Opioid Treatment Program Opens First Clinic in Milwaukee

Community Medical Services (CMS) on Milwaukee’s South Side. (Photo by Isiah Holmes/Wisconsin Examiner)

When patients struggling with opioid addiction walk into the newly opened Community Medical Services (CMS) clinic on Milwaukee’s South Side, “we want them to feel that this is a space for healing and growth,” said Amanda Maria De Leon, regional community impact manager for CMS. The clinic provides therapy and medication-assisted treatment for people working to stabilize their lives after addiction.

Medication-assisted treatment involves medications like Methadone to control opioid cravings and withdrawal symptoms. Together with therapy, medication-assisted treatment allows patients to begin to stabilize and repair their lives. Although studies have associated medication-assisted treatment with reductions in overdoses and other improved recovery outcomes, its use also carries stigma. Confronting that social disapproval, while also providing a comfortable environment for patients, is part of the mission of CMS.

Walking into the clinic, patients are met with an open waiting room and ample seating. There is a small area with toys for young children in one corner, and across the room nurses sit at a desk waiting to check in patients. Hanging over the small play area is a plaque dedicated to a young girl who spoke at one of the city zoning hearings in favor of the clinic opening. De Leon explained that the girl, who was 8 years old at the time, had befriended a local unhoused man to whom she’d given food. “She knew he needed treatment,” De Leon told the Wisconsin Examiner, saying the girl told the zoning board, “I want them to open this clinic for my friend.”

Around a corner from the lobby, behind a set of protective glass windows, nurses dispense liquid methadone into small cups for patients on a daily basis. Walls and therapy rooms throughout the facility are painted calming blues and greens, and feature art or motivational messages. Small, decorative coffee tables sit between two small couches large enough for one or two people to sit facing each other.

“We create a space like this intentionally, because we don’t want a patient to feel like it’s a transaction,” De Leon told the Examiner. She said that the facility is designed to be therapeutic both to the patients and the staff, to mitigate burnout.

Dr. Dan Lemieux, one of the medical doctors at CMS, said that he’s “used to the hustle and bustle” of a clinic. His background began in family medicine, where Lemieux was used to seeing 20-25 patients each day. Over time he also began working in Suboxone treatment programs. “I think about eight years ago I kind of pulled back on family medicine a little bit and did a little more time in addiction,” Lemieux told the Wisconsin Examiner. “I found it more gratifying, enjoyed helping people a little bit more.” Lemieux began working at methadone clinics after the COVID-19 pandemic and found his way to CMS, where he has worked for about two years.

Lemieux has worked as the medical director of CMS clinics in West Allis, Madison, Fond du Lac, and now the southside  Milwaukee clinic. Recalling the workload at West Allis, Lemieux told the the Examiner, “I think the counselors are really good at just keeping the flow going, and the front desk staff. So it never seemed overwhelming or busy, and the clients are always very appreciative.” Lemieux said he likes the highly focused sessions in recovery work, because “you can really spend your time kind of helping the client with those particular issues.”

Overdose deaths driven by the synthetic opioid fentanyl began skyrocketing in Milwaukee County around 2016, claiming hundreds of lives annually. New records for overdose deaths were set and broken every year from 2018 to 2022, when the death toll peaked at 674 lives lost. Nearly 5,800 non-fatal overdoses occurred that same year, according to the county’s overdose dashboard.

Recently, as new programs and services were established to stem the tide, overdoses began to decline. Last year there were 450 overdose deaths in Milwaukee, so far there have been fewer than half that number this year. CMS is one of the many organizations on the frontlines of the crisis, both as a treatment clinic and as a harm-reduction advocacy organization.

De Leon showcased a storage room full of boxes of hygiene kits, testing strips for both fentanyl and the tranquilizer xylazine (a more recent trend in the drug market), and Narcan (used to reverse an overdose), all of which are either used or distributed by the CMS outreach team. Sometimes staff visit homeless encampments and food pantries, other times they hold pop-up events in areas with high overdose rates. The team even organized a sober tailgate at American Family Field at a Milwaukee Brewers game and distributed over 1,200 tickets.

“We just deliver a little hope,” said De Leon. “Hopefully when you’re feeling a little better you’ll walk into a door of a treatment center. We don’t care where you walk into.” CMS also works with numerous partner organizations including the Milwaukee Overdose Response Initiative (MORI), various fire departments, the West Allis overdose response team and other nodes along an evolving network.

De Leon said the network has become bigger and more collaborative. At an open house CMS held at the new clinic, dozens of people showed up, she said, including community members, firefighters and police officers from multiple departments, probation and parole representatives and treatment providers. “I was speechless,” said De Leon. “We had over 70 people show up to our open house…That would have never happened in a methadone treatment world 20 years ago.”

“We’re breaking down silos, we’re educating people,” she added. Today, people have easier access to methadone treatment programs. In Milwaukee County, both the jail and the Community Reintegration Center (formerly known as the House of Corrections) have medication-assisted treatment programs. De Leon stressed that when people are taken to correctional facilities they should tell staff whether they need medication-assisted treatment in order to access those programs.

The West Allis Fire Department became the first to carry Buprenorphine, which is given to people after reviving them from an overdose to stop sudden withdrawal symptoms. Bipartisan legislation at the state level legalized both fentanyl and xylazine testing strips.

