Breathitt County officials approved limits Monday on the location of clinics where drug addicts can receive medication-assisted treatment, but they amended the rule to avoid a legal fight with a clinic set to open soon.
The new ordinance requires pain clinics and other places that provide treatment with Suboxone or methadone to be in shopping centers.
The purpose of the rule is to make it easier for police to patrol and monitor the clinics, Judge-Executive John Lester “JL” Smith said.
The fiscal court changes an earlier version of the rule to exempt any clinic that had a business license by Monday.
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That applies to a company called Trending Upward LLC, which has been at odds with the fiscal court over plans to open a Suboxone clinic just outside Jackson.
Suboxone is a drug that people can use to keep debilitating withdrawal symptoms at bay while trying to stop abusing pain pills and heroin. It also can be abused.
Trending Upward sued the fiscal court after it approved an ordinance last summer barring any new drug-treatment clinics in the county.
Circuit Judge Frank Fletcher struck down that ordinance earlier this month, ruling that it discriminated against people with drug problems and thus violated the federal Americans With Disabilities Act.
Fletcher barred the county from denying a business license to Trending Upward.
The fiscal court took a new approach to limiting clinics last week, with the ordinance requiring any such clinic to be in a shopping center.
Trending Upward opposed that rule as well. It owns a building that isn’t in a shopping center, so the rule would have blocked it from opening.
The business was prepared to sue again, but the fiscal court changed the rule Monday to grandfather in that clinic.
It wasn’t a willing decision. The county’s insurance carrier had notified local officials that it wouldn’t cover the cost of a legal fight over the initial version of the rule, and the county can’t afford an expensive court case, Smith said.
Rob Roark, a Lexington attorney who represents Trending Upward, said he thinks the amended ordinance runs afoul of federal law, Fletcher’s ruling and an opinion from the state Attorney General’s Office.
“It’s one of the worst I’ve seen,” Roark said Monday.
However, the change by the fiscal court means Trending Upward has no basis to sue, Roark said.
Two drug-treatment clinics already open in the county were grandfathered under the rule.
Roark said Trending Upward is waiting on state approval to open, but the owners have made improvements to the building and are interviewing to hire a nurse practitioner and other workers.
Smith said one objection to the Trending Upward clinic is that it’s in residential neighborhood, with a church and houses nearby, but Roark said the building isn’t within sight of any others.
Smith said the fiscal court wanted better control of Suboxone clinics because of residents’ concerns over addicts congregating in residential areas or driving to appointments while impaired.
“We were just trying to prevent this before it got worse,” Smith said. “Drug addicts from out of county and out of state polluting the roadways and causing harm to our citizens.”
The legislature should adopt uniform, statewide standards on where clinics can be, Smith said.
Roark said the Trending Upward clinic will not cause public-safety problems.
The clinic will be open only through the week during the day, with no evening or weekend hours, and patients will be required to take part in counseling in addition to Suboxone treatment, he said.
The clinic won’t dispense any narcotics — patients will have to get a prescription and fill it at a pharmacy — and won’t keep cash on site, Roark said.
He also noted the disconnect in trying to limit drug-treatment options in a county that, like many others, has a serious drug problem.
“They have a stigma attached to people who are drug addicts seeking treatment, which is ridiculous because the county is full of drug addicts, and they should want them to get off drugs,” he said.