Killer or cure
Spike in methadone-related deaths has some seeking drug regulationBy David Hurst, dhurst@altoonamirror.com
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Cause for concern
A drug commended years ago for helping to loosen heroin's deadly grip in Pennsylvania and beyond may now be the region's No. 1 killer.
Coroners say 21 people in Blair, Cambria and Clearfield counties died of accidental methadone overdoses in 2007 - more than the statewide total in 2001.
It's an eye-opening number, particularly in Cambria County, where 12 people died of methadone overdoses last year, even compared with the state's rising toll of deaths - 114 in 2005, the most recent year for which totals are available.
And in this region, the sharply rising number of methadone deaths in recent years vaulted the drug among the top - if not the top - drug overdose killers last year.
It was No. 1 in Blair and Cambria in 2007 - representing about one-third of both counties overdose deaths, coroners' statistics show.
While Blair tallied five deaths, 23 people have died from accidental methadone overdoses in the past two years in Cambria County, compared with six in 2005 and onein 2002, Cambria Coroner Dennis Kwiatkowski says.
Clearfield tallied four after having five in 2006 and none five years ago.
"A lot of the accidental overdoses we've seen, there's been methadone involved," Kwiatkowski said. "And it's not just kids - you're looking at a list where most of these people are in their 30s, 40s and 50s."
"It's killing people at therapeutic levels," said Marti Hottenstein, vice president of Helping America Reduce Methadone Deaths, a grass-roots group battling to tighten regulations on the drug. "It's killing more than illicit drugs - drugs it's supposed to help people from."
Like in other counties, several of those found dead in Cambria County had alcohol, and in some cases, other drugs in their systems when they died. In all 12 cases last year, methadone was the main factor, Kwiatkowski said.
Bedford and Centre counties reported no methadone-related deaths in 2007, although Centre Coroner Scott Sayers said overdoses with two or more drugs in the system were classified only as "multidrug" deaths - an increasingly common finding, he said.
Methadone is a synthetic opioid used to treat addiction to heroin and powerful painkillers such as OxyContin to ease withdrawal symptoms.
Once rarely found outside a methadone clinic's walls, the drug now has become a common doctor's prescription for moderate to severe pain.
And distribution has been on the rise - not just in clinics, but at pharmacies and in doctor's offices, statistics show.
Clinics and attention
Methadone and the clinics that dispense it have become almost synonymous in this area - and for good reason, folks like Hottenstein believe. She believes many clinics are over- medicating users and should face tighter regulations.
Deserving or not, clinics have been a lightning rod for attention in this region, drawing opposition anytime an operator tries to open one.
Although supporters say there is no proof crime and problems follow the clinics, residents picked up signs and protested in Blair County, for example, when plans for a clinic near Foot of Ten Elementary School surfaced.
It has been the same in Clearfield County, where District Attorney William Shaw has been a vocal opponent of the clinics and sought legislation to regulate them further.
"The establishment of a methadone clinic in our community has created an unacceptable situation where these types of senseless deaths occur," Shaw said after Bobbi Jo Morgan's vehicular homicide arrest last year.
A jury found the Patton woman was high on the drug when she crashed her vehicle in Mahaffey, killing two people.
At the time, she was on her way home from a methadone clinic.
But while clinics often take the heat when methadone-related deaths or crimes are reported, they aren't the only place the drug is distributed.
In fact, investigators and experts say, they are just one increasingly minor player.
Not just a clinic drug
Blair, Cambria and Clearfield all had at least one methadone clinic operating within their boundaries in 2007, but more people fear it's the increased distribution of the drug that may be to blame.
Once used primarily to wean addicts off of powerful painkillers, methadone now is being used to treat pain, as well.
In part, experts say it was a reaction by doctors looking for an alternative to another powerful drug - OxyContin, which began wreaking havoc in the region earlier this decade.
Methadone has been around for years as a useful therapy for people who are opiate-dependent, but it wasn't until the past five years that a surge of users started ending up in body bags, said Dr. Westley Clark, Substance Abuse Treatment Center director for the U.S. Department of Health's SAMHSA agency, the Substance Abuse and Mental Health Services Administration.
From a doctor's perspective, there are good reasons to prescribe the drug, he said.
"Methadone is a generic drug," Clark said, adding that the price of methadone has made it a popular option. "Health plans encourage cheaper drugs, and it is an alternative."
But it is putting the drug into the hands of more people - those who may not need a drug that strong - and to help with problems it wasn't designed to treat, he said.
