Q&A on ETSU, Mountain States' addiction treatment center

Zach Vance • Updated Aug 1, 2017 at 4:08 PM

The opening of the region’s first methadone-dispensing addiction treatment clinic in Gray is rapidly approaching.

Mountain States Health Alliance officials have yet to announce an official opening date for Overmountain Recovery, but an August launch seems highly probable.

Just 15 months ago, Mountain States and East Tennessee State University leaders surprisingly announced their intent to jointly pursue the opening of the clinic, despite the region’s unfavorable history with attempts to open methadone clinics.

Strict city zoning ordinances, the high standards of the state’s Health Services and Development Agency and local officials’ contempt toward enterprises operating methadone clinics “for-profit” have all contributed to the complete absence of methadone treatment access in Northeast Tennessee.

Unlike previous efforts, Mountain States and ETSU earned a Certificate of Need from state officials and were able to have land at 203 Gray Commons Circle rezoned to accomodate the clinic, clearing the way for both institutions to get directly involved with solving the region’s opioid addiction problem.

But the idea of opioid addicts driving to their community to receive more medication didn’t sit well with many Gray locals. Roughly 2,100 signatures were collected by disconcerted citizens opposing the clinic, but despite the backlash, city leaders stuck to their decision.

As renovation work at the contentious clinic nears completion, officials from Mountain States and ETSU answered several Johnson City Press questions about how exactly its endeavor will operate:


Q: How many employees, doctors and nurses, will the clinic employ? 

A: “We anticipate 24 to 26 employees when operation is mature. The clinic will employ one full-time medical director, with the addition of advanced practice providers as the clinic grows. Additional doctors will be brought on as volume demands. We anticipate four to five nurses when the operation is mature in addition to one or two certified medical assistants. 

“The clinic will also employ a pharmacist, up to two patient access representatives, two security guards, a billing manager, a program director, and one clinical therapy supervisor, plus up to 10 to 12 therapists when operation is mature, through a services contract with Frontier Health, plus a full-time patient navigator, who will link patients to wrap-around and support services, as the program develops.”

Drug Administration

Q: What types of medications will be dispensed and what will be the frequency of those medications? Will it be off-site or on-site?

A: “The clinic will provide methadone initially, with plans to introduce Suboxone (buprenorphine) as a treatment method in year No. 2 or 3. Other medications will be considered as appropriate to offer a full array of medication assisted therapy based on standards of care.

“Dosing will take place daily for all new patients. For transfer patients who are already under a treatment plan at another facility, we will conduct an intake assessment and create treatment plan as appropriate. Dosing will take place on-site for all new patients. The clinic will follow state requirements for all transfer patients and will comply with state regulations for take-home dosing where appropriate.”

Care Policy

Q: How can someone get treatment at the clinic? Referrals?

A: “Patients can be referred by a physician or another treatment center, or they may be self-referred. The admission process takes 2.5 to 3 hours and includes a comprehensive medical history and physical examination to include appropriate lab results, addiction severity index, drug screening, prescribed medication review, clinical opioid withdrawal scale, and other elements. The medical director will review and evaluate the most appropriate treatment option, and every plan will be individualized to best meet the patient’s needs. The clinic will also offer tuberculosis, HIV and Hepatitis C testing.


Q: How will the clinic ensure its patients and the public is safe?

A: “Security will be staffed on site with traffic control during busy hours. The clinic will also utilize 24/7 security remote monitoring with several layers of security external and internal to the building.”

Q: Will a driver be required to transport patients to and from the clinic? When will patients be allowed to leave after receiving care?

A: “We will follow standard of care and best practice in the industry, and this plan will be individualized to each patient and their needs. There will be an observation period post medication dispensing that is consistent with the industry standards and best practice.”

Follow-up Treatment

Q: How are patients monitored? Regular blood testing? Counseling?

A: “Patients are monitored via observation when they present to the clinic each day. Labs are required annually, and may also be performed at any time on an as-needed basis, according to the individual’s treatment plan. The clinic will provide robust individual and group therapy on-site, which will meet and exceed industry standards and best practices.”


Q: How will the research on opioid addiction be completed?

A: “The ETSU Center for Prescription Drug Abuse Prevention and Treatment will coordinate research components for Overmountain Recovery. The research staff will develop protocols to study a variety of outcomes to monitor patient success, from short-term engagement in treatment to long-term behavioral outcomes and overall quality of life.

“Many research opportunities, such as the benefits of using medication for the treatment of opioid use disorder, may be informed by external agencies such as the National Institutes of Health; however, the guiding mission of Overmountain Recovery is to create a treatment environment that utilizes and measures strategies supported by research to reduce the burden of this disease in our community. The research staff will also pursue funding opportunities to explore new strategies for the treatment and prevention of this disease.”

Email Zach Vance at [email protected] Follow Zach Vance on Twitter at @ZachVanceJCP. Like him on Facebook at Facebook.com/ZachVanceJCP.


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