By Ella Nilsen
Addison Southwick had come off his overnight newspaper delivery shift in the early morning of April 12, 2008.
He and a friend drove to the Keene Metro Treatment Center in Swanzey to get their doses of methadone, like they did every day.
Southwick, of Swanzey, visited a few friends that morning. He was driving on North Lincoln Street at about noon when his car drifted out of its lane, hitting jogger Jenna A. Lydon.
At the crash scene, Lydon lay on the side of the road while Keene EMTs treated her, according to police records. Her face and body were bloody and her left leg badly broken.
Southwick cried as he was questioned by Keene police, and kept glancing over to Lydon, the accident report said. He told police over and over he had not seen anyone on the road, according to records. He also said he had been taking methadone for his heroin addiction, and that it had been making him drowsy.
In a recent interview, Southwick, now 26, said he still doesn’t remember the moment his car struck Lydon.
“… The next thing I know, I was waking up behind the wheel and realized I hit something,” he said.
Court records show Southwick was a client at Keene Metro for eight months, from July 2007 until the crash.
By April 2008, he remembers, his methadone dose had been raised to 155 milligrams; police records corroborate that.
April 12 wasn’t the first time he had nodded off behind the wheel, Southwick said in a recent interview. A former paper deliveryman for The Sentinel, he said he often found himself falling asleep while driving.
It happened so regularly, Southwick said, he used to have a friend ride along in the passenger seat while he delivered papers, to wake him up if he started dozing.
A costly dose
Southwick said staff at Keene Metro raised his methadone dose frequently — “pretty much when I asked for it, that I can remember.”
He said he knew other clients on doses as high as 260 milligrams. Officials from Keene Metro and its parent company, Colonial Management, did not return calls or emails for comment.
In New Hampshire, state government has little oversight over for-profit clinics like Keene Metro, and state investigators rarely inspect the clinics.
Joining Keene Metro was Southwick’s first serious attempt to get clean from heroin, a drug he started using at age 14.
When Southwick decided he wanted to get treatment, “I just went in and told them I had a heroin addiction, filled out some paperwork, talked to a counselor and they starting dosing me,” Southwick said. “And then I saw the doctor … I don’t know, probably within a few days.”
Methadone doses at the clinic cost $15 per day at the time, according to Southwick. Compared to an expensive heroin habit, it seemed like a good deal.
“…You’re doing heroin, spending a couple hundred dollars a day, if not more,” he said. “Methadone, go spend $15 and be able to function all day, it seemed like a pretty good idea.”
The dose cost at Keene Metro has since gone up to $17 per day, according to a current client.
The doctor Southwick saw was Dennis L. Swartout, the medical director at Keene Metro at the time.
Swartout, a former family doctor in Keene, had struggled with addiction problems of his own for years. He no longer lives in the area and declined to comment for this story.
He first became addicted to a prescription painkiller called Stadol in 1994, he told Lydon’s lawyers in sworn testimony. Swartout started taking the drug for migraine headaches, according to records from the N.H. Board of Medicine.
At the same time, Swartout was illegally prescribing another doctor thousands of hydrocodone pills, board records show.
In 1998, the board briefly suspended his license after finding he was taking excessive amounts of a prescription painkiller for three years “without a legitimate medical purpose,” according to their records.
In 2005, Swartout and his wife, Samantha Shad, opened an urgent care center and laser clinic in The Center at Keene, where Swartout also dispensed the addiction treatment drug Suboxone, he said.
Suboxone is an FDA-approved prescription drug used to block the effects of other opioids. It contains naloxone, the same drug first responders use to revive those who have overdosed. The naloxone ingredient in Suboxone counteracts opioids and keeps users from getting high.
Around this time, Swartout also worked as the medical director at the Keene Metro Treatment Center. He started at Keene Metro in 2007 and left in fall of 2008, after Southwick’s accident.
In sworn testimony, Swartout told Lydon’s lawyers he left Keene Metro after a drug relapse with Stadol.
He surrendered his medical license to the N.H. Medical Board in 2009, following a board investigation into alleged misconduct.
The Board of Medicine investigated Swartout’s Stadol use in 2009; it also investigated allegations he had inaccurately documented a patient’s medical records, according to board documents.
Board officials said they could not comment on whether Swartout’s loss of license in 2009 had to do with his tenure at Keene Metro.
The Board of Medicine also reprimanded Swartout in 2006, accusing him of failing to keep adequate medical records for a Keene State College student who fell ill under his care. Swartout was fined for this incident.