Kevin Price, Cambria County Drug Task Force field supervisor, didn't see the drug on the streets four or five years ago.
"A lot of the times we find methadone, we're finding quantities of it - not just one or two. We'll find empty pill bottles that should be filled and aren't," Price said.
The detective has mixed feelings about methadone clinics.
"But from what I know about them, they have strict rules and regulations on how they dispense their methadone, and I think that's the right idea to have," he said, adding that a patient typically only receives a pill or two at a time.
"Do some of those pills still make the streets? Sure, but is that where they are all coming from? Absolutely not."
SAMHSA wrote in a 2007 report on the drug that the greatest rise in methadone tablet distribution is coming from pharmacies - not clinics.
But Hottenstein points out something SAMHSA has seemed to agree with: that no one has proven that any single prescribing practice - whether it's through clinics or local doctors - should shoulder the blame for the surge in accidental overdose deaths.
"You can't rule out clinics because we don't know where most of these deaths are coming from," she said. "We still don't know."
Killer or cure?
Clark supports methadone for opiate addiction treatment, and he believes it is doing its job helping heroin addicts, curbing related overdose deaths and, in many areas, reducing trafficking.
"There was a time when use of drugs like heroin through injection was nearly 40 percent of new cases. That major heroin problem meant a major HIV problem," he said, adding that use of methadone makes injecting the drug worthless by taking away the "high."
With methadone in the mix, injection rates have dropped to 19 percent, Clark said.
There are signs methadone is making a positive difference here, too.
Cambria hasn't had a heroin-related death in several years, and while it remains a significant problem in Blair, it is no longer dubbed an "epidemic" - or spawned double digit deaths since 2005.
But Clark, too, is worried about methadone.
"Methadone," he said, "is a drug with its own unique properties."
It is effective if used properly - but potent and long-acting, he said, adding that a dose of the drug can begin to work slowly in the body and last 12 hours to several days or more.
It gives uneducated users ample time to make deadly mistakes, Clark said.
"Methadone is a somewhat complicated and dangerous drug," Philadelphia-area forensic toxicologist Matthew McMullin testified at Morgan's Clearfield County vehicular homicide case in June. "Unlike other drugs, therapeutic and lethal concentrations overlap with methadone, particularly when someone is just starting to use the drug."
With methadone more readily available than it used to be - and education about it not always following suit - it can lead to deadly consequences for those who mix alcohol or other drugs - even a day or two after the drug is taken, Clark said.
Hottenstein, of Bucks County, said her son didn't know that when he bought a few methadone pills from a friend on the street in 2006.
At the time, the young man was struggling to kick painkiller addiction - the fallout from a car crash that left him in serious pain and medication-dependent.
"I lost my son to methadone," said Hottenstein, who is now part of a Pennsylvania Senate-formed task force to study the drug. "He didn't know what he was getting himself into."
Her son wasn't alone.
It's likely many overdose victims in this region didn't know much about methadone either when they started taking the drug - in many cases, illegally, coroners said.
In Blair County, for example, only one of five who died from methadone overdoses had been a clinic patient, Coroner Patty Ross said after tallying her county's 2007 deaths.
"If used right," Kwiatkowski said, "methadone is a good drug. If it is used the way it is intended, like a lot of drugs, it has helpful qualities.
"But if you abuse it, it can kill you."
Clark: Education needed
Inside state-regulated clinics, education and counseling are part of methadone maintenance programs, Clark said.
Those added measures - combined with "lock boxes" for take-home doses - something SAMHSA recommends - all work to curb the likelihood of overdosing, as well as opportunity for thefts, he said.
But with practitioners, "there has to be a greater emphasis placed on educating them about the dangers of opiates like methadone," said Clark, who believes that, in many cases, there may be better alternatives for pain treatment.
He says SAMHSA is working on drug policy and with the federal Drug Enforcement Administration on strategies to "encourage" practitioners to learn more about methadone.
Because things could get worse, Clark said.
"We need to reach out to patients, the public and the media because we need to be aware that we have a boomer population that will be running into more pain problems associated with getting older. There's going to be that demand [for pain medication]."
His message to physicians: Know the drug.
"Know the drug and know your patient," Clark said, because it might be the best option available for those who cannot afford high-priced anesthetics.
Price agreed. Of course, anyone who uses the drug would be wise to know what they are taking.
"People think, 'Hey, pills like these come from doctors,'" so there's that perception there that this is medicine that will help you," Price said. "But when you start mixing any drugs, it can be a death sentence."
