Pubdate: Wed, 11 Aug 1999
Source: Associated Press
Copyright: 1999 Associated Press
Author: Scott Andrews, Associated Press Writer

OFFICIALS CONSIDER VAST EXPANSION OF METHADONE

SAN FRANCISCO - When former thief and drug pusher Walter Lamarr
Williams wanted to kick his 14-year heroin habit, he turned to the
most successful treatment method: methadone.

Williams made it through detox, but when he got out, there was no room
for another patient in this heroin-plagued city's busy methadone clinics.

"The time I was waiting, I was using," he said glumly on Wednesday,
remembering the drug use that possibly gave him gave him HIV and
Hepatitis C.

It was another two months before Williams got back into detox, and
another three months before he finally got into a methadone clinic.
Other addicts are less diligent. Faced with delays, some abandon
treatment permanently.

The shortage of methadone treatment in San Francisco -- 2,000 clinic
slots for 13,000 to 15,000 addicts -- has led city officials to look
at expanding the drug's availability. The Board of Supervisors is
considering whether to seek state and federal permission to allow
doctors in private offices to prescribe the drug.

If the effort is successful, San Francisco would be the first city in
the nation to use private doctors for methadone treatment on a
widespread basis. Canada, Denmark and other nations already allow it,
and limited trials are underway in New York City, Baltimore and
Connecticut.

Some people are deeply ambivalent about methadone, which is addictive
but gets users high only for the first month or so of use.

New York Mayor Rudolph Giuliani last year made a high-profile effort
to get methadone users to quit. He backed down after only 16 of the
city's 2,100 clinic patients successfully stopped using methadone.

No serious opposition has arisen in San Francisco, which has a serious
heroin problem. The city ranks third in the nation in heroin-related
emergency-room admissions despite being only the 14th most populated
city in the nation.

Dolores Lucas, a 39-year-old methadone user, said she supports
expanding the drug's availability.

She became addicted to heroin when she was a 17-year-old runaway,
hitchhiking across country. She has a face scarred by years of
addiction, disease and life on the streets, and says she is infected
with hepatitis C and HIV. To support her habit, she sold drugs and her
body.

"I shot anything I could get my hands on," she remembers, her bottle
of cherry-flavored methadone tucked into her pocket.

Since she went on methadone about six years ago, she has been clean
and allowed to see her 11-year-old son, she said Wednesday.

A fellow patient, 43-year-old John Bogacki says he would appreciate
going to a pharmacy rather than a clinic.

"It would be more convenient, more like any other medication. You
wouldn't always feel like big brother was looking over your shoulder,"
he said.

Last September, the move to make methadone available through
pharmacies gained the support of Gen. Barry McCaffrey, the White House
national drug policy director.

"There are far too few clinics throughout the country," said Dr.
Steven Batki, who led San Francisco General Hospital's
addiction-treatment programs for 16 years. "Less than 180,000 out of a
million heroin addicts are in methadone treatment."

Methadone is illegal in New Hampshire and not available in seven other
states, according to the Lindesmith Center, a New York-based drug
policy research institute.

Estimates for the number of addicts in the United States vary, from
810,000 to 1 million. Estimates for the number of methadone users
range from 115,000 to 180,000.
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