Those who are addicted to heroin and prescription pain pills often need methadone to help cut their cravings during treatment. Some need it every day, but the FOX 9 Investigators found taxpayers are picking up the tab for transit.
Until the FOX 9 Investigators started digging, even state lawmakers didn't know the true costs of transporting patients to and from the clinics that help them.
Minnesota spends more than $10 million annually to pay for methadone treatment for those who can't afford to pay for it themselves, and it covers about half of the nearly 5,000 people in treatment. What it doesn't cover are the costs to get patients to and from the clinics -- and that's something federal law requires the state to pay for too.
The FOX 9 Investigators found there was virtually no monitoring of the cost of that transportation, creating a system ripe for abuse and an accountability gap big enough to drive a taxi through.
Before day breaks in Brainerd, taxis have already begun rolling in to drop recovering addicts off at Pinnacle Recovery Services one by one. The clinic begins doling out doses of methadone at 6 a.m. six days a week.
For four months, the FOX 9 Investigators watched and noticed cab after cab kept coming from the Duluth area roughly 115 miles way despite the fact that Duluth has its own methadone clinic.
One methadone patient described the process as "outrageous," and said the state pays as much as $500 a day for those fares.
In fact, all over the state, patients receiving medical assistance from the government take taxis or medical transportation to get to methadone treatment -- often driving past clinics that are closer to their homes. Even drivers who profit from the system say they are disgusted.
Stacy Arego takes a cab from Oak Park Heights to Valhalla Place in Woodbury, which is the closest clinic to her home -- and she said she sees about 100 cabs or more coming and going each day.
"Methadone saved my life," Arego told FOX 9.
Arego explained that she had been addicted to prescription painkillers, and that her husband died of an overdose on the drugs. While she has earned the right to bring enough methadone home with her that she only needs to go to the clinic every two weeks, she sees others coming every day.
Arego said she knows some of the patients who come from as far as Hinckley or Rochester although there is a clinic in Rochester too. One patient who travels to Woodbury from Minneapolis by cab admitted he doesn't have a clue how much the trip costs.
It turns out no one had a clue how much those transit tabs totaled until now.
"Wow, you have done your work on this," remarked Sen. Julie Rosen, whom her colleagues at the Capitol call "Senator Methadone."
Although Rosen is the driving force behind tightening methadone laws, she could only wonder how much those cab rides were costing the state because the Minnesota Department of Human Services had not been monitoring the sums.
In part, that's because the companies administering Medicaid for the state don't keep track of what kind of appointments patients travel to by cab, be it an eye clinic or one providing methadone.
The FOX 9 Investigators suggested the state could tally taxi fares for patients at methadone clinics and narrowed the request to Pinnacle Recovery Services in Brainerd. Between February 2012 and March 2013, the state spent $2,554,000 on transporting patients to that clinic alone.
"That is incredible," Rosen said. "It doesn't make sense."
The state now plans to investigate some of those charges to see whether they are accurate, legitimate and what can be done to cut the costs.
One of the reasons some patients have to travel so much is the fact that there aren't many methadone clinics in Minnesota -- but one patent told FOX 9 there is a reason for the pipeline between Duluth and Brainerd.
"They're not accepting people," he said.
It is true that the Lake Superior Treatment Center in Duluth can't take any new patients because they have gotten in trouble with the state for serving too many and not supervising them well enough. Yet, if there are many patients traveling from one area, couldn't they ride together?
Drivers explained that the answer is no due to patient confidentiality; however, time and time again, the FOX 9 Investigators saw patients mingling and interacting with one another while they waited for their cabs to arrive.
The state told FOX 9 it would work with patients and providers on carpooling, and patients who are doing well can work their way up to taking out medications in a locked box instead of making daily trips.
"I am hoping, towards the end of the month, that I will get to break this coming here every day stuff," one patient told the FOX 9 Investigators.
Yet, when that system is abused, it can take good lives and crush them. Vanessa Brigan had taken one dose of methadone at the Brainerd clinic and headed back to her home in Cloquet -- which is much closer to the Duluth clinic on a sunny autumn day when police say she shot up part of her take-out dose. The criminal complaint against her states she then hit a highway department truck, killing workers Mitch Lingren and Zach Gamache.
That's just one of the tragedies stemming from take-home treatment. Between 200 and 2010, there were 364 accidental methadone overdose deaths in Minnesota -- and it's important to note that it's not always the patient with the prescription who died.
One patient confirmed being approached in the parking lot by people who want to buy her medicine. She never sells, but a different patient who makes three trips a week for prescription pickups in a state-paid cab admitted to selling the medicine for $40 a dose.
Over the weekend, state lawmakers voted to tighten general methadone regulations, but they didn't touch transportation. After speaking with the FOX 9 Investigators, Sen. Julie Rosen said lawmakers would tackle that issue next year.