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.