Community Medical Services

Community Medical Services is now open for business in Wasilla to treat opioid-dependent individuals with medication and counseling. From left to right: Managing Clinician Mary Kenshalo, Receptionist Andrea Blackburn, Dr. David Brauner and CEO Nick Stavros.

CAITLIN SKVORC/Frontiersman.com

WASILLA — Local residents will be the first to try out the new medication-assisted treatment program in the Mat-Su Valley.

Following the Alaska Wellness Summit regarding opioid abuse on Thursday, Community Medical Services CEO Nick Stavros stuck around town to open the company’s first Alaska clinic in Wasilla — his contribution to stemming the tide of opioid-related deaths in the Southcentral part of the state.

The Wasilla clinic — like the nine other locations in Montana, North Dakota and Arizona (where the company is based) — will offer opioid treatment in the form of methadone, Suboxone (buprenorphine and naloxone) and Vivitrol (naltrexone) to adults who are or have been physically dependent on opiate medications and/or heroin. Psychosocial counseling will also provided onsite as needed.

“We are way more than just a methadone program,” Stavros said. “We see ourselves as advocates trying to change the world.”

Community Medical Services is a family owned and operated business inspired to action by the fatal heroin overdose of Stavros’ sister. Though the company started in 1983, long before Stavros came on in 2012, it now has Stavros at the helm, his surviving sister as operations manager and his brother-in-law as chief business officer. His brother, similarly, is the medical director for another opioid treatment program.

“I think we were all pretty affected by our sister’s death and a lot of the misinformation that was out there that contributed to her not getting better,” Stavros said.

Stavros said he’s excited about becoming a part of the “treatment village” in Alaska, but that “there’s a lot of community education that needs to take place” for the clinic to be successful.

“There’s a lot of misconceptions about medication being diverted, meaning a patient takes it and turns around and sells it on the street,” he said during a tour of the facility on Friday. “That does not happen in a methadone clinic typically.”

After a patient signs in with a digital scan of their fingerprint at the front desk, he or she would go to a window around the corner to receive a liquid dose of methadone or dissolvable Suboxone tablet from the nurse on staff, consume the medicine in front of the nurse, and wash it down with a cup of water provided by the nurse. Once the nurse has determined the medication has been ingested, the patient is free to go. (Vivitrol is administered by injection onsite, and therefore has no way of being diverted.)

Stavros said that methadone and Suboxone patients are required to visit the clinic daily for the first 90 days of treatment. If the patient has been completely compliant for 90 days — meaning they’ve shown up to take their medication, made all their counseling appointments and tested negative for illicit drugs in all urine analyses — he or she can drop down to five visits per week. After another month the requirement is four days a week, and after another month — five total — three days a week. After two years in compliance, patients are permitted to take home a 28-day supply of medication.

According to the California Society of Addiction Medicine, methadone maintenance success rates range from 60 to 90 percent, and the longer a patient undergoes such treatment, the greater the chances of achieving stable, long-term abstinence.

However, many patients must continue medication-assisted treatment for the duration of their lives — much like a diabetic requires insulin, Stavros said. Like the pancreas of a diabetic needs insulin to convert glucose to energy, an opioid-riddled brain requires a drug like methadone to produce endorphins that reduce the perception of pain caused by withdrawals.

“You can’t compare them physiologically, but the outcome is the same,” Stavros said.

He added that it’s not often said that a diabetic is “hooked” on insulin, though opponents of methadone claim people in treatment are still “addicted” to opioids; rather, Stavros said, the patient is “dependent” on the drug to stabilize their brain and bodily functions for everyday activities.

“A patient could come into a methadone clinic, get started on their methadone … and go back to work that day without withdrawals and cravings,” he said.

Because of this, Stavros said, a medication-assisted treatment clinic is preferable to a detox facility, which doesn’t treat the disease of addiction.

“Detox is not treatment. ... So why even waste taxpayer monies on trying to detox opioid-dependent individuals when it’s not effective?” he said.

According to the National Institute on Drug Abuse’s third edition of “Principles of Drug Addiction Treatment: A Research-Based Guide,” “detoxification alone is rarely sufficient to help addicted individuals achieve long-term abstinence.”

A 2001 University of California study titled, “A 33-Year Follow-up of Narcotics Addicts,” also noted that five years of abstinence from heroin use “considerably reduced the likelihood of future relapse,” but a quarter of the surviving addicts surveyed still relapsed even after 15 years of abstinence.

The bottom line, Stavros said, is to help as many people as possible by working with other health care providers in the community and determining what works for the individual.

“We all need to be working on this together to find the best treatment options for patients,” he said.

Community Medical Services is located at 2521 Mountain Village Dr. next to Lowe’s in Wasilla. The clinic can be reached by phone at 907-290-3760, though some callers have reported problems connecting, and the issue is being addressed.

Contact reporter Caitlin Skvorc at 352-2266 or caitlin.skvorc@frontiersman.com.

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