalition programs. The health
department has also started
going to methadone clinics
so women can get the education they need about NAS
and pregnancy while also
working to make sure clinic
providers are connected
with obstetricians to help
educate local women.
The fact that we have
only 18 percent of those
women on birth control lets
us know that were either not
making it available to them
or were not getting the education out there so that they
know where to go, McLain
said.
Lastly, McLain said the
health department works on
the cases of NAS babies
after theyre born to monitor
for any developmental
delays and prevent another
pregnancy that could result
in another baby with NAS.
The department sends
nurses into the home to help
monitor NAS babies and
their environment.
Pointing to recent data,
McLain said that while the
problem has been rising
over the years, it appears the
rate of growth has slowed
from last year. That might
be due to the medical community working to find solutions to the problem,
resulting in more than
400,000 fewer opioid prescriptions being written in
the past year.
Even with important
strides being made by the
medical community to
combat the areas drug
problem, McLain said, a big
contributor to the addiction
epidemic is a cultural idea
that everything can be fixed
with a pill. While changing
culture is no small feat,
McLain said, the continuing
efforts in the battle against
addiction coupled with a
communal understanding of
the disease will begin to bear
the fruit of progress within
the next few years.
Addiction is one thing
that isnt picky about who it
chooses, she said. It
crosses all socioeconomic
barriers, so its something
that we all have to participate in the discussion.
Communication
with
health professionals is key
for pregnant women struggling with substance abuse,
and Bharti said that the last
thing a pregnant woman
wants to do is treat the addiction herself without consulting a doctor. By cutting
down on dosages or eliminating them completely, the
fetus, who is already
addicted, could become irritated and trigger premature
labor.
And premature labor

results in premature babies,
which may not show NAS
symptoms at their time of
birth even though they have
been exposed to substances
in the womb.
Theres a huge number of
premature babies that might
be exposed to the same substance, but theyre not going
to have symptoms because
their brain is not developed
yet, Bharti said. Youve got
to have an intact, developed
brain to show symptoms.
The danger with premature babies being exposed to
substances, Bharti said, is
that they could possibly be
discharged without treatment before any symptoms
arise. An NAS baby who isnt
treated could face a significant development delay,
Bharti said, because growth
hormones are released when
the baby sleeps.
Since NAS babies are difficult to comfort, those
without treatment get very
little sleep, leading to the
release of less growth hormones.
In addition to the myriad
complications and concerns
carried with an NAS baby,
sudden infant death syndrome, or SIDS, tops them
all for those in the medical
community. While there
hasnt been a direct correlation between NAS and SIDS,
Bharti said he has seen three
NAS babies return to
Niswonger dead just 48
hours after discharge within
the past two years.
And that doesnt count
children who might have
been brought to a different
hospital after discharge, but
even three is too many,
Bharti said.
Nobody wants to talk
about it; for some reason we
all look at it and ignore it.
Its not our problem. But it
is our problem, because
theyre our children and this
is our community, he said.
We need to intervene, we
need to do something.
Follow Jessica Fuller on

Twitter @fullerjf91. Like her on
Facebook at www.facebook.
com/jfullerJCP
icate of need decision was

reversed the following year
by a Davidson County judge,
however, after a legal challenge from the Johnson City
Commission. The judge
agreed with the citys claims
that the board did not have a
legal
quorum
because
member Janet Jones recused
herself from the vote, citing
her husband Johns connection to the clinics opposition
groups.
While the case waited in
court, the Johnson City
Commission approved new
zoning regulations for clinics
dispensing
methadone,
restricting them only to the
MS-1 zone (medical services
district), limiting their operations to between 7 a.m. and
8 p.m. and prohibiting them
from locating within 200 feet
of schools, day care facilities, parks or businesses
selling alcohol on- or
off-premises.
The commission revisited
the regulations 13 years
later and removed the time
limits and distance prohibitions on the recommendation of City Attorney Erick
Herrin, who said the previous leaders may have gone
beyond their municipal
authority.
Were smarter now than
we were then, and since
we are smarter than we were
about methadone clinics,
were looking at what we
are missing in this ordinance
based on what we know,
Herrin said in 2014.
An uproar from residents
near a West Unaka Avenue
counseling center also led to
new regulations for substance abuse facilities prescribing alternatives to
methadone in 2008.
Led by West Davis Park
Neighborhood Association
Co-Chairwoman
Jenny
Lockmiller, the group of residents
lobbied
against
Morgan Counseling, which
prescribed Suboxone, a combination of buprenorphine
and naloxone, to opiate
addicts.
Anything that brings a
concentration of heroin and
opiate addicts to our neighborhood is bad for our neighborhood, Lockmiller said
then.
(Its)
importing
drug-addicted people to our
neighborhood. Its adding
clients to our drug dealers
lists.
Lockmiller is now a
member of the Johnson City
Board of zoning appeals, a
body that reviews clinics
certificates of appropriateness before allowing or
denying their building plans.
After the first failed
attempt to bring a clinic to
the area, other municipalities followed Johnson Citys
example and placed zoning
restrictions on them.
Washington
Countys
zoning regulations limit all
methadone clinics and substance abuse treatment
facilities to the medical services district, stipulates they
must be located on arterial
streets and prohibits them
within 2,000 feet of schools,
day care facilities, parks,
religious buildings, mortuaries, hospitals, businesses
selling alcohol for on- or
off-premises consumption,
areas devoted to public recreation, amusement catering
to family entertainment and
any agricultural or residential zoned property.
In 2010, Jonesborough created a treatment facility
overlay zone for methadone
clinics and substance abuse
treatment facilities, and
leaders were forced to dispel
rumors that the proposed
regulations were being considered because of a town
plan to open a methadone
clinic.
Later that year, Kingsports
Planning Commission and
Board of Mayor and
Aldermen scrambled to put
a new, more restrictive
zoning ordinance in place
when
Dallas-based
Behavioral Health Group
moved to open a methadone
facility in a vacant restaurant near John B. Dennis
Highway.
The city board approved
an emergency ordinance
boxing methadone clinics
and substance abuse facilities into M-2 (general industrial) districts and prohibited them from operating
within 1,000 feet of schools,
day care facilities, parks,
religious buildings, hospitals, mortuaries, establishments selling alcohol, public
recreation facilities and residential dwellings.
Then-state Rep. Tony
Shipley,
R-Kingsport,
encouraged Sullivan County
to enact similar regulations,
saying It strikes me this
program substitutes one
addiction for another. Might
it be possible (the people in
the program) introduce
another illegal substance
into
the
community?
according to Kingsport
Times-News reports from
the time.
Shipley later said there
would be a fight in the
streets against the clinic
and the zoning amendment
was a shot across their
bow.
The clinics backers then
withdrew their proposal for
the facility and vacated their
lease for the property.
Taking the advice of the
state legislator, the same
month the Kingsport methadone clinic application was
withdrawn, the Sullivan
County Regional Planning
Commission
restricted
clinics to general industrial
districts and the Sullivan
County
Commission
approved
a
resolution
opposing methadone clinics
and other nuisance businesses within the borders of
Sullivan County.
Ten years after the first
failed clinics application,
Tri-Cities Holding LLC
applied in early 2013 for a
state certificate of need to
build a methadone clinic at 4
Wesley Court in Johnson
City.
Part-owner Steve Kester
said the company reviewed
50 possible sites before
choosing Wesley Court, a
property that met the zoning
district and distance requirements of the citys code.
Were the antidote to drug
addiction, not the contributor to it, Kester said while
making his case to local
leaders.
After a resolution from
Washington County commissioners
unanimously
opposing the facility and an
overwhelming showing of
opposition from local residents at a public hearing for
the clinic, the state Health
Services and Development
Agency denied the clinics
certificate of need.
Tri-Cities Holdings filed
suit twice, first in Davidson
County Court, then in U.S.
District Court in Greeneville,
claiming the citys zoning
regulations were too restric-
tive and violated the

Americans with Disabilities
Act, which classified addiction as a disability. Both
cases were dismissed.
Last year, two companies,
Crossroads
Treatment
Center and New Path
Treatment Inc., filed for certificates of need to build
methadone clinics.
The citys Board of Zoning
Appeals
approved
Crossroads special exception for a facility at 413
Princeton Road, but then
Mountain States Health
Alliance, one of the entities
currently attempting to
bring a clinic to the area,
sued the company, claiming
its real estate broker misrepresented the owners
plans when buying the property from the system.
Crossroads dropped its
plans to pursue the clinic in
April.
Likewise,
New
Path
applied for a certificate of
need in May, but pulled the
request three weeks later. A
company
representative
said he was not authorized to
say why the application was
rescinded.
In that same month, ETSU
and
Mountain
States
announced their plans to
build a methadone clinic and
counseling center in Gray,
part of the colleges larger
Center for Prescription
Drug Abuse Prevention and
Treatment.
The two local organizations certificate of need
application is now the only
surviving application for a
methadone clinic in the area.
Health Services and
Development Agency officials will consider the application soon, but opposition
among Gray residents has
delayed the process.
More than 300 people,
many opposed to the clinic,
attended a public meeting at
Ridgeview
Elementary
School. At a public information meeting in July, some of
the opponents jeered school
and health officials as they
spoke in favor of the facility.
After the July meeting,
ETSU and Mountain States
delayed their rezoning
request for the Gray
Commons property to allow
local officials time to search
for another suitable location.
If the elected officials
who have opposed the Gray
location wish for us to consider an alternative location
that meets the zoning
requirements, is easily
accessible to those seeking
the service, is appropriately
located based on city or
county priorities and supported by the data, is financially feasible, and for which
they are willing to publicly
support and advocate, we
will give serious consideration to such a suggestion, a
statement from the organizations read.
The rezoning request will
now be heard by the city
Planning Commission after
todays deadline. Last week,
Washington County Mayor
Dan Eldridge reported that
no suitable alternative site
had been identified.
Follow Nathan Baker on