A limited memory
As Jenna Lydon’s lawyers started to build their civil case against Keene Metro and Colonial Management Group, which owns the clinic, they interviewed Swartout.
“It was clear he didn’t know anything about their (Colonial Management Group’s) policies and procedures,” said lawyer Kevin Dugan, of Manchester-based firm Abramson, Brown and Dugan.
In sworn testimony, Swartout told Dugan he worked at the Keene Metro Treatment Center about four hours per week, and said he was never trained on clinic or company protocol. Swartout also testified he did not know New Hampshire had rules and regulations pertaining to methadone clinics.
Swartout’s testimony included telling Dugan he was not aware he was supposed to review clients’ urine screens for other drugs, and also said he knew some patients were continuing to use other drugs while driving back and forth to get their methadone doses.
Swartout also told lawyers he was not certified in addiction medicine while he was the clinic’s medical director. Furthermore, he said, the clinical training he was supposed to get from Colonial Management Group’s corporate medical director never happened.
Swartout said he “had no real contact” with the corporate medical director and didn’t know he was under the man’s supervision.
And Swartout testified that he told the Colonial official who hired him about his own struggle with addiction.
“... My recollection is she said that that gave me a better perspective in terms of treating people with substance abuse problems,” Swartout said.
He also told lawyers he couldn’t recall if any patients at Keene Metro were tapered off of methadone if they consistently tested positive for other drugs. But patients were put off the drug if they couldn’t pay for their doses, he said.
Addison Southwick said he was at the Keene Metro Treatment Center because he wanted to get clean from heroin; he said he was not trying to get high from methadone.
However, he continued to smoke marijuana, which he said he’d had no intention of quitting. In fact, Southwick said he had been up-front with his counselor about his drug use from the start.
“I know a few times he talked to me about smoking weed, ‘cause I told him when I started that I wasn’t ever going to stop smoking weed,” he said.
He said he met with his counselor “10 times, maybe,” during his eight months at the clinic, but said he is not positive on the number. He described those sessions as a “a few minutes” long.
Southwick said he mentioned to the staff at Keene Metro he was nodding off when he drove, but his dose was not lowered in response.
He now says he accepts responsibility for his actions the morning of the crash.
“I have a lot of regrets, just because of the accident,” he said. “That’s destroyed my life.”
But he also said he thinks his course of treatment at Keene Metro is why he fell asleep at the wheel.
“I know it’s my choice and me that did it. I just … wish I never started the methadone clinic.”
Southwick said he didn’t want to live his life dependent on a drug; he also dreaded the eventual withdrawals from methadone, which he said were worse than ones he experienced from heroin. He did eventually withdraw from methadone and said he has been working to stay clean.
He has harsh words for his former treatment center, calling them “legal drug dealers.”
“That place is a joke,” he said. “You’re better off trying to quit heroin than you are trying to quit methadone.”
A life on hold
At the time of the crash, Jenna Lydon was about to finish graduate school and start a new chapter. She was just a few weeks away from her graduation at Antioch University New England and about to sign a teaching contract at a Vermont school.
Instead, she found herself navigating a very different life: one full of hospital visits, surgeries and painful physical therapy.
Rehab “was torture,” she remembers, as doctors tried to get her shattered left leg to bend and straighten. It took months to get her range of motion back.
She had to practice walking for many more months; taking 10 steps in a day was a huge accomplishment.
In the years following her injury and recovery, Lydon still walks with a limp but has made a major comeback. She’s now a 5th-grade teacher in New Boston, completed a triathlon this summer and is signing up for more races.
But physical activity takes a noticeable toll on her body. One of the biggest challenges is getting her left knee working normally. It’s tough “physically not being able to do what I wanted to do and having to push myself,” she said.
She can’t play soccer, a sport she loves, for fear of the ball hitting her face, still fragile years after hitting the windshield of Southwick’s car. However, she runs, bikes and swims regularly.
Still, Lydon will never fully recover from her injuries. Her back and legs are still scarred from the fence — deep scarring that can still open up and bleed if she moves the wrong way. Lydon is considering scar revision surgery in the future.
“It looks almost like a bear pawed my back,” she said.
Lydon says she isn’t angry with Southwick for the accident.
She says she knows he started using drugs at a young age. “I hope that having a severe accident like this would make (him) change.”
Lydon said while she understands methadone clinics serve a need, she hopes crashes like hers will spur state officials to take a harder look at the clinics.
For Lydon, the scariest thing is the randomness of the accident; the fact it could happen to anyone.
“I was just out for a run,” she said. “I was off the road. Just knowing in an instant that your life could be taken … it’s a little scary. It makes you realize how fast things can change.”