Pubdate: Sun, 31 Dec 2000
Source: Register-Guard, The (OR)
Copyright: 2000 The Register-Guard
Contact:  PO Box 10188, Eugene, OR 97440-2188
Author: The Associated Press


MERCHANTVILLE, N.J. - Dr. Lance Gooberman has devoted his medical
practice to perfecting "rapid opiate detoxification," designed to
reduce the agony of drug withdrawal and get more addicts into
recovery. Himself a recovering addict long drug-free, Gooberman says
his practice - which unlike similar rapid detox programs doesn't
require a hospital stay - has successfully detoxified about 2,350
patients in seven years and guided them into long-term recovery programs.

But in four years, seven of his patients died within days of the
procedure. Gooberman says they had undetected heart problems or took
cocaine, triggering a heart attack.

In a civil trial beginning Wednesday, state regulators will try to
strip the medical licenses of Gooberman and his former employee, Dr.
David Bradway.

"We just want to make sure these 'cutting-edge treatments' aren't
cutting off life," says Mark Herr, director of New Jersey's Division
of Consumer Affairs, which oversees the state board regulating physicians.

Gooberman and his attorney, John Sitzler, have lined up medical
experts to testify that accepted medical standards were followed and
Gooberman's procedure was not the cause of any patient's death.

Sitzler says their patients' death rate was just 0.3 percent, lower
than for many surgical procedures, and that outpatient procedures
involving anesthesia are commonly performed in physicians' offices.

Gooberman's program, U.S. Detox Inc., uses medications to rapidly
flush the opiate drugs - heroin, morphine, methadone and prescription
painkillers - out of addicts' bodies to ease withdrawal symptoms such
as diarrhea and tremors. The patients are anesthetized during the
approximately four-hour procedure in his office.

He then implants a pellet of medicine in the abdomen that prevents
patients from "getting high" if they take opiate drugs during the
crucial first two months of recovery.

"I'm just trying to come up with a better way to do detox," Gooberman

Gooberman, 49, for years was addicted to the stimulant methamphetamine
but says he has been drug-free for 14 years after a six-week stay in a
hospital psychiatric unit triggered by a drug binge.

Rapid opiate detoxification was first performed in the late 1980s in
Europe. Gooberman and other doctors who pioneered it in this country
have appeared on television talk shows and magazine programs praising
the method. The procedure also has been depicted on TV medical dramas.

At least a dozen other U.S. physicians perform variations on rapid
detox, but in a hospital and with an overnight stay required.

Some have published articles in medical journals indicating many more
patients were drug-free after six months than with traditional
detoxification programs. And a handful of insurance plans have begun
paying for the procedure.

But even doctors who perform rapid detoxification say it severely
stresses addicts' ravaged bodies, and at least a dozen of the
thousands of American and European patients who underwent the
procedure in a hospital also died. The slower, traditional
detoxification and initiating methadone maintenance therapy have been
documented to kill some patients as well.

New Jersey's lawyers are expected to stress that Gooberman and Bradway
are the only doctors known to perform detoxification as an outpatient

The state alleges, among other things, that the doctors did not have
sufficiently trained support staff and adequate emergency equipment,
warn patients enough about the method's risks or properly instruct the
caregiver taking the patient home. The doctors deny all of that.

Former society president Dr. David Smith, a San Francisco addiction
specialist, says he regards Gooberman's program as the best in the

"There is no evidence of a cause-and-effect relationship between the
procedure and any of the deaths in question," Smith wrote.

Several patients treated by Gooberman and Bradway will testify on the
doctors' behalf.
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