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Monday
August 1, 2016
Volume 95 - No. 339
Rob-Con draws
a crowd/5A
Methadone
Its neat
because
people do
actually get
better. You
get to
witness
them get
their life
back.
Dr. Jana Burson
Stepping Stone
of Boone
the
opioid
war
Exploring East
Tennessees battle
with the pain
of painkillers
By Zach Vance
Press Staff Writer
zvance@johnsoncitypress.com
Press Staff Writer
tcasey@johnsoncitypress.com
On Tuesday, classrooms
across Johnson City will be
filled with excitement, anxiety, confidence and emotion
its the first day of classes
for the Johnson City Schools
district.
Some of the teachers
leading those classes have
been through many first
days, but many others will
be doing it for the first time.
Debra Bentley, the systems supervisor of instruction and communication,
said about 60 new educators
will begin working in
Johnson Citys schools. Some
of those are interim teachers
and others are accepting
full-time positions within
the schools.
I would say, historically,
we have about 50 to 60 new
educators
each
year,
Bentley said. Last year, we
had about 50 and had a
smaller number of retirees.
We never know until we get
through June.
Over the course of the
summer, a teachers situation can change. They might
retire, transfer to another
district, follow a spouse to a
See SCHOOL, Page 8A
It hit me that I
had to change
Man says addiction treatment with
buprenorphine has saved his life
By Zach Vance
Press Staff Writer
Contributed
Misty
Smith
clearly
remembers the moment she
walked into a buprenorphine
clinic, fell to her knees and
begged doctors to admit her
husband, Darrell Smith, into
treatment.
The year was 2008, and
Misty was expecting her
second child.
Darrell had spent two
stints in prison while managing an opioid and Xanax

addiction.
I was four months pregnant, and it really came
down to, Listen weve got
this second baby on the way,
and you have to go to detox.
I cant live like this any
more. I cant raise kids this
way. We just cant do this,
Misty said. It was pretty
much, You either go through
See CHANGE, Page 2A
Some argue case for clinic

to be in Med-Tech Corridor
By Gary B. Gray
Press Staff Writer
ggray@johnsoncitypress.com
There is an argument being

made that if an opioid addiction treatment center were to
open in Washington County, it
would work best if located in
Johnson Citys Med-Tech
Corridor.
Most making this argument
say its zoning would accommodate a facility, up-to-date
infrastructure would provide
better traffic flow and
WEATHER/2A
I think youll have a little

different clientele if you have a
facility that stands out and is
not located among other
medical facilities.
Ed Graybeal
Washington County sheriff
delivery of services and

placing a center in a medical
neighborhood
would
patients in a more controlled
environment.
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Low
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Another
first day:
Its back to
school time
75 cents
By Tony Casey
A fine
line separates
methadones
treatment
attributes and
its deadly
nature.
The difference between
appropriate prescribed doses and
dangerous doses
of methadone is
small, the Centers
for Disease Control
has published on its
website.
Methadone was
first synthesized 77
years ago, but the
substitute medication is still perceived
in contrasting ways by
the public.
Whether deemed a
savior or a monstrosity,
its undeniable that methadone use has increased
over the past 15 years.
And a gain in popularity
means an increase in overdoses and diversion.
According to the CDC,
six times as many people
died of methadone overdoses in 2009 as did a
decade before.
Approximately 15,500 people
died in 2009 from overdoses,
and the CDC says methadone
played a central role in the
See METHADONE, Page 8A
Darrell Smith, pictured

with his family, now owns
and operates his own
electronic cigarette business along with a handful
of rental properties.
Homestead destined
for new role/4A
Medicine or drug?
Inside the dual world of
It can free
an addict
from the
grip of
opioids ...
but it also
plays an
outsized
role in
overdose
epidemic
Log by
log
Follow the Johnson

news, sports and
on Facebook at
facebook.com/
JohnsonCityPresss
and on Twitter at @
jcpress.
The Med-Tech corridor and

East
Tennessee
State
University serve as the citys
largest economic anchors.
See CORRIDOR, Page 2A
Chuck Branham/
The Evening News/Via AP
A plastic cup
holds a dose of
methadone at an
Indiana clinic.
ABOUT
THIS SERIES
While epidemic prescription drug abuse
has long been a concern in Northeast
Tennessee, the issue
took the spotlight this
year when Mountain
States Health Alliance
and East Tennessee
State University proposed to
establish
a substance
abuse
clinic in
Gray. The
proposal generated tremendous concern
among Gray residents
about safety issues
associated with methadone treatment. With
state and local authorization pending, the
Johnson City Press has
developed a five-day
series of articles discussing the proposal,
the challenges of
opioid addiction, legal
implications and treatment options.
Coming Tuesday: Law
enforcement and
courts.
Coming Wednesday:
Pain clinics and pharmacies.
Coming Thursday:
Impact on local agencies and the future of
the proposal.
the
opioid
war
DEATHS/3A
JOHNSON CITY
Virginia Jenny (Mama C)
Collins
Sharron Verran Butler
ELIZABETHTON
Harold Dean Matherly
Kingsport looking
at murals to help
beautify city/3A
In Johnson
City, about
60 new
teachers
will join
veterans to
welcome
students
For me, its

like a movie
premiere.
Then its
like the old
clich
about riding
a bike.
Sherry
Cockerham
system math coach
ETSU FRESHMAN ORIENTATION

Kate
Emmerich
talks to
incoming
East
Tennessee
State
University
freshmen
during an
orientation
session
Friday
morning.
Tony Casey/
Johnson City Press
Incoming
students hear
stark numbers
on rape, abuse
By Tony Casey
Press Staff Writer
To an auditorium filled
with
incoming
East
Tennessee State University
freshmen and their parents
Friday
morning,
Kate
Emmerich used the scheduled key conversations
time slot to address one of
the most important issues
facing college campuses
today.
Sexual awareness was
the topic, but the talk
included many things,
including sexual misconduct
Its not
this tiny,
minute
issue that
were
putting a
lot of
resources
and time
into.
Kate Emmerich
See NUMBERS, Page 2A
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Johnson City

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August 2, 2016
Volume 95 No. 340
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wins/1B
the
opioid
war
The never-ending cycle of addiction caused

by opioids lands many caught in its grip in
The courts
75 cents
JOHNSON CITY
SCHOOLS
Exploring East
Tennessees battle
with the pain
of painkillers
By Becky Campbell
Press Senior Reporter
bcampbell@johnsoncitypress.com
Arrests, legislation, prescribing guidelines, prosecution, drug court are all components used to attack a drug
epidemic that has the nation,
including Tennessee and specifically Upper East
Tennessee, in its tight and
deadly grip.
Opioids and the addiction
they can cause can be a never-ending cycle of pain, prescriptions, arrests and prosecution. It starts out innocently enough as a pain medication prescription for a
broken bone, toothache, surgery or injury of any type.
The patient begins to depend
heavily on that medication
and seeks it out from their
doctor. If they cant get it
there, they might resort to
the streets even the dark
route of heroin because its
cheaper and if theyre
unable to afford the illicit
prescription medication or
illegal heroin, they could
delve down the road of crime
to fund their habit.
Opioids had a big hold on addicts
long before healthcare providers
and lawmakers knew what was
happening, possibly due to its pre-
Tony Casey/Johnson City Press
Schools Superintendent
Dr. Richard Bales said
this will be his last year
at the helm of the city
school system.
Bales
to leave
after
this year
By Tony Casey
Press Staff Writer
vious ready availability by prescription as well as on the street.

According to Tennessee Bureau of
Investigation data, hydrocodone
costs $5-$7 per pill, Percocet is
$7-$10 per pill, oxycodone IR costs

around $30-$40 per pill, and
OxyContin tops the list at about $80
4 See COURTS, Page 2A
Recovery Court sees early progress

By Becky Campbell
Drug Court
phases
Nobody said it would be easy, but as the saying goes,

nothing worth having is ever easy.
Just ask Dylan Greene, Joshua Hammer and Alvis
Lowe the first to graduate from the Washington
County Recovery Court operated in Sessions Court
or the four others getting ready to finish the program.
Greene, Hammer and Lowe graduated in November
after having completed the intensive drug recovery
program in 18 months.
Recovery Court Coordinator Megan
Price, who took the programs helm
after that first graduation, said the fourphase program is designed for adults
with substance abuse issues and misdemeanor criminal charges.
They are brought to us as a result of
their legal charges, but they they dont
necessarily have to be drug-related
charges but most of the time they are,
Price
Price said. We do an assessment on
them to see if they are a fit for the program, and if the team decides to bring them in, they
start into phase one.
The first step of phase one could be a 28-day inpatient
treatment program if the participant has been using
drugs, but if theyre clean and the assessment team
determines treatment isnt necessary, they start immediately. Outpatient treatment includes four days a week
for three hours each day at Frontier Health for men
and three days a week for four hours each at Families
First for the women.
Washington County received a $70,000 grant to plan
and launch Recovery Court, which including hiring the
first director, Ann Snodgrass, in July 2013. The first
participants started in February 2014 and so far,
Greene, Hammer and Lowe are the only participants to
graduate.
Weve had 36 participants with three graduates and
Phase I
(3-6 months)
n Intensive outpatient
counseling or outpatient
treatment
n Probation meetings, up
to three times a week
n Multiple drug screen/
testing search per week
n Daily self-help (NA, AA)
n Appear in Drug Court
each Friday
Phase II
(3-6 months)
n Counseling sessions/
relapse prevention
n Probation meetings
n Random drug screens
n Self-help meetings (NA
and AA)
n Attend Recovery Court
each Friday
n Employment, school or
community service work
Phase III
(3-6 months)
n Counseling sessions
as recommended
n Self-help meetings
each Friday
Phase IV
(Up to one year)
n Counseling sessions
as recommended
(step down)
(step down)
n Self-help meetings
(step down)
every other week
four on track to graduate within six to eight months,

Price said. The three graduates are clean, sober and
law-abiding. We have a zero percent recidivism rate
right now.
The program is similar to the Day Reporting Center,
operated through a federal grant Targeted
4 See RECOVERY, Page 9A
ABOUT THIS
SERIES
While epidemic
prescription drug
abuse has long been
a concern in
Northeast Tennessee,
the issue took the
spotlight this year
when Mountain
and East Tennessee
State University
proposed to establish
a substance abuse
clinic in Gray. The
proposal generated
tremendous concern
among Gray residents
about safety issues
associated with
methadone
treatment. With state
and local
authorization pending,
the Johnson City
Press has developed
a five-day series of
articles discussing the
proposal, the
challenges of opioid
addiction, legal
implications and
treatment options.
Coming Wednesday:
Pain clinics and
pharmacies. Coming
Thursday: Impact on
local agencies and
the future of the
proposal.
Injury, problems lead two to pills, federal court cases

By Becky Campbell
A former Jonesborough pizza

parlor owner was sentenced to more
than six years in federal prison last
week for his part in a prescription
drug ring he apparently used to
feed his own addiction.
Rocky Hendrix, 47, pleaded guilty
in February to conspiracy to distribute oxycodone. He became
embroiled in an
opiate
addiction
after a back injury
several years ago,
according to information gleaned from
documents filed in
U.S. District Court
in
Greeneville.
Hendrix came upon
Hendrix
a direct supply when
he found Resolutions
HealthCare and Weight Loss, a
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sliding scale health clinic started in

January 2010 by Sherry Barnett.
Barnett, 46, started the clinic
after obtaining her nurse practitioner license and after doing clinical work at the Johnson City
Downtown Clinic, according to documents filed by her attorney, Dan
Smith. Clinical practice was
Barnetts true passion, and she
wanted to support the needs of uninsured patients, he said. The clinic
did well, but after a time Barnett
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began to have marital problems and

she had added stress from starting
a doctorate of nurse practitioner
program.
It was at this point that Sherry
became vulnerable, Smith wrote in
the sentencing memorandum he
filed. And while Barnett rarely
drank and never used illegal or
illicit drugs, she came to a point that
she used her first illicit prescription
4 See FEDERAL, Page 2A

