No one disputed the critical need for addiction treatment in Smyth County, and multiple people passionately encouraged the Marion Town Council to approve the permit necessary for a SaVida Health Center to open in its selected location. However, others were adamant in their requests that the council deny the permit.
At the end of a joint public hearing of the council and its planning commission, no decision was made Monday evening. The council sent SaVida’s request for a special use permit back to the commission for a review of possible conditions that could be placed on the permit if it’s awarded.
SaVida Health, a for-profit addiction treatment company with offices in seven states, is seeking the permit to open a center at 219 East Lee St. in Marion.
Using Drugs to Treat Addiction
SaVida officials emphasized before the commission last week and at the joint meeting Monday that the clinic would not dispense methadone and that no drugs would be stored on site. Only the injectable Sublocade, a 30-day extended-release drug used to manage opioid withdrawal and cravings, would be given at the center. However, the tamper-resistant injectable would be delivered to the clinic daily based on scheduled appointments and would be kept in a locked refrigerator. Any remaining at the day’s end would be destroyed, company officials said.
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Gina Spence-Brown, a Family Nurse Practitioner with SaVida, estimated that about 5% of clients get Sublocade. She emphasized that the drug is not mood altering and takes about two weeks to get into a person’s system.
While providers can and do write prescriptions for suboxone, a drug to treat opioid addiction that can be misused, Spence-Brown said there was no way she would write a prescription for someone she believed would sell the drug. She explained that SaVida clients are tested every time they come to the clinic to assess the level of suboxone in their system as well as for other drugs. If a person doesn’t have the correct level of suboxone in their system, she said, they won’t get another prescription.
SaVida staff, Spence-Brown said, do all they can to prevent medication from going on the street. “I would never want that to happen,” she said.
When audience members questioned if using suboxone to ease cravings and manage withdrawal is just replacing one drug with another, Spence-Brown said that research proves otherwise. She also noted that she remembers when psychiatric drugs were regarded with the same suspicion. “We’ve come a long way in what we know,” she said.
Spence-Brown encouraged people to open their minds and research the use of suboxone.
Why Marion
Bert Mosley, a SaVida vice president, told the council, commission, and a capacity crowd, that transportation is often a barrier to treatment. He said SaVida is working to serve people in their communities and help them return to being contributing citizens.
SaVida, he said, is already treating Smyth residents at its Abingdon and Wytheville centers and would like to help them closer to home, where they’re more likely to continue receiving care.
Looking at the gathered crowd, Mosely said, “The opioid crisis is still raging,” adding that the odds were about zero that there was someone in the room not impacted by the epidemic.
Medical Arguments
Jason Pritchard, a former Chilhowie resident who now lives in Bristol, also spoke on behalf of SaVida.
On March 20, Pritchard marked his 12th anniversary of sobriety.
He addressed SaVida’s ability to address separate but related health crises such as Hepatitis C, a viral liver infection, and the risk of Neonatal Abstinence Syndrome for babies born to pregnant women who are using drugs as well as other medical issues such as high blood pressure and diabetes.
Based on Virginia Department of Health data, Pritchard reported that Smyth County’s rate of Hepatitis C cases is double to triple the state rate, especially among individuals 18 to 30 years old. In that category, the rate is 94 to 210.7 cases per 100,000 residents. The state rate is 81.3.
“Hepatitis C is a problem in Smyth County,” he observed.
For NAS, Pritchard said, Smyth County has one of the highest rates in Virginia at 30.7 to 90.9 per 1,000 birth hospitalizations. The state rate is 4.8.
With a medical professional offering care at every client visit, Pritchard said, SaVida can treat Hepatitis C and offer prenatal care and general family care.
Another Family Nurse Practitioner with SaVida Health noted that patients often won’t see a traditional family doctor because of their fear of being treated differently because of addiction.
With clients seeing a counselor one-on-one and a medical provider at every appointment, Pritchard said SaVida sees success.
Saying that the greatest risk of failure comes in the first 90 days, he said, after 60 days, 75% of SaVida clients are opioid free. At 90 days, 91% test as opioid free.
Mosley acknowledged that the treatment isn’t always successful, but he pointed out that neither is cancer treatment.
Personal Stories
James Parks told officials and citizens about trying to get help for his niece at Easter when she went into convulsions while detoxing.
She’d been taking multiple fentanyl pills a day when police arrested her dealer, Parks said. A narcotic, fentanyl is highly addictive and can cause respiratory failure and death.
Parks described taking her to Smyth County Community Hospital, where she was referred to treatment in Kingsport. When they got there, he said the Kingsport facility said they had no record of a referral for her. When Parks took her back to SCCH, he said he was told she couldn’t be admitted because she’d been released into the treatment facility’s care.
“There was no where to take her,” he said. Parks described crying as he watched her vomit and be violently ill.
