Pubdate: Monday, July 5, 1999
Source: London Free Press (Canada)
Copyright: 1999 The London Free Press a division of Sun Media Corporation.
Author: Brodie Fenlon

A highly controlled treatment program using methadone has given at least one
London heroin addict a fighting chance against his demons


In 1982, after a decade of experimenting with drugs, Charlie went to Nepal
to "stare the dragon in the face."

The dragon was heroin, the illegal "opioide" (opium-derived drug) he had
tried many times when living in London and Vancouver. It's a narcotic easily
purchased in Katmandu.

He had not become addicted to the drug, but this time, he knew it would be
different. This time, Charlie was ready to abandon himself to the euphoric
rush of "horse."

"It was experimental, but I was headed for it -- I knew I was going to
become physically dependent on heroin."

After a two-month binge, he hopped a bus out of Katmandu and spent 16 days
in self-imposed exile. He wandered the Himalayas by foot, walking his way
out of the pain of withdrawal.

The first time Charlie tried heroin was in London in the early 1970s, when a
friend introduced him to it.

"I always remember how good it felt. It wasn't just the euphoria and the
sense of well-being, but I felt very confident. And I had always been a shy
guy . . ."

Charlie spent 21/2 years in Nepal and India. Soon after returning to
Vancouver in 1985, he was married. In 1987, he and his wife moved to London,
where he found a full-time job.

Although things were going well, the dragon soon reared its head again.
Three years of heavy addiction to heroin, Percodan and morphine followed and
he made several unsuccessful attempts at detoxification.

"You hear statistics about how young men think about sex every 3.1 seconds?
Well, an addict thinks about getting heroin every 1.1 seconds," he says
about the cravings that haunted him. "It's there every waking moment. . . .
I just couldn't do it."

In 1993, Charlie decided to "get away from it all" by taking his wife to
India. Of course, he was setting himself up for another drug binge.

Within three days of their arrival, he had scored five grams of pure, white
heroin. Although he functioned well enough to visit all the tourist
attractions with his wife, he spent the next six weeks "strung out."

His wife, who didn't use heroin, stayed by his side.

"She didn't like the idea at all," he says, "but she knew there wasn't much
she could do about it."

Today Charlie sits in the living room of their modest home. What's left of
those drug-weary weeks in India hangs as a few photographs on a nearby wall.

A Loreena McKennitt CD plays softly in the background, while a large pet
fish moves sluggishly in its aquarium. Charlie pours himself a cup of tea
and lights a cigarette.

After years of battling addiction to heroin and morphine, the 44-year-old
has at last found peace. He is still happily married, holds a full-time job,
tends a back-yard garden and works "constantly" on his Harley-Davidson.

Ironically, the repose in his life is due to the effects of another
addictive drug he takes every day: methadone.

But unlike heroin and morphine, methadone doesn't make Charlie high.
Instead, it eliminates his cravings and blocks his brain's receptors to the
narcotic effects of heroin and other opioides.  Most importantly, it allows
Charlie to function as a normal human being.

"It was like a miracle. The first dose of methadone and I was so normal. It

wasn't that I felt great and I didn't feel high; I just felt normal. My
confidence was back and I stopped thinking about drugs."

There are three private methadone clinics in London and four local doctors
who prescribe the drug as an addiction treatment.  About 150 patients in the
city are on methadone.

Because the drug is a narcotic, there are strict controls placed on its use:

* First-time patients must visit a clinic twice a week and provide a
witnessed urine sample to be tested for illicit drugs.

* Patients must visit one of three London drugstores daily to fill their

* The methadone, which comes mixed in orange juice, must be consumed in
front of the pharmacist.

* Patients who miss clinic appointments are not given a prescription.

* If patients continue to use other drugs, they are weaned off methadone or
referred to a "low-threshold" clinic, where restrictions are tighter and
expectations lower. (A low-threshold clinic is run out of the AIDS Committee
of London office on Richmond Street.)

The rules are relaxed, however, for those who have had clean urine samples
for more than a year.

As one of these successful patients, Charlie must visit his clinic only once
a week and is given a week's worth of methadone --called "carries" -- at
each drugstore visit. He now takes his morning dose at home.

But despite the drug's effectiveness at stabilizing addicts, it's not a
cure-all for heroin addiction. As many as 95 per cent of short-term patients
relapse within months of being weaned off methadone, says Dr. Martyn Judson,
who opened London's first methadone clinic in 1991.

Charlie, for instance, returned to his morphine habit after he left the
methadone program in 1996. A few months later he was back at the clinic and
has been clean ever since.

Methadone is also pricey: The cost of the OHIP-covered drug, about $5 per
patient per day, may be a tough pill for some taxpayers to swallow.

But Judson says the societal costs incurred by leaving heroin addicts
untreated far outweigh the price of the methadone program.

"If methadone is available to patients, then they don't have to feed their
disease of addiction by buying (these drugs) on the street . . . If they
don't have to buy all these drugs, they don't have to engage in crime to
support that behaviour."

According to the Addiction Research Foundation, the first organization to
open a methadone clinic in Ontario, the costs of illegal heroin -- about
$125 a day for each user -- are largely financed through criminal activity.

This summer, Judson and the foundation will begin to examine whether
personal profiles can be used to better design treatment options for patients.

Part of the study, expected to be completed in a year, will determine
whether a correlation exists between methadone use and a decline in
burglaries and petty crimes.

Like many addicts, Charlie turned to crime to finance his habit. Included in
his criminal record are a number of drugstore robberies.

Although those days are now a distant memory, Charlie says he is wary of the
stigma associated with methadone use. He spoke to The Free Press on the
condition he not be identified.

"When you say you're a methadone patient, you're an admitted drug addict,
right off the bat. The sad thing is, a stable methadone patient is less
likely to do drugs than just about anybody."

Charlie doesn't know when he'll stop using methadone: He says he's too busy
to think about it.

In his spare time, he publishes a methadone newsletter and distributes it at
his clinic. He has also been lobbying the College of Physicians and Surgeons
of Ontario, which regulates the use of methadone, to give stable patients a
month's worth of carries, instead of the current weekly limit.

But most of the time, he just relishes the chance to live the type of life
most people take for granted.

"It's just so good to be normal ... methadone is allowing me to live up to
my potential."


* Methadone was developed in Germany at the end of the Second World War as a
substitute for morphine.

* By the 1960s, the drug was being administered as an oral opioide
substitute to addicts of heroin and other morphine-like drugs.

* When used properly, methadone eliminates cravings and withdrawal, blocks
the brain's receptors to the effects of heroin and other opiates and allows
an individual to function normally, without impairment.

* A single dose lasts 24 hours, without causing euphoria or sedation.

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