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Johnson City Board of

Education member Sheila
Cox endearingly asked what
would happen if all board
members voted no to Dr.
Richard Bales request for
release from his contract as
superintendent of the city
school system Monday night.
But when the roll call
came, all members voted to
release him just before the
first day of the 2017-18
school year, though hes contracted through 2019.
Offering to work through
a transitional period and
help find his replacement
however hes needed, Bales
made the announcement
while touching on his 12
years of experience in the
role.
Over the last 12 years as
superintendent,
weve
accomplished so much
together, Bales said during
the announcement. Our students have experience
unprecedented academic
achievement and tremendous accomplishments in the
areas of art and athletics.
Along the way, you as a
board provided state-ofthe-art, multimillion dollar
facilities to accommodate
our student growth with new
construction and renovation
projects.
As your superintendent,
youve made my dream as
the leader for our schools a
reality for the last 12 years.
Your confidence in me as a
board is greatly and deeply
appreciated.
Bales vowed to go out in
the next year, all while
giving 100 percent of himself to his job.
Board members, as well as
school principals and administrators in the sparsely
attended crowd on the
night before the first day of
2016-17 school year held
back tears as Bales spoke.
Member Tom Hager hopped
out of his seat to visit the
lectern to share a few words
about Bales.
I want to thank Dr. Bales
for his years of service, not
only as superintendent, but
for his other duties, Hager
said. I think Dr. Bales shows
what a superintendent
should be. For those people
out there in the legislature,
who love to bash appointed
4 See BALES, Page 2A

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TODAY
BALES
3 Continued from Page 1A

superintendents, they need
to come to Johnson City.
Bales thanked the current
board and past board
members
for
their
dedication
to
giving
teachers raises and spoke
about how much teachers
had changed his life for the
better.
Teachers have been
taking care of me all my
life, Bales said. Never
underestimate the power of
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
A stray afternoon
t-storm
A shower and t-storm

around
A shower and t-storm

around
A t-storm in the area
88
68
64
A t-storm in the area
A t-storm early; partly

cloudy
87
67
88
69
88
69
NATIONAL WEATHER FOR AUGUST 2, 2016
ALMANAC
Statistics are through 8 p.m. yesterday
Temperature
High/low yesterday ............................ 92/67

Last year high/low .............................. 88/58
Record high ................................. 95 in 1953
Record low ................................... 51 in 1997
Precipitation
24 hours through 8 p.m. yest. ................ 0.00"

Year to date ........................................... 20.93"
Last year to date ................................... 23.15"
Normal year to date ............................... 26.23"
Becky Campbell/Johnson City Press
Interim U.S. Attorney Nancy Harr and First

Assistant U.S. Attorney Rob Reeves discuss statistics related to drug prosecutions in East
Tennessee.
drug addiction. Other
crimes include domestic
violence and driving under
the influence. Although I
dont have a specific
percentage, any officer
who works cases could give
you any number of stories
of arrestees who are in this
category, Sirois said.
Addiction has also led to
numerous pharmacy
robberies, but instead of
demanding cash the robber
demanded drugs, Reeves
said.
During this same time
period, we also had a
drastic increase in the
pharmacy robberies we
were prosecuting, Reeves
said. They were literally
going into the pharmacy,
most of them were armed,
and they were demanding
the morphine and
OxyContin. They didnt
even want the money. They
just wanted the drugs. We
still see that occasionally.
During that time period, it
was really prevalent
because these people would
do anything to get that next
fix. Its not that it makes
them feel so good, but they
dont want to feel with that
down with not being able to
take it. Theyre not only
psychologically addicted,
theyre physically addicted.
If you take opiates and you
quit, you get sick as well as
have the psychological
effect by not taking it.
So what can law
enforcement and court
officials do to to combat
opioids and the devastating
effect they have?
For Interim U.S. Attorney
Nancy Harr and Reeves, its
taking down the dealers. In
the federal court system,
there are no alternatives for
drug traffickers except
prison. There, programs are
available if the offender
wants to break their
behavior associated with
addiction.
On the local level,
officials have many more
options, although Sirois
said the JCPD is in the
business of arresting and
convicting drug offenders.
The Johnson City Police
Department for years has
taken a very proactive and
aggressive approach to the
drug problem, and drugrelated crime, in our city,
Sirois said. Our focus is
drug dealers, because they
are driving the cycle of
addiction and crime. Our
Special Investigations
Squad, working narcotics
cases, vigorously develops
leads and follows up on tips
in order prosecute dealers
in our community, many of
whom come from outside
our community.
Local law enforcement
also works closely with
state and federal
investigators when
necessary and takes an
active role in prosecuting
dealers in federal court.
We partner with state
and federal agencies to
prosecute drug dealers at
the federal level, many of
whom are violent repeat
offenders and armed career

criminals, he said. Two of
these federal programs in
which we participate are the
Federal Bureau of
Investigation Safe Streets
Task Force, and the Drug
Enforcement Administration
Organized Crime and Drug
Enforcement Task Force. To
each of these programs, we
have a Johnson City
investigator assigned fulltime.
JCPD also assigns an
investigator to the 1st
Judicial District Drug Task
Force, which is comprised
of officers from each of the
four counties in the district.
The 1st DTF
investigates drug activity
and brings prosecutions of
dealers across the entire
district, Sirois said.
Additionally, the city
continues to fund the
departments special
(federal) prosecutor
program, which supports a
prosecuting attorney to try
qualifying cases involving
drug-related and violent
crime at the federal level,
where sentencing is much
more stringent than statelevel sentencing, and there
is little to no good time for
these career offenders in
the federal system.
Sirois said without the
help of Harr, Reeves and
District Attorney General
Tony Clark and other
federal and local partners
we would not be nearly as
effective.
But it isnt just
enforcement and
prosecution on the local
level that has proven
effective, Sirois said,
recalling the huge success
of a Department of Justice
grant, the Targeted
Community Crime
Reduction Program.
You cant solve most
crime problems simply by
enforcement, and our society
is not going to arrest itself
out of the opioid addiction
epidemic, he said. It will
continue to demand a holistic
approach. I think you (the
Johnson City Press) are well
familiar with the TCCRP and
its positive impact on the
Mountain Home and
downtown areas over the
past three years. One of the
abiding legacies of the
TCCRP will be the Day
Reporting Center, and its
program to divert offenders
referred by the Criminal
Court from addiction and
criminal behavior to
becoming contributing,
productive members of our
community.
The three-year TCCRP
grant ran out at the end of
June, but just last week, the
DRC graduated 27
participants and turned over
the reigns to the Tennessee
Department of Correction,
which has opted to pick up
all funding and management
for the program.
Several have graduated
from the DRC, and are
moving forward with their
lives. Its not all success,
but it is all worth it, Sirois
said.
a teacher.
The board voted to bring
in the Tennessee School
Board Association into the
process of finding Bales
replacement.
For much of his time in
that role, Ron Dykes was
his peer as director of the
Washington County School
System,
until
Dykes
announced his retirement
in May 2015. Dykes was
replaced in his position by
Kimber Halliburton on July
1.
Follow Tony Casey on Twitter

@TonyCaseyJCP. L ike him on
com/tonycaseyjournalist
THE
ts
Presen
TONIGHT
83

per pill. Heroin, a less-expensive option, costs around
$15 per bag, the TBI data
showed.
Its logical to see how
someone who spends about
$300 a day on OxyContin
would spend a fraction of
that for heroin.
Law enforcement and
prosecutors saw the
problem, and the court
system was inundated with
people charged in opioidrelated crimes before any
real action was taken to
heavily regulate access to
the drugs or help people
kick their addiction.
This is not just a drug
problem, said Rob Reeves,
first assistant U.S. attorney
for the Eastern District of
Tennessee. What we saw
with some of these dealers
is they were also taking
stolen property (for drugs).
They would swap stolen
property, guns, anything
the drug dealer might be
interested in for the
OxyContin. Its a very
strong addiction, so theyre
willing to burglarize
houses, theyre willing to
burglarize cars, whatever
they need to do.
Reeves said the U.S.
Attorneys Office saw a big
influx of cases between 2005
and 2010 of doctor shopping
crimes and pill mills.
We started seeing the
groups going down to,
primarily Florida but also
Georgia and some other
states. They would literally
take van loads of people, go
down there, doctor shop at
these clinics that were set
up to dispense painkillers
and generally there would
be an organizer of the
group who would sponsor
them. Thats what they
called it. They would each
visit the doctor, they would
each get the maximum
prescription, then they
would either come back
and split that with (the
organizer) or they would be
paid cash for their
prescription, then it would
be distributed in the typical
drug conspiracy type of
organization.
Reeves said there was also
a big increase in pharmacy
robberies, and local law
enforcement saw drug fraud
cases start to climb.
Johnson City police know
all too well about opioid
distribution. Patrol officers
and narcotics investigators
deal with it mainly on the
street dealer or user level.
Of prescription
narcotics, we are seeing
primarily oxycodone and
hydrocodone or a
derivative of these,
Johnson City Police Chief
Mark Sirois said. These
are the most prevalent. In
absence of and in addition
to these narcotics, there is
some heroin, which has
similar effects.
Sirois said opioid abuse
also leads to other crimes.
The prevalence of drug
addiction in general
creates a corresponding
impact on criminal
activity, Sirois said. With
drug addiction and its often
life-altering effects, and
the need to maintain the
addiction and its escalation,
many users find
themselves in a situation
where they will participate
in criminal activity in
order to maintain their
addition. This is not to say
that all persons addicted to
drugs commit crime, but
there can be a strong
correlation.
Therefore, a large
percentage of crime
including those mentioned
above may be tied to
Tuesday, August 2, 2016
UGLY
TRUCK
CORRECTION
The Johnson City Press
strives for accuracy in all
its reports. Readers who
notice factual errors in the
newspaper should call
News Editor Sam Watson or
Night Editor Robert Pierce
at 929-3111.
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3 p/m ........................................................ Low
Mold
2670 p/m .................................................. Low

Source: Dr. Marek M. Pienkowski
REAL FEEL TEMPERATURE
The patented AccuWeather.com RealFeel Temperature is

an exclusive index of effective temperature based on eight
weather factors. Shown are the highest values for each day.
Today ........................................................ 99
Wednesday ............................................. 100
Thursday ................................................... 98
Friday ........................................................ 97
Saturday .................................................... 96
LAKE LEVELS
Elevation
Yest.
24 hr.
Change
Shown are noon

positions of
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and precipitation.
Temperatures reflect
todays highs and
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KID'S WEATHER
As of 7 a.m. yesterday
Boone ............................. 1353.24 ft. ........-0.02
Cherokee ........................ 1062.28 ft. ........-0.08
Douglas ............................ 985.76 ft. ........-0.09
Henry ............................. 1260.99 ft. ........-0.10
Holston .......................... 1723.66 ft. ........-0.10
Norris ............................. 1012.57 ft. ........-0.15
Watauga ......................... 1953.52 ft. .........none
SUN AND MOON

The Sun
Rise
Set
The Moon
Rise
Set
Today ..................... 6:37 a.m. ................. 8:34 p.m.

