TREATING ADDICTS

KANKAKEE -- Billy Moore signed in at a Kankakee treatment clinic
Thursday morning and waited his turn to drink a cup of fruit drink
with a methadone tablet dissolved in it.

Moore drove from Champaign to Kankakee after getting off his night
shift maintenance job at 6 a.m. He makes the trip three times a week
to get the methadone that is part of the treatment for his 30-year
heroin addiction. Methadone is a drug used to treat addiction to
heroin and other opiates.

Moore and many other patients would like a methadone clinic in
Champaign-Urbana. Kendric Speagle, executive director of Harm
Reduction Resource, a nonprofit organization that provides HIV
education and prevention services, wants to open such a clinic in
downtown Champaign. He said he is in the process of applying for
approval from state and federal agencies.

But several downtown merchants are concerned the clinic will hurt
their businesses and increase crime in the area. Speagle's plans
originally included the possibility of operating a syringe exchange
at the clinic location as well. Business owners in Champaign have
been particularly concerned about that prospect, fearing that it will
attract addicts to the area and put those trying to overcome their
addictions at risk.

Speagle already operates a needle exchange as a separate program on a
call-in basis. He said he has reconsidered exchanging needles at the
clinic site and will not do so.

Moore has not used heroin in almost four years. Although he stopped
using before he began treatment at the methadone clinic, he said the
program there changed his life.

"There just comes a point in your life where you just get tired and
you want to try to do something else in your life," Moore said.
"Methadone gives you the opportunity to do things you want to do - to
go to work, take care of responsibilities at the house. Once you
start getting yourself together ... whatever the reasons might be for
making that move, you start thinking. The real things come back to
you - what you want to do in your life, enjoying yourself, enjoying
your kids."

At least a dozen others from the Champaign-Urbana area also travel to
the Duane Dean Behavioral Health Center in Kankakee for methadone
treatment, and another 10 or so go to a clinic in Decatur. Moore says
there are many people in Champaign-Urbana who would like to use
methadone to treat their addictions, but they don't have the
transportation to travel to the clinics.

Charman Crayton didn't have a way to get to Kankakee every day when
she started methadone treatment a year and a half ago, so she moved
there from Champaign. She left her three children, ages 6, 4, and 20
months, in the care of family in Rantoul.

Kankakee business owners had some of the same concerns as do
Champaign merchants when the clinic there opened in 1972, at the
intersection of a busy commercial street and a quieter residential
area.

"In the beginning, people had these weird thoughts of these
drug-crazed individuals shooting up with heroin and doing all sorts
of bad things, and no one would be safe," said Herb DeLaney,
president and chief executive officer of Duane Dean Behavioral Health
Center. "Many people believe (methadone treatment) is just a drug
replacing a drug, and people are going to break into houses, going to
disrupt businesses and drive the customers away.

"It was a hard sell," he continued. "No one really wanted to admit
that a community this far away from cities like Chicago and Gary
could have a heroin problem." DeLaney said the clinic did attract
some drug dealers when it opened.

"The fact of the matter is that drug pushers tend to go where they
feel there is a readily available market, and that could be schools,
it could be anyplace where they feel they have some likely
prospects," DeLaney said.

Drug dealers are no longer much of a problem, DeLaney said, because
clients and staff members keep a close lookout for them and warn them
to leave or call police.

Larry Regnier, deputy chief of the Kankakee Police Department, said
he has not seen problems with increased crime around the clinic.

"It's a very well-run facility," he said. "They exist there.
Everybody knows what goes on there. However, to my knowledge, there
has never been a problem there. There have been no complaints about
it. It is kind of like business as usual."

Richard Weisskopf of the state's Office of Alcoholism and Substance
Abuse, who oversees the state's methadone treatment facilities, said
most operate without incident.

"There have been really less than a handful of problems," Weisskopf
said. "I'm not going to tell you we've never had a robbery. I think
the last incident was eight years ago in Chicago. There was a program
that lost some medication to an armed robber.