Hottenstein believes anyone who distributes the drug should have a special Drug Enforcement Agency license to do so - as is required with some other drugs. Clinics, she said, should be open seven days a week - not five or six - to avoid giving users take-home doses and opportunities to misuse the drug.
And in Pennsylvania, where a 2007 Senate resolution was passed to commission a task force to study methadone, she's hopeful the findings will yield stricter laws to regulate the drug.
To date, though, no state in the region has passed laws to regulate methadone further, she said.
Law enforcement, physicians, the community - everyone "needs to pay attention to what's happening," Price said, "because people are dying."
Mirror Staff Writer David Hurst is at 946-7457.
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kjmama
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07-17-08 11:51 PM
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METHADONE CLINICS ARE NOTHING BUT A LEGAL DRUG HOUSE FOR DOPE DEALER TO SELL THERE DOSES I LOST MY SON TO THIS DIVERSION GO TO htt://myspace****/kjpeaceout you will see my son was just a kid,had a future, and now it is lost to the diversions to this drug. When my son died I went to the clinic to stop this man,and report that there was two deaths in this mans home they still let him walk out with his doses,and three months after my son's death he was selling again too,,so to it is concern shut down all clinics are do the walk in and take your dose! No! take homes! Go to my sons memorial page there is more on my blogs
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dragonflymoon
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07-17-08 6:47 AM
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this is a killer no matter what way u look at it in the long run if u take it to long it shut downs your body even if it is taken the way it is sup.. to be for drug addict it is just a free high .they r useless after treatment ..to me if they drive while on it there is no diff..then a drunk driver they have no control over there body function ..if they r drug addicts let them be let them die on there own why should the GOV..give them a drug for free ..sorry but that is the way i feel my nephew had passed away from this drug he got his hands on from someones stupidity and there take home dose that was sup..to be in a locked box some trust the clinics have LOL.. our GOV is a joke ? they make there life what it is ...
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BlahBlahBlah
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07-16-08 1:34 AM
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It's stupid to say "I didn't choose to be an addict". Who can say they never heard that drugs were addictive before the were ever around drugs? You knew they were and you chose to shoot up anyway, because you were not strong enough to say "NO". You said "Yes"... addiction is the consequence... and you knew it. Forget clinics, how about mandatory military, 2 years min. with leave restrictions. Then you'd be doing tax payers a favor, A N D coming out clean. Everyone wins!!!
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marasmom28
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07-15-08 4:24 PM
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Woa there ferndawg, I agree with you about all of this. If you go back and read all my posts on this story you will see that. I see the last comment I made is a little misleading, the comment was directed at "ignorantpeoplesuck", not you. I am in no way an addict. I am a product of addiction, my father was an addict and alcoholic. I would never degrade myself, my family, or God by using. I think junkies are the lowest of the low.
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ferndawg44
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07-15-08 12:30 PM
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FDA and DEA monitored??? PLease!! How the heck is this drug making it to the streets so that addicts and sell it and purchase other stuff. What like bread and milk and food?? Yeah ok, They are taking this stuff and selling it so that they can buy the alternative and we all know it. 27 OD's. That sure sounds regulated to me. In fact, I don't know the statistics but I bet this number is closer to the "H" OD's of the past three years.
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ferndawg44
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07-15-08 12:27 PM
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Hey Marasmom28, Calling me names isn't going to kick your habit. If you feel better calling me ignorant than please feel free to do so. If you need some money for the next "H" run than please break into my house. One problem, If I catch you than you are going to need the ER not the Meth clinic. And that goes for all of you JUNK"O"S out there. Don't waste my time with asking for sympathy. Eat a bullet and get it over with. Your only killing yourself slowly. Get it over with man. Don't prolong this thing!!!
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RUKidding
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07-15-08 6:55 AM
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I love the comment " No one chooses to be an addict"... I'm sure the first time that the se addicts used... They didn't know that dangers of addiction... "It won't happen to me". I guess they didn't see Christmas coming either... Am I being sarchastic?
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RUKidding
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07-15-08 6:51 AM
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KMadak... I never mentioned getting rid of the "treatment centers". I just think they should be better regulated or at least their patients should be! You might know the answer to the following questions... Are these patients screened for any other drugs when the enter the treatment facility? Are they required to have someone drive them home? It seems to me that the methadone clinics are more about making a buck than anything else. Sort of like a landlord of subsidized housing... They know the gov't will pay the bill, so who cares about the damages.. Besides, they can't be held liable... at least, not yet. CONTACT YOUR REPRESENTATIVE!