Wednesday ............ 6:38 a.m. ................. 8:33 p.m.
Karina,
second
grade,
Fairmont
Today ..................... 6:22 a.m. ................. 8:22 p.m.

Wednesday ............ 7:23 a.m. ................. 9:03 p.m.
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Last
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Forecasts and graphics provided by AccuWeather, Inc. 2016
FEDERAL
drug, and eventually began
writing opioid prescriptions
for others including Hendix
and one of his employees,
Robert Stanton II.
With all that was going
on in her life, the moment
that she used the drug she
was euphoric and she felt
that she could handle her
crumbling marriage and
the excessive amount of
work and school she had
planed
on
her
own
shoulders, Smith wrote. It
began with a half pill a day,
then two pills a day, then
five and finally 20 to 30 pills
a day after the death of her
husband in July 2013.
Barnetts guard was down
and the ugly face of
addiction was staring right
at her.
She knew she was in
trouble and she began to
search for a way out, even
using Narcan, an opiate
antidote, to help herself
withdraw. She realized the
clinic was an obstacle to her
recovery, but it was the only
way she had to support her
children, and threats from
her fellow addicts and friends
and their pleas of being dope
sick was a significant barrier
to her taking more decisive
action, Smith said.
But when the Tennessee
Bureau of Investigation
came knocking on Aug. 19,
2014, Barnett apparently
took the opportunity to
escape the pressure of her
fellow dope addicts and
seek recovery, Smith said.
She closed the clinic that
very day and ended up
hospitalized two days after
passing
out
due
to
hypertension. She remained
in the hospital for two
weeks, which allowed the
opiates to leave her system.
The two weeks away
from the drugs gave her the
first clarity from her
addicted state and she knew
that she needed help, Smith
said. Barnett reached out to
TnPAP, the Tennessee
Professional
Assistance
Program,
that
assists
impaired
healthcare
professionals rehabilitate
from addiction and facilitate
their safe return to practice.
After three months of
sobriety, Barnett obtained
employment at an area
hospital
as
a
nurse
practitioner, but lost that job
in May 2015 when the state
Board of Nursing put her
license on probation for two
years. Through friends who
knew her non-addict self,
Barnett was able to get a job
at another area hospital as an
RN. She began volunteering
to help others recover from
addiction.
At the one-year mark of
her sobriety, Barnett learned
shed been indicted in federal
court on the drug distribution
charges. Again, she lost her
job but eventually found
work as a case manager in a
recovery clinic. Her nursing
and nurse practitioner
licenses expired. She has
remained under supervision
in the TnPAP and completed
numerous
educational
requirements, a psychiatric
evaluation, continued to
attend two 12-step meetings
each week and is subject to
random drug tests.
As of May 31 the date
of Smiths filing the
sentencing memorandum
document Barnett had 19
clean drug tests from
TnPAP and four clean drug
tests from U.S. Probation.
Most of these actions were
initiated by and completed
long before Sherry was
indicted.
After
her
indictment, she has continued
her recovery, Smith said.
But during Barnetts
struggle with her addiction,
she aided others in theirs as
well, including Hendrix.
Through the words of
friends and relatives, by
means of 11 letters of
support filed in federal
court on Hendrixs behalf,
the story of his addiction
reads like so many others.
Hendrixs introduction to
opioids apparently occurred
after injuring his back in a
water-skiing accident, for
which he was legally
prescribed painkillers to aid
in his recovery. He, like
millions of other Americans
who obtained that first
prescription through innocent
means, became addicted to
the drugs and could not
function without them.
A single father of two girls,
Hendrix has been a fixture in
the community since opening
his first restaurant, Rockys
Pizza, in Jonesborough, in
1996. Since then, two more
stores opened. Hendrix was
always involved in community
events and donated to various
organizations, churches and
schools in the areas his
restaurants served. His family
maintains the restaurants now
and continues the things he
started.
Hendrixs arrest in the
opioid conspiracy was his
first brush with law
enforcement, but it proved
to be a hard one.
In the U.S. Attorneys filing
regarding
Hendrixs
sentencing, it stated a
sufficiently punitive sentence
is necessary to promote
respect for the law. Hendrixs
behavior in the instant case
demonstrates a lack of respect
for the law. His crimes were
not limited to obtaining a few
unlawful prescriptions over a
short period of time; rather,
he obtained hundreds of them
over approximately three
years.
Prosecutors had sought a
9- to 11-year sentence for
Hendrix. U.S. District Judge
Ronnie Greer opted for 78
months, or 6 years. He must
compete 500 hours of
substance abuse treatment
while in prison.
In April, Stanton was
sentenced to six years, which
will be followed by three
years of supervision. He
must compete 500 hours of
substance abuse treatment
while in prison, and the court
recommended
Stanton
receive credit for his
participation in that program.
Barnetts
sentencing
hearing is set for Sept. 28.
Prosecutors have asked for
a sentence of 70 to 87
months.
(USPS276-320)
Volume 95 Number 340

Published Daily and Sunday except
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Volume 95 - No. 341
Air patrol?
Elizabethton considering
airport site for police
headquarters/10A
Negotiations go into
extra innings/10A
75 cents
the
New laws cut opioid Incomplete?
war
Board
cant
clinic numbers
WASHINGTON COUNTY BOARD OF EDUCATION
By David Floyd
Press Staff Writer
dfloyd@johnsoncitypress.com
In 2014, there were about 333

pain clinics in Tennessee.
Now there are about 237.
Officials
believe
that
decrease marks a step forward
in the states fight against prescription opioid abuse.
Several state laws have been
passed in recent years to
improve the overarching
quality of pain treatment in
Tennessee and crack down on
With new
database
and tougher
guidelines,
number of
Tennessee
pain clinics
has fallen by
nearly a third
pill mills, a pejorative term

used to describe select pain
clinics that prescribe medication against proper medical
procedure.
Dr. Mitchell Mutter, the
medical director of special
projects at the Tennessee
Department of Health, said
these laws have had a strong
impact on the number of pain
clinics in the state, weeding
out clinics that dont follow
proper procedure.
See LAWS, Page 2A
Exploring East
Tennessees battle
with the pain
of painkillers
You treat heart

disease not just
by giving pills.
There are a lot
of different
things you do.
And you treat
pain in many
different ways.
Dr. Mitchell Mutter
select new
school site
Members consider new options,

again reject Williams property
By Jessica Fuller
Press Staff Writer
jfuller@johnsoncitypress.com
Beyond medication: A
shift to multi-modal care
Tennessee Department of Health
Johnson City clinic links

patients with options for
in-house pain therapy
By David Floyd
Press Staff Writer
dfloyd@johnsoncitypress.com
Patients who visit Pain Medicine

Associates in Johnson City oftentimes
lead lives saddled by persistent, invisible
discomfort.
Pain Medicine Associates, a multi-disciplinary treatment center, has multiple
locations in the Tri-Cities and offers a
variety of in-house pain therapy options.
Medication is one of those options.
But it definitely isnt the only one.
At the centers Johnson City office,
physicians and registered nurses work
alongside a physical therapist and a psySee MULTI-MODAL, Page 2A
David Floyd/Johnson City Press
Dr. Turney Williams, medical

director at Pain Medicine
Associates, and Marcus Cooper,
the centers psychologist, confer.
Pharmacies on the front line

With no
easy fix in
sight, area
pharmacists
watch for
red flags as
they meet,
search for
solutions
The
number of
pain clinics
per county,
as of July
21.
0-1
2-4
5-9
10-15
16-28
ABOUT
THIS SERIES
While epidemic prescription drug abuse has
long been a concern in
Northeast Tennessee,
the issue
took the
spotlight
this year
when
Mountain
and East Tennessee
State University proposed to establish a
substance abuse clinic
in Gray. The proposal
generated tremendous
concern among Gray
residents about safety
issues associated with
methadone treatment.
With authorization
pending, the Johnson
City Press has developed a five-day series of
articles discussing the
proposal, the challenges
of opioid addiction, legal
implications and treatment options.
Thursday: Impact on
local agencies and the
future of the proposal.
the
opioid
war
By Tony Casey
Press Staff Writer
In the past few years,

Tennessee has taken a strong
top-down statewide approach
to curbing chronic pain prescriptions.
Stronger guidelines were
rolled out about two years ago
in a letter from Tennessee
Department
of
Health
Commissioner
Dr.
John
Dreyzehner, who pointed at
the epidemic of substance
WWW
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Follow the Johnson

news, sports and
on Facebook at
facebook.com/
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and on Twitter at @
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Order up! Noli

owner expects to
be serving soon
Johnson City Press
By Tony Casey
Press Staff Writer
See PHARMACIES, Page 2A
High
A file photo
shows customers at the
Noli food
truck. Owner
Jason Howze
said the
trailer, taken
last week,
was recovered Tuesday
in Mars Hill,
North
Carolina.
Taken last week from a downtown lot,

food truck found Tuesday in Mars Hill
WEATHER/2A
Washington County School

Board
members
said
Tuesday night that after several months of deliberation,
its time to get a new Boones
Creek K-8 school off the
board and under construction.
The problem is, the board
still cant decide on a site to
begin that construction.
After hearing about a new
potential site on Dove Lane,
another vote on the Williams
property which the board
rejected in a split vote last
month failed by a 6-3
margin, leaving the board
without a site.
Architect Tony Street pre-
sented the new possibility, a

43-acre property off Dove
Lane near Highway 36. The
suggestion didnt come
without provisions, though,
as Street said it would be
difficult to find a way to
install two connections from
the school to the road. The
property is pretty uneven as
well, Street continued, and
about 5 acres of the property
is unusable do to uneven
land.
The property is asymmetrical and Street said it looks
a bit rockier than other properties that have been considered, so he advised board
members to prepare for the
possibility of spending a
couple million dollars to
See SCHOOL, Page 7A
CDC
The owner of the Noli food

truck plans to be back behind
the counter by the weekend
after his stolen trailer was
recovered in Mars Hill,
North Carolina, Tuesday
morning.
Noli owner Jason Howze
said the support of residents
DEATHS/3A
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Deana Morganstern
Johnson City
JOHNSON CITY
Charlene D. Barrier
Robert G. Dunworth
BRISTOL, Va.
Bishop Dean Livingston
ELIZABETHTON
Clarke Joaquin Lewis
MOUNTAIN CITY
Virginia Kate Eller Shupe
NASHVILLE
Helen Clark
WISE, Va.
Larry Ronald Clark Sr.