"But the incidents have been very few. A lot of them have been in
business a very long time. They pay attention to the things they need
to pay attention to. It's not just security. We're talking about
client care as well."

Weisskopf said he believes treatment facilities have reduced crime in
the areas in which they are located.

"People are getting treatment, so they are not out looking to get
their fix," he said. "They're not out looking to grab somebody's
purse and not out looking to break into someone's basement."

David King, administrator of the Champaign-Urbana Public Health
District, said he supports efforts to provide treatment to drug
addicts.

"This is an issue of facing up to the problems people have and trying
to serve them in this community, rather than sending them to other
counties to get methadone," King said. "I hope that as a community we
would be supportive of that kind of treatment. It's much better to
have someone in treatment than have them using addictive drugs.

"We definitely have new cases of HIV, new cases of hepatitis B and C
in our community," King continued. "There are new cases of women and
children being infected. Most new cases of HIV across the state and
across the country among women and kids are caused by transmission
from dirty needles. It is not uncommon for HIV to be passed from a
drug user to a woman, and then from a woman to an unborn child.
That's how most of the cases occur, and it's large numbers, and
that's what we're trying to prevent."

Julie Pryde, director of social services for the health district, is
also the project director for the Illinois HIV Region 6, in which she
oversees HIV prevention, counseling and testing through the Illinois
Department of Public Health in a 14-county area.

Pryde said 70 percent of AIDS cases among women and 95 percent of
pediatric cases in Illinois are linked to intravenous drug use. In
Champaign County, of the 250 known cases, 33 people reported they
were intravenous drug users.

"These are just the people themselves who shot drugs. It's really
difficult to figure out the women who are infected because of the
injectors," she said.

The Kankakee clinic now has a good working relationship with the
business community, and several prominent businessmen and
professionals help with fund raising for the facility. A labor union
and some women's organizations have pledged their help in the
clinic's efforts to turn a nearby labor hall into a women's center.

"Some of our biggest supporters are our downtown business people,"
DeLaney said.

The clinic includes offices, rooms for group therapy sessions, a
nurses' station where the methadone is dispensed, a record storage
area and a waiting room. A second location provides space for group
counseling for women and child care.

In addition to methadone treatment, the clinic provides treatment for
alcohol and other substance abuse problems.

Those interested in methadone treatment must go through an assessment
at the clinic that provides a detailed medical, psychological and
criminal history, as well as information about his or her drug use.
Someone other than the person with the addiction must sign an
affidavit attesting to the potential client's drug use.

He or she must also submit to a drug test and a medical exam, then
meet with the clinic's medical director, who determines the proper
dose of methadone based on the severity of the addiction.

The 93 clients who are part of the methadone treatment program must
initially come to the clinic six days a week to receive the drug, and
they can take home a dose for Sunday. After at least 90 days and
three clean urine samples, some clients can reduce their visits to
three times a week, and with more progress, two times a week.

Methadone does not create a high in its user. Rather, it suppresses
the cravings an addict has for heroin. DeLaney compared the effect of
the drug on its user to that of the first cigarette of the day for a
smoker.

"It's not a situation where community members would see people
wobbling out of the building or staggering," he said. "A significant
number of individuals that are in opiate maintenance treatment
programs are employed, and many of them work in jobs that handle
machinery or equipment. Many are construction workers.

"(Those from Champaign) drive up early enough to get medicated and be
back in time to get to work on time. If they are driving, certainly
they cannot be driving under the influence and do that on a daily
basis."

DeLaney said those in methadone treatment are from all demographic
groups. The patients are almost evenly split between blacks and
whites, and they range from people who qualify for Medicaid to at
least one patient with a six-figure income. About 70 percent are
employed.

DeLaney believes the number of heroin addicts is increasing. The
clinic had between 30 and 36 clients in 1996. With its recent
outreach efforts, he expects the current caseload of 93 to double in
the next few years.