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KMadak
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07-14-08 10:11 PM
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What's going to happen if you get rid of the treatment centers? You'll have no treatment centers, and still have all of those people addicted and selling. Getting rid of a place for people to get clean won't get rid of our problem. Getting rid of prisons won't end crime.
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bigboy
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07-14-08 6:40 PM
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Methadone can be effective in curtailing opiate abuse. . The client has to be sincere about staying clean.I worked as a nurse for 15 years in a methadone clinic and have seen some sucess stories.Hospital based meth clinics are regulated by DEA,FDA, the Joint Commission, the Commonwealth of Pennsyvania and the county in which it is located.Unfortunately there are some addicts t use on top of their daily methadone and this can cause deadly consequences.
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marasmom28
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07-14-08 6:15 PM
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I hear you ferndawg! As for your comments ignorant (very fitting by the way) I am a product of addiction and so is my step son that I've raised for 6 years because his junkie mother chose a needle over the love a wonderful child. So please, save your BS because I've heard all the excuses before.
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ferndawg44
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07-14-08 5:30 PM
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That's a thought, "If you want Methedone than you have to take it up the BUTT in the waiting room of the clinic where everyone can see. I'll bet that humiliation alone would get you off the crap.
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ferndawg44
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07-14-08 5:27 PM
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304mad thank you for the kind words, "there was only one "perfect" human that walked this earth" however I do have my flaws too. Hey junkie's on this blog, You are not gettin any sympathy here by us law abiding citizens. You steal from your mother to stick a needle in your arm. You rob from your neighbor so you can feel good about you again. You beg for free clinics so that you can kick a habit your mind and body can't. Here's a thought, Move to Cambria County and get your **** from them. We don't want you here "PERIOD" Liquid, pill form, or up your buttocks I don't care just get it out of Altoona please. Has it ever occured to you that perhaps you are a misfit and shouldn't be allowed into Altoona. You are a JUNKIE and nothing more. Beg all you want but there will be ZERO tolerence for Meth clinics in Altoona. Sorry about your luck.
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lambs1
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07-14-08 3:50 PM
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Also, ignoramus I would suggest you research a bit of medical information in regards to strokes, diabetics, cancers and so forth before you make another incipid comment that holds no merit to anyone with even the slightest intelligence!
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lambs1
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07-14-08 3:44 PM
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yea ignoramus, I have the pleasure of reading everyday how you pieces of crap broke into someones home or just simply rob us on the street for your fix, now you need your welfare/ goverment (us the taxpayers, we do work and pay taxes to take care of your sorry *****)to get you your next drug of choice. I have not read yet that Joe Blows house was robbed last night to get money to go to rehab and never will! Stop looking for the easy handout, get up and go to work and be accountable like the rest of us INTELLIGENT people do it. But,then again by the sound of your intelligence or lack of, you never worked a day in your life and do not plan on it!
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metrohick
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07-14-08 3:25 PM
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ignorantperson, saying that a druggie does not choose to shoot up/whatever is like saying an overweight person does not choose to put oreos into their mouth. It's not their fault....its a disease. Should our taxes start going to Weight Watchers and Jenny Craig so those who are overweight can get their Slim Fast fix? I'd gladly support that! I don't mean to trivialize drug addiction but I get sick of hearing the 'poor me I'm an addict, and it's a disease so it wasn't my fault but it's your job to pay for my treatments' malarkey. Whatever happened to personal responsibility? If you had the money to pay for the drugs, then you should have the money to finance your own recovery.
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RUKidding
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07-14-08 2:59 PM
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Then again... after reading the last two post from him/her a bit more thoroughly.. It became more clear... someone hasn't had the governemt provided fix today... You can thank the taxpayers of the USA later lowlife..
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RUKidding
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07-14-08 2:57 PM
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Apparently, Ignoramus has graduated from MIT and is the president of the Central PA of Mensa... all while winning the Ironman Triathalon... All while making Euell Gibbons look like a carnivore! Everyone else posting here is undereducated, overweight, backward, naive, or simply ignorant according to him/her
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304mad
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07-14-08 12:03 PM
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...so let's not be ignorant here, each case is different...some educated people still "choose" to "recreate" thinking they can control the drug...others do it for whatever reason....but some children do it without the knowledge of long-term effect. When my son was in your school system, he never heard about the effects of his drug...just of m...j.... We at home did our best to warn of all cigarettes, alcohol & drugs, but children have peers and that is a stronger force than some realize....so quit throwing stones...there was only one "perfect" human that walked this earth...