of Johnson City and the surrounding area made the

recovery possible. When the
news hit last week, posts
about the stolen concession
trailer went far and wide
across the internet. Howze
believes this made it very
unlikely anyone could move
his trailer without getting
noticed.
See NOLI, Page 2A
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PHARMACIES
From Page 1A
abuse and misuse driven by

prescription opioids.
Dreyzehner
acknowledged the many people in
communities across the
state who work passionately
and creatively to fight for
the cause.
Pharmacies and pharmacists are certainly in that
group, as theyre often the
people who process doctors
orders and pass along the
medicines.
Wayne Copp, the pharmacy manager who heads
Johnson Citys Blankenship
Pharmacy, said two of the
most frequent prescriptions
he fills and disperses are for
Subutex and Suboxone,
which contain the drug
b u p r e n o r p h i n e .
Buprenorphine can be very
addictive, which often drives
the behavior of those who
get hooked.
But regardless of whether
a certain percentage of his
customers are using their
prescriptions for potentially
the wrong reasons, he said,
the policy is to treat the customer getting buprenorphine the same as the customer whos been getting the
some high blood pressure
medicine for 30 years.
Unfortunately, theres no
easy fix for this growing
problem in Copps eyes, as
he said its multi-faceted.
Thats why hes part of a
group of other pharmacists,
counselors and medical doctors in the area who discuss
matters related to what
Dreyzehner labeled an epidemic.
His peer, Joe Nicely, the
pharmacist manager at West
Towne Pharmacy, said the
solution needs to be top-
down, in the sense that there

need to be fewer prescriptions to fill. He said that until
doctors collectively stop
writing so many, there will
continue to be what looks
like an insatiable public need
for these drugs.
In the past, Nicely said
doctors were more reluctant
to offer those drugs to
patients, and they were
reserved for post-surgery,
traumatic injuries or hospice-level situations.
But that doesnt appear to
be the case any more.
Customers are constantly
going into pharmacies for
opiates.
Nicely and his staff often
see obvious reasons not to
fill the prescriptions of some
customers.
There are various reasons
the red flags might come up:
multiple prescriptions using
the same address, an appearance in the local newspaper
for drug-related charges, or
simply anything that doesnt
pass the pharmacists personal sniff test can end in a
denial.
And thats all in line with
their legal rights.
Though neither pharmacist commented on the more
dangerous situations theyd
encountered with customers
looking for drugs, they
acknowledge those situations happen, and both said
its sad.
Nicely said its worse with
the youngest generation.
Im just so sad, he said.
I think weve lost a significant portion of the population to this.
The opioid epidemic also
poses a safety risk for pharmacists and other employees
at local drug stores.
Numerous pharmacies in
Northeast Tennessee have
been robbed in recent years,
not just for cash, but for the
controlled substances themselves.
Drug-seeking robbers hit
five Johnson City Walgreens
stores in a six-month period
beginning last summer.
Some have been armed,
demanding
prescription
drugs from the pharmacists
at gunpoint. In some cases, a
robber leapt over the counter
to obtain drugs. In one incident, a pharmacy technician
was clubbed with a gun.
In an earlier incident, a
robber fired a shot into the
ceiling of Bevins Pharmacy
and demanded Oxycodone
and Oxymorphone. Police
charged 24-year-old Andrew
Ryan Givens with the robbery four months later.
Police say one repeat
offender struck pharmacies
in Kingsport and Johnson
City,
alleging
that
Christopher J. Fox struck
the same Kingsport pharmacy in May and August of
2015 before robbing a
Johnson City location the following October. Each time,
he demanded drugs.
And in November 2014, a
Johnson City pharmacy robbery led to a police standoff
that ended when the robber
took his own life. Anthony
Eugene Goad, 46, 2421
Clearview Dr., Johnson City,
died outside his vehicle at
Blakemore
Circle
and
Mayfield Drive after police
pursued him after the robbery at Val-U-Pharmacy on
West Market Street.
Police said Goad had
forced employees inside the
pharmacy to lie on the floor
while he took narcotics.
years. Like the first patient,

he receives injections, but
he also takes a pain pill a
couple of times a day.
However, injections and
medication arent the only
aces up the centers sleeve.
Marcus Cooper, the Pain
Medicine
Associates
in-house psychologist, said
the centers strong focus on
multi-faceted,
in-house
treatment is relatively
unique.
What sets our clinic apart
from a lot of clinics ... is we
have an in-house psychologist, an in-house acupuncturist, an in-house physical
therapist, Cooper said. So
we are a true multi-disciplinary pain clinic, and that
sets us apart from most pain
clinics in the area who just
kind of pass out pain medicines.
Pain Medicine Associates
also takes behavioral health
into account when it treats
patients.
Cooper said people who
suffer from chronic pain
also generally suffer from
various co-morbidities, additional diseases or conditions
that co-exist with their pain.
This can make treatment
difficult.
If you have chronic pain,
it starts affecting all sorts of
things in your life, Cooper
said. You can get depression, you can get sleep disorders, you can get anxiety ...
but you also get morbid obesity, diabetes and it seems
like the chronic pain patients
have a lot of the other health
problems.
Because Cooper has an
office in the Pain Medicine
Associates
branch
in
Johnson City, he has immediate access to other physicians and can suggest treat-
ments for patients who have

these additional conditions
or are at risk of developing
them.
Dr. Stephen Loyd, the
medical director for substance abuse services at the
Tennessee Department of
Health, said multi-modal
pain treatment centers are
few and far between in East
Tennessee, but theyre
increasingly becoming a
desired model for pain treatment.
Those are the effective,
legitimate places that were
emphasizing that patients be
referred to, Loyd said.
The
Tennessee
Department of Health
recently oversaw the creation of a series of chronic
pain guidelines that help
physicians determine when
its appropriate to prescribe
opioids.
The guidelines encourage
the use of multi-modal pain
treatment, a term used to
describe a multi-faceted
approach to alleviating pain.
Loyd said the type of treatment offered at Pain
Medicine Associates could
eventually become the norm,
but the cost of offering alternative treatments does frequently act as a barrier,
which could explain why
multi-modal treatment isnt
as prevalent as experts
desire.
Loyd, however, is hopeful.
Were realizing that abuse
of opioid pain medications
are obviously more widespread than the literature of
the 1990s and early 2000s
told us it was, Loyd said.
Places that take a multimodal approach to the treatment of chronic pain, its my
opinion that theyll become
the standard.
They definitely picked

the wrong food truck to
steal, Howze said. Even
after we recovered it and
were bringing it back,
someone saw us moving it
and called the police about it.
That means people were
really looking out for it.
After a few days of
cleaning the trailer and
returning the missing pieces,
Howze said they will be up

and serving food by the
weekend. He wanted to
thank everyone for their
help in getting back the
trailer.
With an upcoming scheduled wedding, Howze was
dreading that he was going
to have to cancel the catering
opportunity, but is happy to
be back on track.
MULTI-MODAL
From Page 1A
chologist to ensure patients

receive the treatment they
need.
The center connects
patients with various types
of treatments, including acupuncture, massage therapy
and implants. The sheer
amount of resources at the
clinics disposal can be
helpful to physicians when
theyre dealing with patients
who need more specialized
forms of treatment.
For example, physicians at
the center see a lot of degenerated spinal discs, soft,
fibrous cushions that prevent vertebrae in the spine
from grinding against each
other. This condition is a relatively common cause of
lower back pain, producing
troubled sleep and intense,
day-to-day pain.
One patient, who remained
anonymous to keep her medical history confidential,
cannot receive surgery on
the degenerated discs in her
spine because her back is too
fragile. But the clinic has
managed to provide her with
alternative paths to relief.
The only relief I get from
pain is through the epidurals, the patient said,
describing the injections she
receives at the center on a
regular basis. They last me
about three months, and Ive
been getting them for about
two or three years now.
Another of the centers
patients works on a dairy
farm, a job that requires a
lot of backbreaking lifting
and lugging.
If I wasnt coming here,
he said, I couldnt work.
The patient has been visiting
Pain
Medicine
Associates for about 15
NOLI
From Page 1A
The trailer was found

abandoned behind a gas station across the North
Carolina-Tennessee line with
only a sandwich board
missing. The truck and its
equipment had an approximate value of $50,000, and
the missing piece was valued
at about $1,000.
We got a call this morning
that someone has spotted it,
Howze said.
With the trailer back in his
possession, Howze and his
team are working with the
Johnson
City
Police
Department in its investigation, and plan to pursue the
culprits in court.
THE
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first
grade,
South Side
Auto sales weaken at months end

The Associated Press
DETROIT U.S. auto

sales wilted in July, as hot
weather and softening
demand kept many buyers
at home.
Sales rose less than 1 percent over last July, to just
over 1.5 million new cars
and trucks, according to
Autodata Corp. Sales were
strong at the beginning of
the month thanks to
Independence Day promotions, but weakened after
that, Kelley Blue Book senior
LAWS
From Page 1A
Of these laws, the

Prescription Safety Act is
one of the most notable. The
law requires opioid prescribers to register with a
statewide database and,
when they prescribe medication, to put the recipients
information in the database,
enabling other physicians to
determine whether the same
patient has already been prescribed opiates.
As a result of this practice,
Mutter said the law has
caused an almost 50 percent
decrease in doctor shopping,
the act of visiting multiple
physicians to obtain more
than one prescription.
The Tennessee General
Assembly has also passed
laws that have established
more rigorous qualifications
for the staff at pain clinics.
For example, the medical
directors of pain clinics
must be a pain medicine specialists, which requires them
to have a certificate from
the American Board of
Medical Specialties or the
American
Osteopathic
Association, the status of a
diplomate with the American
Board
of
Preventive
Medicine, and a passing
grade on an exam administered by the American Board
of
Interventional
Pain
Physicians.
In 2014, the Tennessee
Department of Health also
drafted guidelines to define
the way that pain clinics
treat chronic pain, suggesting that clinics consider
alternatives to medication
before they give their
patients a prescription.
You treat heart disease
not just by giving pills,
Mutter said. There are a lot
of different things you do.
CORRECTIONS
The Johnson City Press strives
for accuracy in all its reports.
Readers who notice factual errors
in the newspaper should call News
Editor Sam Watson or Night Editor
Robert Pierce at 929-3111.
analyst Alec Gutierrez said.