Everyone in the program has a treatment plan that includes education
about the stages of addiction, what might trigger a relapse and how
to manage those triggers. They must participate in group counseling
twice a week and individual counseling at least once a month, and
they must submit to random drug tests.

The clinic also offers family and couples counseling, outreach to
addicts to encourage them to seek treatment, and community education.

After receiving his medication, Moore spent more than two hours in a
group counseling session Thursday morning. Half of the 10 patients in
the session were from Champaign County. Almost all of the men have
jobs and families.

The group had a heated discussion of the pros and cons of needle
exchanges, then talked about their lives. One member was getting
ready to stop taking methadone. Another had just moved out of his
home and gone through a painful divorce. In spite of the stress in
his life, he did not turn to heroin, which brought applause from the
rest of the group.

The men are close-knit, and although they argue, they also refer to
each other as family.

Moore said the methadone is just part of his treatment. It stops the
physical cravings for heroin, but the real work is dealing with what
led to drug use in the first place and finding the strength to resist
it. The men say that strength comes from each other, and for Moore,
from his faith in God.

He has had a full-time job for several years. He is active in church
activities, including coaching basketball and softball, and he spends
more time with his wife Christine and his four stepchildren. He said
others need the same help he has received.

"I know plenty of people in this town that are using. I see them
every day. All they talk about is they are tired, and they want
help," Moore said. "We don't like to be running from the police or
waking up and having to get money before you brush your teeth or go
see your mother.

"It dawns on you what you did with your life ... and then you go
looking for help, and there is none. Then you are beat in a corner."

State, Federal Agencies Regulate Methadone Clinics

CHAMPAIGN - Before an organization can open a methadone clinic to
treat drug addicts, it must gain approval from three state and
federal agencies.

An organization must get approval from the Illinois Department of
Human Services' Office of Alcohol and Substance Abuse, as well as
from the U.S. Food and Drug Administration and Drug Enforcement
Administration.

Richard Weisskopf, who oversees Illinois methadone treatment
facilities for the state's Office of Alcoholism and Substance Abuse,
said the application to the state must include the proposed location
for the facility and identify the medical director and program
sponsor, as well as how the facility will provide treatment and its
hours of operation. Counselors and nurses must be certified.

Weisskopf said private programs that charge for their services do not
have to demonstrate a need for a treatment facility in the area as
part of the approval process, but those funded by the state do have
to show a need.

Weisskopf said the FDA oversees clinical issues involving medical
treatment, while the DEA ensures the facility complies with security
and record-keeping requirements.

After the application is reviewed, the building where the clinic will
be housed is inspected for safety, and physical and electronic
security is tested by the state and the DEA.

"They are very concerned and very watchful about anything involved
with a Schedule II narcotic," Weisskopf said. "It has to be in a
secure situation, and they want doctors involved in treatment who
know what they're doing. There is a lot of accountability."

Illinois statutes list controlled substances in schedules according
to several factors, including the potential for abuse, medical use,
scientific knowledge regarding the substance, risk to public health
and potential to produce psychological or physiological dependence.
Schedule II substances have a high potential for abuse, a currently
accepted medical use in treatment, and abuse may lead to severe
psychological or physiological dependence.

Weisskopf said the agencies periodically visit the facilities to
ensure they are still complying with the regulations.

"We like to make sure everybody is getting the appropriate standard
of treatment," Weisskopf said. "When we go out, we're looking to make
sure if a doctor orders a decrease or increase in medication, that
takes place, and they don't wait a week. If dosages change, that is
because of an order by a physician. We make sure counseling is taking
place. With counselors and nurses, we make sure they maintain their
certification. We're looking in client records to make sure
everything is in place."

The federal government is changing its regulations for such clinics,
requiring them to gain accreditation from a private accrediting body
and doing away with FDA oversight. Some clinics have already
completed the accreditation process through a pilot program to see
how it will work. Weisskopf said a dozen or so Illinois clinics that
participated in the pilot program, including the Duane Dean
Behavioral Health Center in Kankakee, all received accreditation.