Nevertheless, stigma associated with both addiction and medication-assisted treatment creates barriers to progress. Although CMS has clinics in West Allis and South Milwaukee, its new clinic is the first it has been able to open in the city of Milwaukee itself. The opening marked an end to years of contentious meetings with the city’s zoning board and local residents. Now, patients living near the South Side won’t need to travel far, and the new clinic could also lighten patient loads at other clinics.

Ald. Marina Dimitrijevic, who represents the district where the new CMS clinic is located, said she supports the treatment center opening. “I strongly supported this facility opening in our community,” Dimitrijevic told the Examiner. “Providing residents with nearby access to needed health care and harm reduction tools makes us all safer and healthier. I am proud to have led by example on this issue by welcoming CMS to our community and am grateful for their work serving our residents.”

Another clinic is expected to open up on Milwaukee’s North Side in early 2026. But many people are not sold on medication-assisted treatment, fentanyl testing strips and overdose-reversing medications. In 2023, when the city of Milwaukee’s zoning board approved a clinic at 76th and Capitol Dr., reactions from the community were split. Leadership from the fire departments of Milwaukee and West Allis spoke in favor of CMS opening a clinic, stressing the dire need for relief and treatment access across Milwaukee County.

Others called treatment centers “predatory” and expressed concerns about the clinic’s for-profit business model.

At least one 2014 study, which analyzed self-reported services from disease testing to psychiatric care, found that for-profit providers “were significantly less likely than nonprofit and public programs to offer comprehensive services.” The study said that “interventions to increase the offering of comprehensive services are needed, particularly among for-profit programs.”

Other objections to the new clinic came from neighbors who argued that opening the clinic would hurt their property values and quality of life. A corporate representative and a real estate attorney from the Vin Baker Treatment Center, a facility named for a Milwaukee Bucks player that is located on N. 76th Street in Milwaukee, said that CMS would disrupt its business, jeopardizing a $3 million investment into the Vin Baker center. Ald. Lamont Westmoreland, who represents a North Side district, also opposed CMS, referring to city planning documents which recommended against opening social service businesses in the area. “I support treatment facilities, just not at this particular location,” Westmoreland said before the center opened. Though it received approval from the city, CMS has yet to open this clinic.

John Koch, national director of community and public relations at CMS, explained that CMS is a for-profit entity with private equity backing. Koch said that the private equity investment, coupled with grants, has allowed the clinic to scale up to address the overdose crisis. opening new treatment centers, providing grants to extend clinic hours and embedding staff with local fire departments and homeless outreach programs for harm reduction. CMS bills Medicaid and other patient insurance to cover patient care, “and 90% of our people are on Medicaid”, Koch told the Examiner. “We work very heavily with Medicaid. And then outside of that we receive grants to open new projects.”

The private equity backing allows for “continuous investment back into the company to address the opioid epidemic as it’s needed,” said Koch. “If we were Ma and Popping it and just growing non-profit style, it’s so much slower and we would never be able to match the need.” CMS has opened seven clinics across Wisconsin, with over 70 clinics operating nationwide. “What we’ve been able to do is be innovative with our money, and meet people where they’re at,” said Koch. “So that’s our secret sauce, is using funds to just continue to provide more access to treatment. If we did not have private equity backing, we would never have been able to be this big, or be treating 30,000 people…That’s what’s allowed us to beat the opioid epidemic.”

Koch knows firsthand how treatment access can be the feather on the scale deciding life or death. In 2013, he was living on the streets of Chicago struggling with a heroin addiction. One night, not long after completing his second adult prison sentence, Koch encountered a police officer who saw that he needed help and gave him the number to a treatment center. Koch went the next day to begin recovery, which also included medication-assisted treatment. Today Koch is raising a family and works to give people the second chance he got years ago.

Despite such success stories, there is still public skepticism about medication-assisted treatment. De Leon recalled a conversation she had after making a presentation on harm reduction at a national conference. “This guy came up to me and said, ‘You know, you really changed my thinking,’” she said. He mentioned that in some cases people on probation or parole are expected to get off methadone in order to be fully released from supervision, despite the fact that he’s seen it significantly improve people’s lives.

De Leon asked why people were being forced to get off methadone and the man replied, “Well, nobody should be on these medications for the rest of their life.” She countered that if someone is finally stable after decades of addiction then, “Why not?…Would you tell me to get off of my insulin?” The man said no. “Then why would you tell somebody to get off of lifesaving medication that has him the most stable he’s ever been?” People are free to work on tapering off if they choose, but the priority should be stabilizing and saving a life, she argued.

Dr. Lemieux said that he’s also seen medication-assisted treatment make a difference. “It’s always a tough conversation to try and change minds,” Lemieux told the Examiner. “Just the data that comes out shows that people in recovery are getting jobs, they’re reuniting with family, they’re working more, crime goes down, and it’s just a win. They’re getting their lives back, and just being a part of that is very rewarding and amazing. I just hope that more people see this, realize this, and reducing deaths is just another huge point, too.”

Opioid treatment program opens first clinic on Milwaukee’s South Side was originally published by the Wisconsin Examiner.