GMs sales fell 2 percent
while Fords U.S. sales fell 3
percent. Toyotas sales
slipped 1 percent. Fiat
Chryslers sales were flat.
Volkswagens sales fell 8
percent. Several automakers
eked out sales increases.
Hyundais sales were up 6
percent and Hondas sales
rose 4 percent. Nissans were
up 1 percent.
After six straight years of
growth and record sales
of 17.5 million new vehicles
last year U.S. auto sales

are beginning to plateau. In
the first six months of last
year, for example, sales
were up 4 percent, or more
than double the pace of this
year.
Still, analysts say low gas
prices, low interest rates,
enticing new vehicles and
strong consumer confidence
should keep them at a very
high level. If sales stayed at
the same pace they were in
July, they would reach 17.9
million this year.
And you treat pain in many

different ways. Theres not
one good answer.
Pain clinics are also subject to regular inspections,
and the frequency of these
inspections will increase
from once every three years
to once every two years on
July 1, 2017.
While many of these problems might seem remote to
people
in
Washington
County, Johnson City Police
Department Chief Mark
Sirois said residents have
contacted the station to criticize the management of local
pain clinics.
We have received negative comments from community members regarding
the way some pain clinics
are operated, that drugs are
given like candy, and
readily available, Siriois
said. This is especially the
case for those families who
have lost their loved one to
an overdose.
Like the state at large,
however, Washington County
is also witnessing a decrease
in the number of pain clinics.
In 2015, the county had 10
pain clinics; now there are
seven.
The Prescription Safety
Act has also had an impact
on the number of morphine
equivalents that have been
prescribed over the past two
years, which has dropped by
about 500 million. But
experts believe theres still a
lot more work to be done.
(That decrease) is huge,
but its also a drop in the
bucket, said Dr. Stephen

Loyd, the medical director
for substance abuse services
with
the
Tennessee
Department of Mental
Health and Substance Abuse.
(The law) has had some
impact, but it has not had an
impact on overdose deaths.
But there is some reason
to be hopeful.
Before 2010, the number
of morphine equivalents prescribed in Tennessee was
increasing on an average of
10 percent a year. Now, there
has been a reversal in these
figures, and in comparison
to the first half of 2013, there
has been a 22 percent
decrease in the number of
morphine equivalents prescribed in the state this year.
Mutter said the introduction of new laws and the
creation of pain guidelines
carry a simple message
from the state: We dont
oppose treating pain. Were
in favor of it, but we want
increased access to quality
pain treatment.
Cabinet Refacing Re-dooring

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GOOD
MORNING
Thursday
August 4, 2016
Globetrotter
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park
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for King Basin area/4A
And now...
Volume 95 - No. 342
Rezoning
request for
proposed
Gray drug
addiction
treatment
clinic goes
before
Planning
Commission
Aug. 9
By Zach Vance
Press Staff Writer
East
Tennessee
State
University and Mountain States
Health Alliance are pursuing a
February 2017 date for their proposed addiction treatment clinic
at Gray Commons Circle to be
completed.
But potential hurdles remain.
Before the clinic can open, the
Johnson
City
Planning
Commission and City Commission
must approve a rezoning request,
and the Tennessee Health
Services and Development
Agency will have to approve the
clinics certificate of need application.
The rezoning request will be
heard Aug. 9 during the Planning
Commissions next meeting. If
approved, the request will
be sent in ordinance form
to the City Commission for
consideration on three
readings.
The clinics certificate of
need application would
then be heard by the HSDA
Board on Aug. 24 in
Nashville.
Well have our attorneys there. I mean thats
the real deal. Thats where
the decision is going to be
made, said Alan Levine,
CEO of Mountain States.
During the CON meeting,
Mountain States and ETSU
will have the opportunity
to make a short presentation on why they believe
the Tri-Cities region needs
an addiction treatment clinic, and
how the CON application meets
the necessary criteria for being
approved.
The 11-member board will then
ask questions of the applicant,
any supporting party or opposing
See REZONING, Page 6A
Jessica Fuller/
Johnson City Press
Protest signs line

the highway
around the proposed location of
a methadone
clinic in Gray.
THERES
MORE
For the regions

human service
agencies, the
impact of the
opioid addiction
epidemic is multigenerational
and dramatically
adding to the
need for almost
every emergency
service the
agencies provide.
Page 2A
A Johnson City flooring manufacturers

plans for a $15 million local expansion are
official, as the company accepted a $1.2
million local incentive package from
Washington County and Johnson City.
Mullican Flooring officials along
with Tennessee Gov. Bill Haslam and
Economic and Community Development
Commissioner Randy Boyd announced
Wednesday that the flooring manufacturer will indeed expand its Johnson City
operations and create 200 new jobs during
the next five years.
Washington County was competing
with incentives offered by Bowling
Green, Kentucky, and Wise, Virginia,
where Mullican currently maintains
property. The governing commissions of
the county and city each voted to commit
$600,000 to the effort, aimed at fending
off other suitors.
Under the plan, the Washington County
Industrial Development Board will proSee MULLICAN, Page 6A
By Zach Vance
Administration.
They have such a long history
and they are so effective for pain
management when used propAs opioid overdose deaths rise, erly, Batson said. I dont think,
a growing stigma can obscure the realistically speaking, that we
medicinal benefits of
say they would
We have to be could
the pain medication.
be eliminated from
But is doing without
judicious and pain control.
opioid prescriptions
Batson said there is
you dont
having a patient
no doubt that opioids
live without some- necessarily need
have legitimate uses,
thing to douse the
especially
when
Lortabs
to
treat
excruciating pain
cancer
worth extinguishing kidney stones or treating
patients and as an
the addiction?
an abscess. end-of-life treatment.
Dr. Jim Batson,
There are defichairman
of
the Dr. Anastasia Brown
Tennessee Medical Association nitely legitimate uses (for opiBoard of Trustees, doesnt believe oids), Batson said.
Opioids are likely to remain a
opioids will ever be withdrawn by
the U.S. Food and Drug
See PROTOCOLS, Page 6A
By Nathan Baker
nbaker@johnsoncitypress.com
Addiction treatment advocates complain TennCares lack of coverage of

methadone clinic services for opioid
addicted beneficiaries is slowing the
A patients daily
dose of methadone is dispensed
into a small cup
to be taken orally.
ABOUT
THIS SERIES
Olive
Advocates: TennCare
rules slowing response
Assistant News Editor
Exploring East
Tennessees battle
with the pain
of painkillers
From staff reports
Press Staff Writer
Program stopped covering

methadone to treat drug
dependency in adults in 05
the
opioid
war
Mullican
expansion
a go, with
200 jobs
75 cents
Flooring manufacturer will

invest $15 million in project
Pain treatment protocols evolving

Rising
problem
of opioid
abuse
leads to
new ideas
to deal
with
patients
pain
Brown
states response to a public health epidemic and unequally impacting the wellbeing of low income residents.
In 2005, amid pressure from lawmakers and a drastic purge of TennCare
rolls, Tennessees Medicaid program
stopped covering methadone as a treatment for drug dependency for those 21
and older.
Under the programs rules, the drug
can be used to treat chronic pain, but its
on the non-preferred list, meaning the
See TENNCARE, Page 2A
While epidemic
prescription drug
abuse has long been a
concern in Northeast
Tennessee, the issue
took the spotlight this
year when
Mountain
States
Health
Alliance
and East
Tennessee State
University proposed to
establish a substance
abuse clinic in Gray.
The proposal
generated tremendous
concern among Gray
residents about safety
issues associated with
methadone treatment.
With authorization
pending, the Johnson
City Press has
developed a five-day
series of articles
discussing the
proposal, the
challenges of opioid
addiction, legal
implications and
treatment options.
the
opioid
war
Zach Vance/Johnson City Press
From left, U.S. Rep. Morgan

Griffith, Isreal OQuinn and U.S.
Rep. Phil Roe tour the future
facility of Bristol Lifestyle
Recovery on Wednesday.
Expanded
Manna House
concept draws
lawmakers eyes
By Zach Vance
Press Staff Writer
BRISTOL The third try is a charm.

At least thats what officials at Fairview
Housing Development Corporation are
hoping.
Fairview is an affordable housing organization trying to expand its abstinence-only housing concept of Johnson
Citys Manna House into a 240-bed former
nursing home at 241 North St. in Bristol.
But the nonprofit still lacks about
$200,000 to complete the venture.
On Wednesday, Fairview owner Bob
Garrett led U.S. Rep. Phil Roe, R-Johnson
City, U.S. Rep. Morgan Griffith, R-Salem,
and other government officials around
the facility in an attempt to gain support
and find extra funding.
And most of the officials spoke highly
of the buildings potential.
Garrett said approximately $1.3 million
had already been pledged toward opening
the long-term affordable addiction
housing project, which will be called
Bristol Lifestyle Recovery.
See HOUSE, Page 6A
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and on Twitter at @
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ELECTION DAY
The polls will be

open from 8
a.m. to 8 p.m.
today for federal
and state primary voting and for county
general elections. For more
information on the races
and candidates, go to johnsoncitypress.com, choose
the sections/search tab and
search for county election.
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Police: Asheville food truck

manager suspect in Noli theft
Thursday, August 4, 2016
By Tony Casey
Press Staff Writer
Noli food truck owner

Jason Howze said as soon as
his recently recovered concession trailer is up and
serving food again, hes
going to run a special:
Grand Theft Tacos.
That name
relates to the
recent theft
of the trailer
from
the
Downtown
Farming on
C h e r r y
Street.
Howze is
Profitt
looking for
justice, and that might occur
as law enforcement authorities have arrested a suspect,
someone from within the
food truck industry.
Police say the woman who
manages the Asheville,
North Carolina, Destination
Eggroll food truck is suspected of stealing the popular Noli food truck concession trailer.
According
to
police
reports, Rhonda Kay Profitt,
27, 162 Fietop Road, Maggie
Valley, North Carolina, was
arrested Tuesday evening by
deputies of the Madison
County Sheriffs Office and
charged with possession of a
stolen vehicle. The arrest
took place at 348 Medical
Park Drive in Marshall,
North Carolina. She was
being held on bond for
$25,000 and awaiting trial.
A vehicle similar to the
one shes accused of stealing,
a dark Chevy Surburban,
appears to be pulling the
Noli concession trailer in
video footage released after
it was reported stolen by
Howze the morning of
Friday, July 29.
Nathan Baker/Johnson City Press
Shown in a file photo, Noli food truck owner

Jason Howze said he plans to offer a special dish
when his recently recovered concession trailer is
up and running again: Grand Theft Tacos.
Police say a North Carolina woman is suspected
of taking the trailer.
Johnson
City
Police
Department Lt. Kevin Peters
whos been investigating
the trailers disappearance
said a charge of theft over
$60,000 awaits Profitt in
Johnson City.
Having recovered a tablet
from the Downtown Farming
lot that had information containing Profitts name, as
well as having Profitt show
up at the site of the trailers
recovery in Mars Hill
Tuesday, helped investigators to their suspect.
Peters said he doesnt
know why she appeared at
the site of the abandoned
trailer while police were
there.
Peters said theres the possibility of an extradition process from across the state
line, and if that extradition is
waived, the JCPD would
have to get a governors war-
rant to bring Profitt to

