METHADONE MORATORIUM SUGGESTED BANGOR -- The state's top federal prosecutor on Wednesday urged a special panel studying opiate addiction in the region to back a two-year moratorium on a methadone clinic slated for the city. U.S. Attorney Jay McCloskey said that given the likely approval of a less-addictive alternative drug, and what he called the region's "relatively recent" heroin problem, a moratorium was appropriate. "Methadone may still have a place for some people," said McCloskey, adding that those hard-core addicts could still travel to the Winslow clinic. "But based on the newness of the problem and the upcoming availability of buprenorphine, are we going to open a clinic here, with all the problems that come with it, for a dozen people?" Acadia Hospital, a division of Eastern Maine Healthcare, in February applied at the request of the state Office of Substance Abuse, to open the methadone clinic in the city. But while McCloskey, citing state figures, suggested the region's opiate problem is a recent one, figures provided by Acadia suggest just the opposite. According to Acadia officials, patients currently seeking opiate addiction treatment at the hospital have been using for an average of six years, making the more powerful methadone a better alternative for some. In the last six months, 109 patients were admitted for opiate treatment. On Wednesday, state officials praised McCloskey for his work to educate area students and parents on the dangers of drug addiction, but took issue with the idea of a two-year moratorium. "From our perspective, we've already provided a one-year moratorium," said Katie Fullam Harris, deputy commissioner of the Maine Department of Mental Health, Mental Retardation and Substance Abuse Services, referring to the state's decision to postpone the clinic until the committee finishes its report in December. "The problem is only increasing and unless we start providing appropriate treatment for people in the near future, it's only going to get worse." McCloskey's comments come on the heels of the first direct comparison of the three leading treatments for opiate addiction -- methadone, buprenorphine and Orlaam. Previous studies have shown all three medications to be effective in treating heroin addiction. This study looked at them together for the first time. The findings were published in Thursday's New England Journal of Medicine. The two newer drugs could improve treatment of heroin addiction by giving doctors more options, said researcher Rolley E. Johnson of Johns Hopkins University School of Medicine, who led the study. "There are some patients who perhaps have tried methadone and didn't think it was the thing that could help them. They may benefit from [Orlaam] or they may benefit from buprenorphine. Maybe we can get those people back into treatment," said Johnson, who has worked as a consultant for makers of all three medications. Methadone, a synthetic narcotic, has been used for more than 30 years to treat heroin addiction. It suppresses withdrawal symptoms and curbs the craving for heroin. Unlike methadone, which has to be taken daily, the two other drugs are longer acting and can be taken only three times a week. Buprenorphine has yet to gain Food and Drug Administration approval. However, recent federal legislation will allow doctors in office-based practices to prescribe buprenorphine once it is approved. The more tightly controlled methadone and Orlaam are now dispensed through heavily regulated clinics only. To test the three medications, researchers at Johns Hopkins recruited 220 heroin addicts and treated them for 17 weeks in 1996-97. The patients were given one of the three medications -- Orlaam or buprenorphine three times a week, or a high dose of methadone daily. A fourth, control group was treated with a low dose of methadone each day. Researchers tracked the patients' continued use of heroin, and the participants graded the severity of their drug problem. High-dose methadone and the two newer medications were all effective in treating heroin addiction, and all worked significantly better than low-dose methadone. Patients in all four groups reported a 90 percent drop in heroin use when they began treatment. At the Wednesday meeting, McCloskey also said the clinic would likely draw addicts to the area, making it more difficult to drive out the problem if there were no moratorium. At a previous meeting, state officials said the addict population around the South Portland clinic had not changed since its opening five years ago - -- suggesting that addicts do not move closer to a clinic to seek treatment.
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