Pubdate: Thursday, 01 Oct 1998
Source: Hartford Courant (CT) 
Author: Tom Condon, Courant Columnist


Mary, I'll call her, is in her mid-20s, but looks older. She was
attractive, tall with auburn hair, but years of heroin use took the bloom
off the rose. She's trying to come back.

Mary, her girlfriend and I were sitting in a car in front of Community
Substance Abuse Centers' methadone clinic in the North Meadows last week,
talking about methadone.

"Does it work?" I asked.

"Yes," Mary said quickly. "It takes away the craving for heroin."

Her experience affirms scores of studies. Methadone lets 125,000 Americans
lead stable lives. But an estimated 810,000 persons are addicted to
opiates, and many can't get methadone.

If it works, then it ought to be available to the people who need it.
Thankfully, the country's top drug official agrees.

Gen. Barry R. McCaffrey told the national conference of the American
Methadone Treatment Association in New York this week that methadone is a
"well-researched and efficacious therapy" for opiate addiction.

He outlined a new policy that will make methadone treatment available on
demand. He recommends that doctors be allowed to administer methadone to
patients in their offices.

As it happens, New York Mayor Rudolph W. Giuliani has criticized methadone
treatment programs, saying they substitute one addiction for another.
Apparently no one has tried to break into Gracie Mansion lately.

Methadone doesn't create a new addiction -- it stabilizes an existing one.
It does this by occupying the brain receptor sites affected by heroin. The
most recent study by the National Institute on Drug Abuse found that among
participants in outpatient methadone treatment, weekly heroin use declined
by 69 percent, cocaine use went down 48 percent -- many users are cross-
addicted -- illegal activity dropped 52 percent and work increased 24 percent.

At a cost of about $13 a day, this is vastly less expensive than jail. 

Of course, using physicians to distribute methadone will have to be done
carefully, with proper monitoring and training. There are a few daffy docs
who hand out prescription drugs such as Percocet like lollipops. They could
make the problem worse. On the other hand, the many responsible physicians
could make a positive difference, particularly with people who need the
treatment but won't go to a clinic, for whatever reason.

Connecticut may be the first state to discover if this works. The state
will soon start a pilot program, in which 30 stabilized and employed
addicts will be referred to six physicians in Waterbury. The doctors will
be connected to and monitored by Connecticut Counseling Centers' clinic.

The program is expected to begin before the end of the year, and will be
evaluated by Yale University officials, said Richard Bilangi, director of
the center.

Dr Thomas Kirk, deputy commissioner of the state Department of Mental
Health and Addiction Services, said the experimental program is part of a
broader effort to increase access to a variety of psychological and medical
treatment programs.

There's an idea. For decades, we've been spending about two-thirds of
anti-drug money on Coast Guard boats, giant barrage balloons, police
overtime, etc., and there are more drugs around than ever.

When a retired four-star general sees the value of treatment, maybe we're
finally smartening up.

Copyright 1998 The Hartford Courant Company
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Checked-by: Richard Lake