FARGO -- Late last year, Joe Moran lost seven friends in just a few weeks to drug overdoses or drug-related deaths. Prior to that time period, he lost many more.
In fact, Moran has a zippered pouch in his apartment where he keeps funeral programs for people he cherishes -- people he met in recovery. The deaths, though profoundly sad, don’t shock him anymore.
“This is reality,” Moran said, thumbing through the bulletins.
Moran, 39, knows he could easily have been one of them. A drug user since his early teens, he’s now a recovering addict after six years of medication-assisted treatment received through his physician.
Soon, another similar option will arrive here: Fargo will be the site of just the second methadone clinic in North Dakota, a step many think is a key move in combatting the area’s growing opioid problem.
Community Medical Services set up its first clinic in the state in Minot a few months ago and will open one in Fargo at 901 28th St. S. late this spring or early summer. The site is near the Southeast Human Services Center, in a non-residential neighborhood. CMS already runs four methadone clinics in Arizona, four in Montana and one in Alaska.
Mark Schaefer, regional manager of CMS, has dealt with addiction previously in work with Dakota Boys and Girls Ranch and the state Department of Human Services, and in his own family. He says medication-assisted treatment is making a difference.
“It’s changing the world, really, for this population,” Schaefer said.
The clinic will provide physician and nursing services and counseling, in addition to daily dispensing of methadone. When taken as prescribed, the drug can reduce opioid withdrawal symptoms and cravings, yet shouldn’t give the user a high.
‘We need more options’
The CMS methadone clinic in Minot has nearly 70 clients after just a few months of operation. Schaefer expects the Fargo location to draw 150 or so at first, eventually building to about 300.
It will employ a clinic manager, two counselors, a medical provider -- either through telemedicine or in person -- along with nursing and clerical staff.
First, a client is screened and sees a doctor, who assesses the depth of their addiction. Then, they see a counselor and start a plan of care. That first day, they receive a dose of methadone.
Clients return daily to receive a single dose, which they ingest with a nurse observing.
Throughout their treatment, they receive counseling, doctor visits on a regular but tapering basis and random drug tests. In order to earn the privilege of taking multiple doses home, the client needs to keep all of their appointments and have negative urine tests.
For now, the Fargo site will dispense methadone only, but CMS is testing suboxone, another medication used to wean opioid addicts off drugs, at an Arizona clinic.
The cost will be $85 per week and will include physician, nurse and counseling services, along with the methadone. It’s private-pay only, but Schaefer said they have an application in for Medicaid coverage, and he hopes someday, the treatment will be covered by most health insurance plans.
Schaefer said about 80 percent of the people who stick with it 30 to 90 days or more don’t go back to using opioids.
“People are getting back into the community, being a safer worker, or having their children back in the home,” Schaefer said.
Before the clinic can open, it needs licensing through the Substance Abuse and Mental Health Services Administration and the Drug Enforcement Administration.
Schaefer said the DEA will inspect the building to see it has property security systems, including video cameras, alarms and a secure safe to store the methadone.
Fargo Police Chief Dave Todd said he was cautious when first approached about the clinic a year and a half ago, but he and city leaders have met with the operators. Todd has also spoken with Minot Police Chief Jason Olson, who told him they haven’t had any problems on site.
Despite his early concerns, Todd said it’s another tool for people with addiction issues.
“We’ve got overdoses happening on a regular basis,” Todd said, “so we need more options and this is one of those options.”
Schaefer said the company aims to be a good neighbor wherever they set up shop. His own family, including four young children, live in Minot.
Schaefer encourages people to reach out to him if they have questions or concerns.
“I prefer to have conversations rather than have people opposed,” he said.
‘It saved my life’
Moran was treated with suboxone and credits it with allowing him to function normally, to hold a job and attend recovery meetings.
He said his last taste of illicit drugs was in 2010, and after starting suboxone, he has been clean since.
“It saved my life,” Moran said.
The Moorhead High School graduate moved to Minneapolis at age 21, became heavily entwined in methamphetamine and later turned to opioids.
“I slept in dumpsters, I ate out of garbage cans. I did whatever I had to do, mostly to use,” Moran said.
He’s been arrested on drug charges, beaten and threatened at gunpoint, all as a result of trying to support his habit.
At age 33, he finally grew tired of the chaos and tried to stop but couldn’t deal with the withdrawals.
For the last year and a half of his drug use, he said he took opioids “begrudgingly” to avoid the flu-like symptoms, sleeplessness and sensation of wanting to “rip my skin off.”
Moran was on suboxone for six years before weaning off it completely. He said he didn’t say much to others due to the stigma that you’re not “clean” if you’re on medication-assisted treatment.
Last fall, he let the cat out of the bag.
“I got such good responses from everyone, which I was really grateful for,” he said.