Pubdate: Tue, 11 Jul 2000
Source: Bangor Daily News (ME)
Copyright: 2000, Bangor Daily News Inc.
Author: not listed
Note: This commentary was signed by Bangor-area physicians Paul A. Shapiro, Jane N. Laeger, Gary Parker, David J. Koffman, Thomas L. Watt and William R. Wood.
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Methadone maintenance, by any reasonable measure, is not "effective."
Studies abound which suggest that methadone maintenance clinics have high
(anywhere from 50 percent to 90 percent over time) "dropout" rates. But
even for those who continue with methadone treatment, frequent relapse is
common. Although most studies report reductions in overall illegal opiate
use among methadone-maintenance patients, patients still routinely use
opiates and other drugs while in treatment.

One such study proclaimed: "Patients in the high-dose [methadone] group
reported using opiates no more than once a week. The moderate-dose
[methadone] group reported using drugs two to three times per week on
average." (Journal of the American Medical Association 1999). Methadone is
a highly addictive narcotic.

Those few highly motivated patients who do totally abstain from illegal
opiates and other drugs still face lifetime methadone maintenance.

The proposed methadone clinic comes at a huge cost to the greater Bangor
community. Because our opiate problem is in a fledgling stage, we have a
chance to come together and turn the tide against heroin and other opiates.
A long-term methadone maintenance program, however, will bring more opiate
addicts to Bangor.

By Acadia Hospital's own estimates, as many as 200 addicts may be seeking
methadone maintenance treatment in Bangor. Some of these addicts may have
the motivation necessary to beat their drug addictions. But at least half
of those who start treatment will drop out. And many -- if not most of
those who continue with treatment -- will periodically revert to illegal
opiates and other drugs.

With a sizable and permanent population of opiate addicts in Bangor, we can
expect to see increases in crime, HIV, hepatitis B and C and tuberculosis.
But perhaps most chilling, opiate users -- in order to get the money to
support their own habit -- will be addicting other people in order to
create a market. Unless heroin and opiate use is stoped by a zero tolerance
law enforcement effort and by education and demand reduction, it will
spread through our community like a virus.

As members of the Bangor health care community, we call on Acadia Hospital
and the Office of Substance Abuse to use their resources to prepare to
implement soon-to-be-available cutting-edge treatments, including
buprenorphine and naloxone, which are more effective than methadone and
which are less dangerous to the community that "hosts" the opiate-dependent

We also ask Acadia Hospital to table the proposed methadone clinic to allow
the greater Bangor community -- medical care providers, law enforcement
officials, educators, clergy, business people, members of the media,
parents and students -- the chance to implement prevention, education, and
alternate treatment strategies before it is too late.

This commentary was signed by the following Bangor-area physicians: Paul A.
Shapiro, Jane N. Laeger, Gary Parker, David J. Koffman, Thomas L. Watt and
William R. Wood.
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MAP posted-by: Eric Ernst