Pubdate: Sat, 24 Oct 2009 Source: Telegram, The (CN NF) Copyright: 2009 The Telegram Contact: http://www.thetelegram.com/ Details: http://www.mapinc.org/media/303 Author: Alisha Morrissey, The Telegram Bookmark: http://www.mapinc.org/find?136 (Methadone) Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone) Bookmark: http://www.mapinc.org/rehab.htm (Treatment) Bookmark: http://www.mapinc.org/heroin.htm (Heroin) Note: read Part 1 at http://www.mapinc.org/drugnews/v09/n958/a03.html PART 2: THE CONTROVERSY Is methadone good medicine or just another opiate for addicts? Even though he takes methadone every day, J.J. says he's been clean for more than two years. And most treatment programs would agree with that assertion. But even the people who prescribe and distribute methadone know it's not a panacea. Methadone became part of addictions treatment in this province earlier this decade in response to a widespread abuse of OxyContin and other opiates and the crime wave that followed in its wake. J.J. has been a drug addict since he started sniffing gas behind St. Theresa's school in St. John's as a teenager. His parents were "potheads," J.J. says. But even though he didn't want to be like them, it didn't take him long to become smitten with drugs after he tried them - first marijuana, then Valium at age 15, then cocaine. Eventually, in prison in British Columbia, he started smoking opium and shooting heroin. "I tried (heroin) once and that was it. ...," he says. "Some people thinks that junkies are gross ... the worst people on the face of the planet. ... Looking at it now, it's just another way of doing drugs. But I'm sure I thought the same thing - I'm not a junkie sticking needles in (my) arms. I'll never do that." Now, as he looks for work and is trying to wean himself off methadone - - he's down to 39 milligrams a day from more than 100 mg in the first few weeks of treatment - J.J. says he's keeping clean for his son. "I'll tell him the truth," he says when asked what he'll tell the little boy playing with dinkies in the next room. "Drugs ruined my life." But some people question whether a person can really be clean when they're still taking opiates. And some of those people don't want addicts in their backyard. This summer, when a methadone program opened in Windsor, Ont., the community rallied against it. More than 100 neighbours turned out to protest the clinic and pharmacy, even though the police said they'd received next to no extra calls from the neighbourhood since it opened. The controversy surrounding the use of methadone was perhaps best characterized in 1998, when then New York mayor Rudy Giuliani spoke out against the long-term use of the drug. Giuliani accused methadone providers of "enslaving" addicts instead of pushing them toward abstinence, according to a New York Times article on his plan to get 2,000 addicts off heroin. The former mayor was sharply criticized by drug treatment experts, including scientists at the National Institutes of Health and White House drug policy officials. Yet in Europe, a methadone treatment program is often used as an example of the problems that can arise when the drug is provided in a free-for-all-style program. In the U.K., there were plenty of glitches when a methadone program was rolled out in the late '80s and early 1990s, including hundreds of overdoses after addicts were allowed to get dozens of doses of methadone to go from pharmacies. An article in The Independent in July 2000 asked whether methadone was a "Cure or Con." The in-depth report examined the use of the drug in Glasgow - then the heroin capital of the U.K., with more than 8,500 addicts on the streets. "One, (methadone), is legally prescribed by doctors. The other, (heroin), is illegally procured from dealers. What, they're asking in Britain's drugs capital, is the good of that?" the article asked. Critics argued that methadone was simply a "method of social control, introduced to contain HIV infection," by getting needles off the streets. Advocates, however, took one look at Glasgow and pointed out that a "3 million pound methadone programme looks (like) good value when set against the 194 million pounds of goods that Glasgow addicts steal annually to fund their habits." Dr. Laurence Gruer, director of public health science in Scotland and one of the experts who created the Glasgow methadone treatment program, acknowledged years later that the drug and the program was an "easy option." In 2007, he told a conference of justice officials in Scotland that more money should have been put into rehab services to help prevent addicts from going back to drugs after getting clean. At the time, an estimated 20,000 people in Scotland were on methadone. - -------------------- Methadone providers in this province say that they've learned from others' mistakes. Barry Hewitt, who runs the local program, says it's relatively well-funded and staffed as compared to some other programs across the country and even internationally. At the opiod treatment clinic in Pleasantville, there are two drugs counsellors, an addictions nurse, a licenced practical nurse, a pharmacist, security team, and one and a half support staff. There are also two fee-for-service doctors who prescribe methadone. And the centre has one thing that many community-based methadone options don't - counselling. Dr. Jeff White, who prescribes the drug from his Paradise medical practice, says rehab facilities are sorely lacking. He says he's seen patients with short addiction histories looking for help and only finding methadone. "This is not the way that methadone is supposed to be used. ... So it's either all or nothing," White says of patients addicted to morphine or OxyContin for only a few months to a year. But the contradiction of prescribing a drug for long-term use after a short addiction is one White has to live with because of the lack of options for rehab after detoxing. After all, White says some of his patients really clean up their lives and get out of the day-to-day rut of using drugs thanks to their a daily "drink." "To me that sounds better than where (they were) before. It's a tradeoff - harm-reduction is what we call it." - --- MAP posted-by: Jo-D