A new facility that offers medication-assisted treatment to people with opioid addictions has opened in south Bismarck.

Ideal Option, a Washington-based organization, has expanded into communities across the United States. Three weeks ago, the company opened up locations in Bismarck, Grand Forks and Fargo.

The Bismarck clinic opening was met with some questions from community members and Bismarck Police Chief Dan Donlin, who met with Ideal Option representatives Wednesday afternoon. Donlin said he was unsure of what the company did and requested a meeting to learn more.

Dr. Jeff Allgaier, president and CEO of Ideal Option, said the inquiries are warranted and typical in communities where the company opens a new location. Other sites include Alaska, Idaho, Maryland, Montana and Oregon.

Ideal Option offers suboxone and buprenorphine to opioid-addicted patients, in addition to connecting them with other resources, such as counselors. Unlike the Heartview Foundation in Bismarck, the location cannot dispense medications.

Allgaier said the company researched and recognized there was a need for another treatment program in Bismarck, particularly to increase access to addiction treatment drugs.

"We have researched and researched and, in many communities, that's a challenge," said Allgaier, who runs the Bismarck location along with Dr. Kenneth Egli, executive vice president and medical director of Ideal Option.

The facility is located at 549 Airport Road in Bismarck, behind the Ken's Flower Shop building, which offers privacy to patients, Allgaier said. Since opening, the facility has seen nearly 50 patients.

Geoff Godfrey, a nurse practitioner, was at the facility on Wednesday. Godfrey also runs the Everett, Wash., clinic, where staff has coordinated with law enforcement to help people addicted to opioids, who, many times, are homeless.

"We work with law enforcement often," said Godrey, who is applying for a North Dakota license and not currently practicing at the Bismarck facility.

Patients who come into Ideal Option are subject to urine analysis at each visit. Godfrey said staff members are wary of "diversion," or the selling or trading of prescribed medications, so they work closely with patients to ensure this does not happen.

"We do everything that we can to assist the patients in developing a good method of self-accountability, and, by doing that, they know they have to give (urine samples), they know that we do vitals signs (and) we often do blood alcohol testing," he said.

Patients start with visits twice a week, then graduate to once a week and finally once every two weeks, which is usually where they stay. They are only given prescriptions to last until their next visit.

Larine Zoeller, 45, of Bismarck, is a patient at Ideal Option, which she heard about from a friend. Wednesday was her second visit to the clinic.

Zoeller has been in and out of recovery her whole life. She grew up drinking  then got hooked on opioid prescription pills, including a fentanyl patch, for almost nine years. She was prescribed the medications after she had multiple back surgeries and hip and knee surgeries. After the pills, she moved on to heroin and methamphetamine.

She said she has been to treatment twice, once in 1998 and 2004. She has overdosed six times and started shooting up heroin last year.

"That's scary, because six times in two years. The first thing I thought about every time I got better was using," she said.

Zoeller said she is "grateful" to find help in Ideal Option and wants to get back in recovery and re-train herself to understand there are other ways to deal with pain. She said she believes she needs some type of medication to assist her.

"It's just extra help," she said. "Four months ago, I didn't have much hope. Opioid withdrawal and addiction, it's like a sinking black hole."

Allgaier said one goal of the facility in Bismarck is to eliminate "cash clinics," or doctors who trade addiction treatment medications for cash.

In North Dakota, Ideal Option has five providers and nurse practitioners, though the organization is recruiting local practitioners to work at the clinics. Allgier said he and the other doctor fly into the Bismarck facility often to meet with patients. They also work closely with patients, though some follow up can be done with nurse practitioners.

"We know our patients very well," he said. "Currently ... I have 14 patients in Bismarck. I can tell you just about everything about all of them, because it's really important that you know your patients."

(Reach Blair Emerson at 701-250-8251 or Blair.Emerson@bismarcktribune.com)