Valley's sole methadone clinic to close

WASILLA — Patients from the Valley’s lone methadone clinic may have to drive into Anchorage to maintain access to their treatment regime.

The clinic operated by Dr. John D. Zipperer’s medical group will close next week over an inability to staff the clinic adequately, at least in part because of a federal investigation, Zipperer said.

Staffing the clinic has always been a tenuous affair, Zipperer said.

“We had a really hard time finding a nurse,” he said. “It’s Alaska, and there’s not as many people available to work, especially in certain fields.”

In addition, Zipperer said he faced scrutiny from public officials and a public for whom narcotic replacement therapy is still deeply stigmatized. Methadone suppresses addictive and withdrawal symptoms without acting as an intoxicant, according to the Centers for Disease Control. The goal is to allow addicts to function in society while they gradually wean themselves off of opiates. It can take between one and three years of daily treatments with the drug for addicts to condition themselves for life without addiction. The most common criticism levied against methadone treatment is that it essentially replaces one addiction with another.

That long course of treatment means that when the clinic closes Aug. 24, some patients will have to drive to clinics in Anchorage. Zipperer says a smaller number of patients will transition to suboxone treatment at his adjacent regular clinic.

The clinic opened last year. Methadone is a Schedule II narcotic, meaning it carries a high potential for abuse. That means approval was required from two federal agencies — the Drug Enforcement Administration and the Substance Abuse and Mental Health Services Administration — as well as state authorities. Zipperer said he was required to construct and staff the clinic before it was allowed to open. The state took nine months to approve Zipperer’s application. Zipperer reduced his personnel after about five months, and likely would have closed the clinic if a pharmacist for his company hadn’t pushed to keep it open.

However, by December, additional problems began to materialize. A physician’s assistant with the clinic mysteriously quit about that time.

“That was the first personnel change that was kind of weird that I couldn’t fully explain,” he said.

Then earlier this year, several other personnel, including a doctor, also quit. Zipperer said the sudden exodus caught him by surprise. At first, he thought personal differences had sparked the change, especially when one departing employee told him she’d left because of questions from the FBI about billing practices, Zipperer said. Other employees have since told him the same thing.

“The last one that quit told me that she had been interrogated — her words, not mine — by an FBI agent in her home,” he said. “What was weird about it was I was interviewing other pharmacists, and the pharmacist I had interviewed told me the name of the agent.”

Zipperer said his attorneys have instructed him not to disclose the name of the agent. Officials with the FBI’s Anchorage office said they can’t confirm or deny a possible investigation.

Zipperer said he would have closed the clinic earlier, until his patients begged him to keep it open.

“First I decided I probably had to close it, and some of the patients got together and put a book together where they put their comments in about how this had saved their lives and this was so grateful, and it really moved me, and I got a pharmacist to commit and come up,” he said. “But it was sort of just like too little, too late.”

The closure comes as health officials say heroin deaths in Alaska have soared, mirroring a nationwide trend. In 2014, for example, EMS providers administered 490 doses of Naloxone, a drug used to treat symptoms of overdose. And heroin-related deaths have jumped 300 percent in the two-year period ending in 2013, according to figures in a July 2015 epidemiology bulletin.

Ultimately, the clinic’s closure arose from concerns that federal officials could be targeting his clinic for extra scrutiny, despite a November 2014 audit by Blue Cross, which found nothing amiss.

“With me being a small businessman, not a massive corporation, I concluded that even though I could probably scramble to get the personnel together, what I couldn’t do was deal with a more coordinated attack against me,” he said.

Contact Reporter Brian O’Connor at 352-2270, brian.oconnor@frontiersman.com, or on Twitter @reporterbriano.