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304mad
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07-14-08 11:50 AM
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I'm very sorry to see such hatred among all posters...I'm not going to take sides here...I just know that if an addict wants to make a life for him or herself, it can be done. I put a son through rehab twice for ******...he learned nothing there except how to recognize his "triggers" and how others abused there drug of choice. It was only when "he" realized what a mess his life was that he moved from the area and began his life elsewhere adding help from a clinic that began a different protocol of prescibed medication. Three years later now, he is free of meds, works full time and enjoys his life...he will always be an addict-in-recovery, he does know that and he also knows he will never see Altoona again...friends, family, etc. At age 14...did he know the longtime dangers and ramifications of what a minor needle stick would create....I doubt it...he took the advice of older kids (and sellers) that it was just "a great ride"...'go ahead, try it'....so let
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ignorantpeoplesuck
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07-14-08 10:29 AM
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oh but wait mara'smom, people get cancer from Smoking Cigarettes, which they put to their own mouth, People have strokes, because they ate too much fried foods, People get diabetes also because of their diet, High Blood Pressure, Liver Disease, Cnacers, and many more diseases comes from people making bad choices. No one said that addicts didn't make the initial choice to stick that needle in their arm, but we all make mistakes especially when we are young, maybe you are old & grew up when ****** wasn't on every corner, but I'm sure you have drank before, and you're lucky that you didn't have that desire to drink more and more, addiction is a disease NOONE chooses to be an addict. We're all human, just because we are addicts, we don't deserve to be treated like a person with feelings? You have to be the cruelest scumbag on the face of this planet. Because I'm an addict I should have to listen to you talk trash about me? I will enjoy spending every last taxdollar of yours, B****
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ignorantpeoplesuck
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07-14-08 10:09 AM
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marasmom, I think you need to get over yourself. Your town will not be safe until you get the treatment facilities out??? That is the most backwards, most unintelligent statement ever written. Go ahead and get rid of all the treatment programs, then you'll see how stupid of an idea that was. When addicts are breaking in your home stealing your shit, selling drugs to your children, and costing you taxpayers double what you paying now. HA, you are so naive to think that the treatment places are bringing in crime, sorry sweetie but even in the nicest towns, as I live in a wealthy small town, there is ****** and painkillers on every street. I always laugh when morons like you, say your town will be safer, without rehabs. As far as we made the choice to stick the needle in our arm, you are just another highly uneducated person. People like you are laughable, who think addiction isn't a disease. Wait until your lil mara becomes a ****** addict, then we'll see what your take is on it.
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marasmom28
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07-14-08 9:59 AM
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common street trash. Get over yourself. YOU did this, you chose this, you caused it. Our town will not be safe again until we get all these rehab houses out, continue the fight to keep the clinics out, and push for stronger jail time of the losers.
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marasmom28
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07-14-08 9:57 AM
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I'm so sick of hearing addicts say oh it's not my fault, excuse me??? I believe you CHOSE to stick that needle in your arm, no one held you down, put a gun to your head and made you do it. It was a decision you made, so deal with it, and deal with the nasty comments and the dirty looks and the fact that no sane, moral human being wants you in their town, around their kids, or here period. You lived that life, no one just wakes up one day and starts on junk for no reason, you were already doing how many other drugs first, so yeah cry me a river. I just can't wait for the first idiot to start saying it's the same as cancer on here. Yeah in what world mororn? I didn't wake up one day and say hey ya know what I haven't tried cancer yet, lets do that! So while I'm taking my meds and doing my treatment for an actual disease, not something given the term b/c no one knew how else to milk the system besides calling it a disease, I get to have some moron say I'm the same as common street
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marasmom28
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07-14-08 9:51 AM
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Mama64, to answer you're question about what happened to Altoona, it dates back to the early 90's when the first rehab house was built along 6th ave. I'm not saying there weren't drugs in this town prior to that, only an idiot would believe that. HOWEVER the extreme problems didn't start until they started busing in the out of towners here for their "treatment". That's when the rise of drugs, crime, and even more poverty started. Beacuse the patients weren't getting treatment, they were here to set up shop, and they did. Their family and drug family moved here because you can make tons more money here selling drugs than you can in NY, NJ, Philly, etc. So thank the idiots that started building these rehab houses. Close the*****rehab houses and kick the filth out of this town and see what happens. If I'm not mistaken it was Williamsport that did the same thing and their town has done a 180, complete turn around. I get so sick of hearing the addicts say oh it's not
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