“Just try to get someone help,” he challenged. “We need something.”
Dawn Stafford implored officials and citizens that when they call those who are addicted “those people,” “you’re talking about my baby.”
When he was 19, Stafford said her son called her, telling her he was scared and had done something bad. He had tried one pill at a party and then couldn’t stop taking the drug.
Stafford said she tried to get him help, taking him first to a family doctor, who said there was nothing she could then prescribe to help.
“I needed someone to help my son,” she said.
Stafford described the night terrors and physical suffering that came with detoxing. If she hadn’t stayed with him, she believes her son could be dead.
“If there was somebody else who could have helped…”
All I know is this community better do something, Stafford said. She declared, “These people could have helped him.”
Stafford again urged people to stop saying, “Those people.” Instead, she said, say, “That’s Dawn’s son.”
She told of another boy who had overdosed and was at Smyth County Community Hospital. He refused to go to Northern Virginia for treatment and has disappeared. His parents, she said, don’t know where he is. “Maybe if there had been a door… I don’t care where it is,” Stafford said.
The Location
Other people who spoke before the council and commission did care about the where the clinic would locate, and multiple individuals opposed the Lee Street location, including a number of nearby business owners. Among them was Derek Trail of the neighboring auto body shop Turkey Pen, who said having the treatment center so close was a concern. He encouraged the council to focus on inpatient care options.
A spokesperson for Home & Auto Tire Center, also on Lee Street, described already seeing an increasing amount of foot traffic and a growing number of problems. “I feel like we’re getting ready to pour gasoline on the fire,” he said.
Crystal Farley told of having addicted individuals knocking on her door. “It’s scary,” she said and told of a neighbor who found someone sitting on their couch.
Farley expressed fears about the medication being sold on the street. She described the proposed center as not a fix but a Band-Aid. She urged officials to think outside of the box and bring in something preventative.
When asked his position, Marion Police Chief John Clair expressed concern that the center would create a focal point. However, he also said that he found much of what the SaVida representatives said to be compelling. The chief acknowledged a “runaway need for service.”
Nathan Berg, the property owner of the proposed SaVida site, told the group that he wasn’t thrilled when he was first approached by SaVida. However, he did research and found that he lives and is raising his children near the SaVida center in Abingdon and that its office shares a parking lot with his attorney and his physical therapist. The center is so low profile, Berg said, he would never have noticed it.
In working with the company, he said, “I’ve been blown away by their professionalism and compassion.”
Berg told the council, “Not all treatment clinics are created equal.” For emphasis, he repeated the statement.
Other Locations
The Abingdon SaVida Center is on Main Street and shares an office building with a variety of other businesses. It is across the street from the Abingdon Police Department.
Multiple times, Mosley reiterated that the centers do not allow loitering on its property.
In Wytheville, the SaVida Center also has an office in a professional building that is occupied by hair stylists, lawyers, and other service providers. That building is across the street from the county office building complex, the sheriff’s office and courthouse.
Since that center opened, Wytheville Police Lt. Bryan Bard said, “We have only had one call regarding SaVida.”
That call came on May 18, 2021, when the center first opened and someone reported “a suspicious person knocking on a door next door. It was a client going in for an appointment and went to the wrong office door,” Bard said.
The Abingdon Police Department had not answered a request for similar information by press time.
Just last week, SaVida Health opened an office in Bristol.
SaVida began providing addiction treatment in 2010 and now has 50 locations. The first Southwest Virginia clinic opened in 2019 in Abingdon. Now 15 clinics are located from Lynchburg to Pennington Gap, including sites in Tazewell, Lebanon, Blacksburg, and Roanoke.
A package of materials sent from SaVida to Marion officials included seven letters of support from a variety of individuals at multiple agencies and organizations, including Bland Correctional Center, Southwest Virginia Legal Aid Society, the Health Wagon, Clinch Valley Community Action, Family Crisis Support Services, the Buchanan County Department of Social Services, and Martinsville Adult Probation and Parole.
Mosley told officials that the Marion center has been licensed by the Commonwealth’s Department of Medical Assistance Services, which would oversee its operations.
Initially, SaVida officials said the center would be open three days a week, but as client numbers grow it could expand to five days a week – all 9 a.m. to 5 p.m. The clinic would accept Medicaid, Medicare, and commercial insurances and has a sliding fee scale for those without coverage.
Official Action
During Monday’s hearing, the planning commission referred the permit request to the town council with no recommendation of approval or denial.
The Lee Street site is zoned for commercial/general use, but a special use permit is required for a treatment facility.
As the town council discussed the permit, they and staff talked about conditions they could place on the permit such as how loitering on neighboring properties might be controlled, managing walk-up clients, potentially restricting the clinic to only seeing Smyth County residents, and other matters.
In the end, the council unanimously voted to send the permit request back to the commission for consideration of conditions.