Pubdate: Sun, 15 Jun 2003
Source: Portland Press Herald (ME)
Copyright: 2003 Blethen Maine Newspapers Inc.
Author: David Hench


A state-sponsored advertising campaign to improve methadone's public image 
is drawing fire from police who object to the state's advocacy of the drug 
and say the ads benefit for-profit clinics.

The state Office of Substance Abuse launched a six-week, $24,000 radio ad 
campaign intended to show the benefits methadone offers to addicts in 
recovery and alleviate the stigma associated with daily methadone 
treatments. The effort comes after the opiate substitute was linked to a 
third of Portland's record 28 overdose deaths last year.

"Stigma is such an important aspect of substance-abuse treatment," said Kim 
Johnson, the agency's director. "It's such a barrier for people getting 
into treatment, a barrier for people resuming their lives after treatment. 
It's an incredibly important issue we have to address in order for people 
to get well."

But some of those who are skeptical of the way methadone treatment has 
worked so far object to the state's publicity campaign, which began airing 
Monday on five Greater Portland radio stations.

"I'm sure there are success stories, but there are horror stories too," 
said Portland Police Chief Michael Chitwood. "Methadone is not a panacea 
for curing opiate addiction."

Methadone is a synthetic painkiller that also can be used to suppress the 
cravings that afflict addicts trying to quit heroin or other opiates.

The medicine gained notoriety last year when it was found to be involved in 
many of the state's 106 drug overdoses in 2002. From 1997 to 2002, the drug 
was blamed in 18 percent of the state's 374 overdoses. The surge in 
methadone-related deaths puzzled treatment professionals because it has not 
historically been thought of as a recreational drug, and yet nonpatients 
were the ones dying from it.

Police and prosecutors attacked the dispensing practices of Greater 
Portland's two clinics. Discovery House in South Portland and CAP Quality 
Care in Westbrook, which combined serve about 1,000 recovering addicts, 
provide many of their patients with up to two weeks worth of daily 
methadone doses that they can take home with them. The state's other two 
clinics, in Winslow and Bangor, also allow take-home doses.

The authorities criticized the availability of take-home doses, which they 
said can wind up in the hands of drug users who are not patients.

Johnson said the outcry over the overdose deaths and the involvement of 
take-home methadone overshadowed the benefits of the program for the many 
people who use methadone responsibly. As a result, a state survey found 
that many in the public were unaware of the therapeutic benefits of 
methadone and believed only that it was a dangerous, and therefore bad, drug.

"Because this particular treatment is relatively new in Maine, because 
there have been some prominent people that have vocally opposed it, that's 
increased the stigma," Johnson said. "The public has gotten a misperception."

Ongoing daily methadone treatment is most effective at keeping addicts off 
illegal drugs, she said. Without take-home doses it would be impossible for 
many patients, some of whom drive long distances to obtain a bimonthly 
supply, to hold down jobs and function normally, she said.

The public education campaign about methadone is part of three-pronged 
effort launched last year with the support of the National Center for 
Substance Abuse Treatment. The effort included information targeting drug 
users and patients about the dangers of taking methadone if it is not 
prescribed and the legal consequences of giving methadone to someone else. 
The state also has educated health care providers about how to help prevent 
misuse of methadone.

The development of the radio spots and other educational material was 
funded by the federal substance abuse agency. But the Office of Substance 
Abuse paid $24,000 from its budget for radio air time.

The radio campaign is based on the stories of Shawn Davis and Suzanne 
Gandolfi, both recovering addicts in southern Maine who say they would be 
dead had they not started methadone treatment.

In one radio spot, Gandolfi, a self-described soccer mom, tells how she 
lost custody of her son because of illegal drugs but how methadone enabled 
her to break free from addiction and reclaim her son and her self-esteem.

In the other ad, Davis explains how he was given painkillers after a 
serious car accident nine years ago, then discovered he was addicted. He 
turned to street drugs and doctor-shopping to keep up with his habit, and 
eventually did jail time for forging prescriptions. He says that if he had 
not enrolled in methadone treatment, he believes he would be dead.

Cumberland County Sheriff Mark Dion said he was startled when he heard the 
ads to find that they were sponsored by the state Office of Substance Abuse.

"I was expecting the closing to be an advertisement for a for-profit 
methadone clinic," Dion said. "It sounded like they were selling a service. 
This sounded like an ad selling methadone. I wasn't aware they had taken a 
position on the plan of care associated with methadone."

Methadone maintenance programs have been criticized because they do not 
cure an addict of cravings for opiates, but eliminate the cravings while 
methadone therapy is in place. Some critics say that methadone clinics 
simply replace one drug with another.

Dennis Bailey, a spokesman for the Westbrook clinic CAP Quality Care, said 
any drug can be abused, but experience shows methadone treatment works to 
keep people off dangerous drugs.

"I realize people think of all the downsides," he said. "The real downside 
is letting people continue on heroin. What happens when they run out of 
money and they're addicted and get into crime and the cost to society of 
that versus a methadone maintenance program that allows them to hold a job 
and keep their family together?"

Chitwood said he believes the state's advertising money would be better 
spent creating its own clinics that ensure a comprehensive treatment 
approach that includes counseling, physical exams and strict drug testing 
to be sure patients are not using again. The goal should be to wean addicts 
off all substances, not to replace one with another, he said.

Johnson says the clinics are required to engage in such a comprehensive 
approach. She said research into addiction has shown that methadone 
maintenance is more effective at keeping people off illegal drugs than 
simply using methadone for detoxification.

Johnson says she is sensitive to the charge that the state is advertising 
for the methadone clinics, three of which are for-profit companies. But she 
noted that each has a waiting list and no shortage of new clients, an 
indication of the severity of the drug problem. She also said the radio 
spots reflect the experiences of real people, and show the real benefits to 
society of methadone as a treatment.

"The effort is to reduce stigma, to show that there are quite a number of 
people living in the community that have used this method of treatment to 
get well," she said.

The rate of overdose deaths in Portland and around the state has slowed, 
officials say. It is unclear whether that is because last year was an 
anomaly, education campaigns are working, or media coverage of overdose 
deaths and prosecutions has changed behavior. Police say the Greater 
Portland clinics have become more strict in dispensing take-home doses of 

Portland has had eight unattended deaths so far this year where the cause 
of death remains uncertain pending blood tests, which often indicates a 
drug death. In two of those cases, methadone was present at the scene, 
Portland police said.

At this time last year, Portland had experienced 17 suspected overdose 
deaths. The city had 16 drug deaths in all of 2001.

Jerry Cayer, director of Portland's Department of Health and Human 
Services, said it is important that the public realize addiction is a 
disease and that methadone is one treatment that can help. The city's Fatal 
Opiate Overdose Prevention Advisory Group - assembled in response to last 
year's surge in drug deaths - was consulted in the development of the ads, 
he said.

"There is a place for methadone in the toolbox," he said. "The real issue 
is making sure it's managed and used appropriately."
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