Pubdate: Thu, 02 Nov 2000
Source: Bangor Daily News (ME)
Copyright: 2000, Bangor Daily News Inc.
Author: Jeff Tuttle
Note: The Associated Press contributed to this report.
Bookmark: Methadone items:


BANGOR -- The state's top federal prosecutor on Wednesday urged a special 
panel studying opiate addiction in the region to back a two-year moratorium 
on a methadone clinic slated for the city.

U.S. Attorney Jay McCloskey said that given the likely approval of a 
less-addictive alternative drug, and what he called the region's 
"relatively recent" heroin problem, a moratorium was appropriate.

"Methadone may still have a place for some people," said McCloskey, adding 
that those hard-core addicts could still travel to the Winslow clinic. "But 
based on the newness of the problem and the upcoming availability of 
buprenorphine, are we going to open a clinic here, with all the problems 
that come with it, for a dozen people?"

Acadia Hospital, a division of Eastern Maine Healthcare, in February 
applied at the request of the state Office of Substance Abuse, to open the 
methadone clinic in the city.

But while McCloskey, citing state figures, suggested the region's opiate 
problem is a recent one, figures provided by Acadia suggest just the opposite.

According to Acadia officials, patients currently seeking opiate addiction 
treatment at the hospital have been using for an average of six years, 
making the more powerful methadone a better alternative for some. In the 
last six months, 109 patients were admitted for opiate treatment.

On Wednesday, state officials praised McCloskey for his work to educate 
area students and parents on the dangers of drug addiction, but took issue 
with the idea of a two-year moratorium.

"From our perspective, we've already provided a one-year moratorium," said 
Katie Fullam Harris, deputy commissioner of the Maine Department of Mental 
Health, Mental Retardation and Substance Abuse Services, referring to the 
state's decision to postpone the clinic until the committee finishes its 
report in December. "The problem is only increasing and unless we start 
providing appropriate treatment for people in the near future, it's only 
going to get worse."

McCloskey's comments come on the heels of the first direct comparison of 
the three leading treatments for opiate addiction -- methadone, 
buprenorphine and Orlaam.

Previous studies have shown all three medications to be effective in 
treating heroin addiction. This study looked at them together for the first 
time. The findings were published in Thursday's New England Journal of 

The two newer drugs could improve treatment of heroin addiction by giving 
doctors more options, said researcher Rolley E. Johnson of Johns Hopkins 
University School of Medicine, who led the study.

"There are some patients who perhaps have tried methadone and didn't think 
it was the thing that could help them. They may benefit from [Orlaam] or 
they may benefit from buprenorphine. Maybe we can get those people back 
into treatment," said Johnson, who has worked as a consultant for makers of 
all three medications.

Methadone, a synthetic narcotic, has been used for more than 30 years to 
treat heroin addiction. It suppresses withdrawal symptoms and curbs the 
craving for heroin.

Unlike methadone, which has to be taken daily, the two other drugs are 
longer acting and can be taken only three times a week.

Buprenorphine has yet to gain Food and Drug Administration approval. 
However, recent federal legislation will allow doctors in office-based 
practices to prescribe buprenorphine once it is approved. The more tightly 
controlled methadone and Orlaam are now dispensed through heavily regulated 
clinics only.

To test the three medications, researchers at Johns Hopkins recruited 220 
heroin addicts and treated them for 17 weeks in 1996-97. The patients were 
given one of the three medications -- Orlaam or buprenorphine three times a 
week, or a high dose of methadone daily. A fourth, control group was 
treated with a low dose of methadone each day.

Researchers tracked the patients' continued use of heroin, and the 
participants graded the severity of their drug problem.

High-dose methadone and the two newer medications were all effective in 
treating heroin addiction, and all worked significantly better than 
low-dose methadone. Patients in all four groups reported a 90 percent drop 
in heroin use when they began treatment.

At the Wednesday meeting, McCloskey also said the clinic would likely draw 
addicts to the area, making it more difficult to drive out the problem if 
there were no moratorium.

At a previous meeting, state officials said the addict population around 
the South Portland clinic had not changed since its opening five years ago 
- -- suggesting that addicts do not move closer to a clinic to seek treatment.
- ---
MAP posted-by: Richard Lake