WSU TEST PAYS HEROIN ADDICTS

As Fentanyl-Related Deaths Spike, School Tries Similar Painkiller On Users

Drugs laced with fentanyl are suspected in 50 overdose deaths in
Wayne County over the past two weeks, but beginning today, Wayne
State University will pay heroin users to take the powerful painkiller.

Under contract with a pharmaceutical company the university refuses
to identify, researchers will pay about eight heroin users $25-$40
per day for three-week trials to test a version of fentanyl that's
supposed to ease pain but has been modified to produce side effects
if used illicitly.

The study has been planned for months, but comes amid a crisis
involving the opiate used by cancer patients. Described as 50 times
stronger than morphine, illegally made fentanyl -- mixed with heroin
or cocaine -- is blamed on 130 overdoses in Wayne County since
January 2005. The county received no reports of drug-related deaths Thursday.

"We're not just giving people a joyride," said Dr. Mark K. Greenwald,
a professor of psychiatry and behavioral neurosciences who is leading
the study.

"I feel very confident this study will be conducted safely and
volunteers will receive the highest possible standard of care."

Testing drugs on addicts is rare in Michigan, but not nationally.
Since the 1920s, numerous research universities including Harvard and
Columbia have done so, and studies are governed by tight federal
rules, said Dr. Charles Schuster, director of Wayne State's Substance
Abuse Division.

"We have to test users," said Schuster, the former director of the
National Institute on Drug Abuse.

"Unfortunately, we've had a variety of medications that look very
good in lab rats and even monkeys, but put them in humans, and it
doesn't work. We're different."

In the past decade, Wayne State has become a Midwestern leader in
drug research, conducting at least 30 studies in the past five years.
Many involved testing users of illegal drugs.

Still, the study's timing has some concerned. Betsy Rheaume, who
spent much of her morning Thursday taking her 23-year-old recovering
heroin addict son to Narcotics Anonymous, called the research "a
horrible idea."

"These are people who aren't thinking very clearly, and it seems like
they're being taken advantage of," said Rheaume of Deckerville. "If
they make a fentanyl that addicts can't use, they'll just go to
something else for their high. It seems like a waste of time."

Greenwald said the study's goal is to take fentanyl out of the hands
of abusers, not put it in them. Volunteers are carefully screened and
must indicate they have no interest in quitting heroin, Schuster
said. They are kept at the university's Jefferson Avenue Research
Clinic in Detroit while on fentanyl, then weaned off with methadone
by the study's end. The study participants will not be allowed to use
other drugs during the research period.

When the study is over, they emerge clean and are encouraged to enter
treatment, Schuster said.

The studies measure vital statistics such as heart and respiration
rates, body temperature and mood to gauge the effect of the drug,
Schuster said.

"Even though this comes at a tragic time, this is the kind of (test)
that is needed so the lawful use of medicine is honored and we do
everything in our power to decrease the misuse of this drug," Greenwald said.

Wayne State's studies are well-regarded among recovery experts of
Metro Detroit, said Shirlie Arrington, a supervisor at the New Light
Recovery Center, a Detroit methadone clinic.

"This is how we learn about these drugs," she said.

The tests come amid increased research in the past 10 years about how
best to manage pain without creating dependencies, said Dr. Judith
Martin, of Oakland, Calif., who serves on the American Society of
Addiction Medicine.

Already tolerant to drugs, addicts in tests can show whether they
have the potential for abuse, she said.

"There have always been ethical debates, but the decision has come
down: If individuals provide informed consent and know the risks and
benefits of these studies to society, then this is permissible," Schuster said.

Detroit News Staff Writer Brad Heath contributed to this report.