Johnson City for her charges
here. The investigation is
ongoing, as Peters said more
charges could be piling up
for Profitt.
Howze credited the help
and support of his food
trucks followers for recovering the Noli trailer, and he
said he hopes to be up and
serving food by this
weekend.
Its crazy to think that
another food truck would
steal your work, he said.
In seeing the support for
the Noli trailer when it was
missing, Howze said he suspects the opposite backlash
of social media will not be
pleasant for Profitts business.
Follow Tony Casey on Twitter

@TonyCaseyJCP. L ike him on
com/tonycaseyjournalist
Human service agencies find

impact of addiction far reaching
By Sue Guinn Legg
Press Staff Writer
slegg@johnsoncitypress.com
For the regions human

service agencies, the impact
of the opioid addiction epidemic is multigenerational
and dramatically adding
to the need for almost every
emergency service the agencies provide.
We see it every day. They
come to us. And they are
especially quick to come to
us if there are children,
said Aaron Murphy, executive director of Good
Samaritan Ministries and
the emergency services the
ministry provides to people
in five Northeast Tennessee
counties.
The problem is compounded by the scope of
opioid addiction particular
to this region.
While not every state
tracks the data, Murphy said
the reports he has seen put
the incidence of opioid addiction in the area among the
highest in the country and
Sullivan County as the
national leader.
We serve Sullivan County.
Thats who we are there for,
he said.
To address addiction on
the
front
end,
Good
Samaritan pays a stipend
salary to a licensed certified
counselor who meets with
addicted clients at the ministry three days each week.
Her schedule is full and she
is in demand every day she
is here, Murphy said.
Because the need for
addiction counseling is
greater than the ministry
can meet, Good Samaritan
reaches out to area churches
and other professional counselors for assistance.
We would like to have a
couple more licensed certi-
Sue Guinn Legg/Johnson City Press
Aaron Murphy, center, executive director of

Good Samaritan Ministries, with Genn Fasu,
right, pastor of World of Faith Church on Sell
Avenue in Johnson City, and Ricardo Docean,
pastor of The Fathers Kingdom Christian Center
of Kingsport.
fied counselors to volunteer
with us. But we get most of
our support from churches.
And we partner with
churches in this, Murphy
said.
We partner with these
churches to counsel with
people with addictions. We
partner with churches to get
volunteers to rock babies
who are addicted and cry
and cry and will not stop.
And we partner with them in
a baby food distribution to
get baby food to these
babies.
Beyond addiction and the
need for counseling to
address it, when a person
with an addiction has children, incarceration, loss of
employment and loss of custody often places the many
responsibilities of child
rearing on their older family
members.
Grandparents
and
great-grandparents
who
have passed their prime
earning years some who
struggle to meet their own
needs on Social Security
incomes take on those
responsibilities to prevent a
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child from being placed in

state custody.
And because state laws
mandating parental child
support do little good when
an addicted parent is unable
to maintain employment, the
emergency need for food,
clothing, school supplies,
rent and utility assistance,
medical bills and other needs
met by nonprofit service
agencies multiplies with the
areas addiction rates.
Our clients come in every
day, especially children with
parents who are addicted to
prescription drugs. To serve
those children, we have to
serve their parents, Murphy
said.
He believes the key to
addressing
widespread
opioid addiction lies in community partnerships like
those employed by Good
Samaritan. And as a minister, he foresees a great
revival of churches.
Where a lot of people see
someone on the street and
say Oh, that person is a pill
head, we see a person who
needs love, Murphy said.
I dont believe clinics are
the answer because they are
putting them off one pill and
putting them on another.
The pastors we work with
understand what we are up
against and they are willing
to work together. Thats
important to bring about
change. This is a community
problem. And I think it will
be the church that takes this
demon by the horns.
Hudson,
kindergarten,
Lake
Ridge
TENNCARE
From Page 1A
patient must first meet a

long list of prior authorization criteria, and then is subject to quantity limits.
In an emailed statement,
TennCare
spokesperson
Sarah Tanksley said the decision to cease coverage was
made because of quality of
care and delivery system
concerns. The change went
into effect with the support
of the Tennessee General
Assembly and with approval
from (the Centers for
Medicare
&
Medicaid
Services), she wrote.
When the policy was
changed, Tanksley said
TennCare members could
not find adequate access to
clinics because of the clinics
refusal to contract with the
programs
Behavioral
Health
Organizations,
drawing safety concerns
when patients sought treatment outside the network.
Methadone also has a narrow
therapeutic range and a
higher risk of overdose than
buprenorphine, a drug on
TennCares preferred drug
list for the treatment of
opioid addiction.
The state program also
covers drugs to reverse
opioid overdose in an emergency situation and drugs to
block the effects of opioids.
In 2004, state Sen. Rusty
Crowe, R-Johnson City, and
Rep. Jerome Cochran,
R-Elizabethton, sponsored
legislation seeking to prohibit methadone treatment
providers from receiving
reimbursement by the states
health insurance option for
low income residents.
I have a big problem with
us basically reimbursing
people for drug habits,
Cochran said, before Gov.
Phil Bredesens prescription
drug limits to help turn
around the insolvent state
program were put in place.
The legislation was not codified, but the next year,
TennCare stopped paying
for methadone clinic services to get or stay off drugs.
Joycelyn Woods, executive director of the National
Alliance for Medication
Congressional, legislative races focus of primary

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focused on congressional
and state legislative races.
An open congressional
seat in western Tennessee
attracted a bakers dozen of
candidates to enter the fray
for the Republican nomination, while U.S. Reps. Scott
DesJarlais and Diane Black
are trying to fend off primary challenges from GOP
candidates who are trying to
Re-Elect
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Assisted Recovery, a national

group that advocates for the
use of methadone and other
prescriptions to treat addiction, said the stigma
expressed by Cochran has
negatively affected the
availability of research-supported treatments and has
been difficult to counteract.
It has nothing to do with
common sense, or helping
people or public health, she
said. The decision is made
for political reasons, and it
sounds like to me theyre
saying, if the care isnt good,
well make sure you wont
get any care at all.
Ending TennCares reimbursements for methadone
has limited the number of
clinics in the state, forcing
all patients in Northeast
Tennessee,
whether
receiving state benefits or
not, to drive hundreds of
miles for treatment, Woods
said.
In an application to the
state Health Services and
Development Agency for a
certificate of need to operate
a methadone treatment
clinic
in
Gray,
East
Tennessee
Healthcare
Holdings Inc., a partnership
between Mountain States
Health Alliance and East
Tennessee State University,
lists the nearest clinics for
most county residents being
in Knoxville; Galax, Virginia;
or Weaverville and Boone,
both in North Carolina.
We would be so delighted
to see Tennessee cover treatments, we have been getting
calls from Tennessee about
methadone availability for
20 years, and Ive been getting calls from Johnson City
for 20 years, she said. Its
really awful to have to tell
somebody that theyre going
to have to pay about $400 per
month for treatment, and
then tell them theyre going
to have to drive several hundred miles for it, too. I
couldnt do it.
In the certificate of need
application, the two regional
institutions say they plan to
investigate the ability to contract with TennCare for services, but they do not immediately plan to seek Medicaid
Lifelong resident of
Washington County
Paid Pol. Ad by John Phillips, email jphunt@charter.net
position themselves to the

right of the incumbents.
In the Tennessee General
Assembly, all 99 House seats
and 16 of 33 Senate seats up
this year.
Thirty-eight GOP incumbents are facing challenges
by candidates seeking to join
the strong Republican
majorities in both chambers.
and Medicare certification

for the center, because of the
lack of benefit coverage.
The new corporation
excluded TennCare and
Medicare members from its
expected patient counts
650 in the first year and
1,050 in the second in the
200-page document, because
of uncertainty regarding
whether those patients
would be covered.
Clinic managers expect to
charge $13 per day per
patient
for
treatment,
including medication, counseling, social work and
testing, leading to about $400
per month.
In states where opioid use
and methadone treatment is
more stigmatized, which
tend to be in the Southeast,
Woods said, its more difficult to respond to the public
health issues caused by
dependency.
They tend to have the
highest overdose rates, and
they tend to react several
years after the fact, after the
epidemic starts, she said.
If they had acted when they
started to see changes in the
overdose and use rates, they
might have been able to do
something, but its even
harder when you dont have
the states cooperating.
According to age adjusted
and
Prevention
data,
Tennessee had the 11th
highest drug overdose rate
in 2014 and the 11th highest
number of deaths, 1,269.
Follow Nathan Baker on

Twitter @JCPressBaker. Like
him on Facebook: www.facebook.com/jcpressbaker.
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PROTOCOLS
From Page 1A
key component of pharmacology, but in March, the

and Prevention responded
to the opioid epidemic by
issuing strict guidelines for
doctors to follow when prescribing medicines to treat
pain.
The CDC says opioid prescriptions have quadrupled
since 1999, which has incited
the addiction intensification.
More than 40 Americans
die each day from prescription opioid overdoses, we
must act now, said CDC
Director Dr. Tom Frieden.
Overprescribing opioids
largely for chronic pain
is a key driver of Americas
drug-overdose epidemic.
The updated CDC guidelines now say opioids should
not be considered firstline or routine therapy for
managing chronic pain,
except for patients seeking
cancer treatment, palliative
care or end-of-life care.
The guidelines encourage
doctors to prescribe nonopioid therapies and medications, such as acetaminophen, NSAIDs, serotonin
and topical agents, for
chronic pain and ailments
before turning to an opioid
prescription.
Since graduating from
medical school in 2005, Dr.
Anastasia Brown, an urgent
care physician in Kingsport,
said the medical communitys views on the treatment
of pain have shifted.
When I first graduated,
they were really starting to
be concerned about patient
satisfaction and customer
service. Thats around the
time these pain scales were
becoming popular in the
ERs (emergency rooms).
Physicians and other providers were instructed to
control everyones pain,
Brown said.
So I think opioids probably were being, well they
were definitely being, overprescribed in an effort to
make everybody happy, and
now the pendulum is
swinging back as we realized there are definite risks
to doing that. We have to be
judicious and you dont necessarily need Lortabs to
treat kidney stones or an
abscess.
In the past five years, Dr.
Kenneth Olive, associate
dean for academic and fac-
HOUSE
From Page 1A
Were very, very close to

being able to open it. Were
working with a local lender
and the USDA. They are processing a guaranteed loan
for us. Its a business and
industry loan so we feel very
fortunate. They really like
this facility, Garrett said.
Bristol Lifestyle Recovery
will operate under the same
model as Manna House,
except it will serve additional subpopulations instead
of just veterans.
Most of the facility will
be for affordable, long-term
addiction recovery. Theres
just a huge need for that in
our community, Garrett
said.
We will also be serving
several different sub-populations, such as pregnant
women, people coming out
of incarceration, people sentenced to drug court and
children aging out of foster
care. Those are all very huge
needs.
Garrett said rent will cost
about $800 a month for each
occupant, but that amount
will cover food, medical,
dental and transportation
needs.
While treatment wont be
offered inside the housing
structure, Bristol Lifestyle
Recovery will provide referrals for addiction and medical needs to local treatment
centers and hospitals in the
area.
Roe applauded the projects concept because it provided long-time support for
an addict who would be
experiencing withdrawal
symptoms after leaving an
addiction treatment or detox
center.
We have someone who is
in acute withdrawal. And
then when theyre out of
acute withdrawal, they have
nowhere to go. So theyre
right back into the system
again, Roe said. So what
(Fairview) is trying to do is
have a place, where after
youve gotten out of that
acute phase, is to put them
into a long-term phase.
Maybe six months, maybe a
year, maybe two years even,
so you can then get job skills
and training and go out and
be a productive member of
society.
Garrett said the owner of
the property, once learning
From Page One

