Pubdate: Tue, 23 Apr 2002
Source: Portland Press Herald (ME)
Copyright: 2002 Blethen Maine Newspapers Inc.
Author: Mark Shanahan
Bookmark: (Methadone)
Bookmark: (Heroin)
Bookmark: (Treatment)


State officials are confident that methadone is being prescribed properly 
in southern Maine, but they have concerns about other drugs being used to 
treat opiate addiction.

Lynn Dube, commissioner of the state Department of Behavioral and 
Developmental Services, said Monday that the presence of methadone at 
several recent overdose deaths does not mean that clinics in South Portland 
and Westbrook are dispensing the drug casually.

But Dube said her office is looking into reports that a highly addictive 
class of drugs called benzodiazepines also is being administered to treat 
heroin addiction.

"I think it does make sense to look at that issue," Dube said.

Ten overdose deaths in Portland since January are grim confirmation that 
the use of heroin and other opiates is on the increase in southern Maine. 
That has increased business for two local clinics that dispense methadone, 
which is still considered the most effective treatment for heroin addiction.

Discovery House in South Portland and CAP Quality Care in Westbrook have 
seen a spike in the number of heroin addicts seeking treatment. Discovery 
House, in business on Western Avenue in South Portland since 1994, is 
serving about 425 people. CAP Quality Care, which opened last October on 
Delta Drive in Westbrook, is seeing 480 people.

But police and drug enforcement agents are concerned that methadone, like 
heroin and the other drugs for which it's a treatment, is becoming a 
commodity on the street. They say some patients who are allowed to take 
home a week's worth of methadone, or more, are selling it, which may 
explain why methadone has been found at several recent overdoses.

Of greater concern to Portland public health officials and local doctors is 
CAP Quality Care's practice of prescribing benzodiazepines in conjunction 
with methadone.

Benzos, as they are called, are psychiatric medications that are helpful in 
treating opiate addiction in some people, but abrupt withdrawal from the 
drugs can be deadly.

Dube said she is comfortable with how Discovery House and CAP Quality Care 
are dispensing methadone, noting that her office reviews and signs off on 
every take-home order.

She said the methadone that is showing up at overdose deaths may have been 
prescribed by a doctor, and not by the clinic.

But Dube shares the concern about the use of benzos, and plans to have the 
state Office of Substance Abuse investigate.

Steve Cotreau, program director at CAP Quality Care, said the clinic 
commonly uses benzos to stabilize addicts who also have psychiatric 
problems. Frequently, he said, these patients come to the clinic because 
their doctors no longer will prescribe benzos.

"Withdrawing from opiates, you feel like you're going to die," Cotreau 
said. "Withdrawing from benzos, you can die.

"There's not anything we do here that we don't take seriously," he said.

Many methadone patients, like 24-year-old Richard Vallier, believe the 
clinics do their best to screen addicts before allowing them to take home 
medication. But, he said, it is inevitable that some patients will abuse 
the privilege of taking medication home.

"Sure, people sell the stuff. You're dealing with drug addicts," said 
Vallier, who's been on methadone for three years, first at Discovery House 
and now at CAP Quality Care. "But they do not make it easy for you to take 
home doses. You have to jump through hoops."
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