REZONING
ulty
affairs
at
East
Tennessee State Universitys
Department of Internal
Medicine, said the curriculum has been updated with
more pain management and
pain therapy education.
In fact, Olive also said
ETSU will soon implement
CDCs new opioid guidelines
into the medical programs
curriculum.
Olive said a student going
through ETSUs medical
program would have had
less opioid addiction education than today.
There would be much
less emphasis on problems
related to opioid abuse
and say prescribing than
there is today, Olive said.
Olive said students first
begin learning about prescribing
medications,
including opioids, during
their second year in medical
school, before gaining firsthand experience during a
third-year clerkship.
Virtually all of our thirdyear clerkships include
issues on pain management
in patients, Olive said.
Olive said ETSUs location
gives medical students the
advantage of direct exposure to treating the opioid

epidemic.
This is not a theoretical
problem were talking
about, because they see it
every day when theyre on
the clinical rotations, so it
helps in that sense, said
Olive, whos been an associate at ETSU for more than
a decade.
Every day, Brown and
thousands of other physicians across the state face a
decision: Does a particular
patient really need an opioid
to treat their pain?
Now those decisions are
based more on objective
measures and professional
judgement, and less on a
pain scale.
The way one person
experiences (pain) may be
different from another. So
its very subjective. As a
physician, you want to be
able to take everyone for
their word, you dont want
to have to feel suspicious of
your patients. You want to
make them feel better,
Brown said.
So it can be a very difficult balance in trying to
treat them properly without
causing further harm to the
patient and community by
increasing risk of addiction.
Brown added, Patient
satisfaction is certainly
important, but if the patient
is only going to be satisfied
if they get a narcotic so they
can go down the street and
sell it or get a high, then that
person is not going to leave
satisfied.
Because Brown works in
an urgent care clinic, she
primarily treats acute pain,
which is short-term, temporary pain that can typically
be measured in hours and
days.
Medication prescribed for
acute pain requires less
oversight since its bestowed
in smaller, lower dosages.
Brown said prescribing for
acute pain is easier and simpler than for a chronic pain
or ailment.
I dont want patients to
think that if they come to
the doctor or urgent care
and complain of pain, were
automatically going to think
theyre a drug-seeker,
because thats not the truth
at all, Brown said.
Were not suspicious of
everyone, and we do try to
treat everyone appropriately.
of its purpose, reduced the

price of the building substantially so it could become
long-term
affordable
housing for those in need.
The facility is already
here. It really doesnt need
much done to it to be able to
open up, Roe said.
A couple of years ago,
Fairview used Johnson Citys
Manna House, a 24-bed supportive housing complex for
homeless veterans located
on West Walnut Street, as
collateral to meet debts
incurred on a failed $2-million subdivision for low-income families in Kingsport.
The collateral for the
building was also used for a
portion of rental income to
maintain operations of The
Downtown Apartments in
Johnson City, which operated at a loss for some time.
They were sound investments (that failed) because
of the economy and because
Fairview served low-income

people who could least
afford housing, Garrett told
the Johnson City Press in
February 2015.
In March 2015, about two
dozen groups and individuals contributed funds to
Fairview to clear approximately $50,000 in accumulated debt in order to avoid
the foreclosure of the Manna
House.
The
problems
that
Fairview Housing had in the
past was not due to Manna
Houses operations. We were
able to raise enough money
to resolve that, Garrett
said.
So when we open this
facility, we will have a years
worth of operating funds to
start with. So we wont have
financial difficulties. We
dont want to start out with
any financial needs. Thats
why were doing our fundraising before we open.
CLINICAL REMINDERS
From the CDCs Guideline for

Prescribing Opioids for Chronic Pain
The Village Antique

& Home Decor Malls
From Page 1A
party, then discuss it in a

public forum.
The HSDA board will then
vote to approve or deny the
application. Occasionally,
the application will be
deferred by the board so
additional information can
be obtained.
Within a week of the decision, Mountain States and
ETSU will be issued approval
or denial letters, and if
approved, the actual certification will be sent four
weeks after the decision.
An appeal can also be
made within 15 days of the
decision.
Before the HSDAs decision, a public meeting will be
held Friday at Daniel Boone
High School for Gray residents to meet with HSDA
members.
Rep. Micah Van Huss
requested the meeting,
which will run 6 p.m. to 8
p.m., so Gray residents interested in the process wont
have to travel to Nashville.
I asked for the meeting.
Given the distance involved,
very few, if any, of my constituents will be able to make
the trip to Nashville to make
their concerns known to the
agency and board, Huss
said in a press release.
I dont believe the
Agencys report to the board
will convey an accurate pic-
ture of the situation unless

someone from the Agency is
able to hear these concerns
personally. People have a lot
of questions about the CON
process.
Levine said the HSDA
members attending the
Daniel Boone meeting will
likely be more interested in
the need for the clinic rather
than its location.
Another variable that
could potentially derail the
February 2017 timeline is if
Dan Eldridge finds a more
suitable site to replace Gray
Commons.
As it stands, Eldridge said
he still hasnt recommended
a site to Mountain States for
consideration, although hes
looked at 37 potential sites.
Eldridge said hes looked
at Mountain States-owned
property, the Med Tech
Parkway and commercial
properties on North Roan
Street, West Market Street
and South Roan Street.
However, none of the
properties have what is
needed to open a medication-assisted
treatment
facility.
Either the building was
not an appropriately designated street or the property
just couldnt accommodate
the 10-to-1 parking requirement, Eldridge said. Then
there were some others that
was a really good site, but it
was just a really expensive

site.
With a glimmer of hope
remaining for Eldridge to
find an alternative, he still
has his eye on a couple of
potential sites.
Were about to run out of
time. Were on borrowed
time right now. We are
working through the final
couple of sites that I think
are strong prospects to be
used, Eldridge said.
I think (those sites) are
certainly more suitable than
the site in Gray in regard to
little or no residential
impact. But there is not a
perfect site, believe me.
Levine said the final deadline to consider an alternate
location would be the CON
hearing.
(The CON) is a critical
factor. If the location
changes, wed have to withdraw our CON application
and submit a new one. So
thats really the issue for
us, Levine said.
As far as were concerned, Gray is the location
unless something as good or
better comes along. So were
moving forward as though
were going to Gray. In terms
of deadline, Id asked if we
could get this resolved by
Aug. 1. Theyre still working
diligently on it and at this
phase, obviously I want to
give them every opportunity
to identify an alternative.
for the economy of our community, but it is also further

confirmation of Mullican
Floorings ability to compete
globally from their Johnson
City-based operations.
This is very encouraging
as we look for other significant opportunities for an
existing employer to expand
or to attract a new employer
to this community.
The Roweland Drive
building will be used to store
raw materials and finished
products.
Mullican Flooring has
always found Washington
County, Johnson City and the
state of Tennessee to be
exceptional partners to local
businesses, Neil Poland,
president
of
Mullican
Flooring, said in the release.
The tremendous work ethic
of our existing employees
has created a successful

foundation at our Johnson
City plant to help make this
expansion possible. We look
forward to reaping the benefits that this expansion will
provide to both Mullican
Flooring and our hometown
community.
Mullican Flooring plans to
hire 50 to 80 new employees
during the next year.
Over the next five years,
the company plans to invest
approximately $15 million in
equipment, buildings and
working capital in Johnson
City. Once completed, the
latest expansion will nearly
double the companys current employment base in
Washington County. The
expansion marks Mullican
Floorings fourth major
growth initiative in Johnson
City during the past 16 years.
MULLICAN
From Page 1A
vide the funds to buy property at 129 Roweland Drive

and allow Mullican to expand
its operations beyond its 855
Woodlyn Road facility. The
purchase would be conveyed
to the IDB and leased back
to Mullican for 15 years
under a payment-in-lieuof-tax incentive.
Mullican Flooring is one
of Tennessees homegrown
success stories and I applaud
them for their commitment
to provide another 200 jobs
for Johnson City and
Washington County residents, Haslam said in a
news release from the state
agency.
Also in the release,
Dan Eldridge said, The
decision to create 200 new
jobs is not only great news
ts
n
e
s
e
r
P
THE
1375 Volunteer Parkway, Unit 2, Bristol, TN

(423) 797-4412 www.facebook.com/VendorsVillageMall
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and Upload your Ugly Truck Picture Today!
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Contest ends August 23.

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Region's History Not Favorable To Methadone Clinics: The Opioid War

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Volume 95 - No. 338

Bristols BCMA Museum celebrates

NEONATAL INTENSIVE CARE

Exploring East Tennessees battle with the pain of painkillers

ABOUT THIS SERIES

Assistant News Editor

A topic of discussion for more than a

Follow the Johnson

While epidemic prescription

Contributed/Mountain States Health Alliance

The neonatal intensive care unit at Niswonger Childrens

Even the youngest are

Amid the conversations about methadone

Jessica Fuller/Johnson City Press

Dr. Des Bharti, a neonatal specialist at

At conventions, Trump, Clinton

Darla Sarver Davenport

Front Page Design/Brian Reese

From Page One

Sunday, July 31, 2016

Johnson City Press, Page 7A

who are born withdrawing

What are opioids?

Centers for Disease Control

or a friend, McLain said.

And premature labor

Follow Jessica Fuller on

icate of need decision was

Centers for Disease Control

tive and violated the

Follow Nathan Baker on

Phil Roe Negotiated the

VETERANS CHOICE ACT

IN TUNE WITH EAST TENNESSEE.

100% Voting Record

Volume 95 - No. 339

Press Staff Writer

Press Staff Writer

Press Staff Writer

stints in prison while managing an opioid and Xanax

Some argue case for clinic

There is an argument being

I think youll have a little

Washington County sheriff

delivery of services and

Darrell Smith, pictured

Follow the Johnson

The Med-Tech corridor and

For me, its

system math coach

ETSU FRESHMAN ORIENTATION

Press Staff Writer

See NUMBERS, Page 2A

You can, too. Visit facebook.

Front Page Design/Brian Reese

Volume 95 No. 340

The never-ending cycle of addiction caused

Press Senior Reporter

Tony Casey/Johnson City Press

Press Staff Writer

vious ready availability by prescription as well as on the street.

$7-$10 per pill, oxycodone IR costs